Why Peer-to-Peer Documentation Reviews in Physical Therapy Organizations are Likely Not Worth the Effort

In every physical therapy clinic, time is one of the most valuable resources. Organizations that prioritize patient care, operational efficiency, and compliance with industry standards have more than enough challenges in 2025—but one piece of the compliance puzzle that often raises questions about its effectiveness is peer-to-peer documentation reviews. The Office of Inspector General (OIG) identifies 1 of the 7 elements of a meaningful compliance program to include “internal audit and quality assurance”.

While the idea of having licensed clinicians review each other’s documentation may seem beneficial in theory, in practice, it often proves to be more trouble than it’s worth. Here are some reasons why:

It’s a Time-Consuming Process

Physical therapists already juggle packed schedules filled with evaluations, treatment sessions, progress notes, and other administrative burdens. Adding peer documentation reviews to the workload takes time away from recharging lunch breaks. When clinicians are spending extra hours reviewing each other’s notes, that’s time they could be using to learn and discuss patient management or professional development strategies.

Peer-to-peer reviews can be a waste of time.

Burnout Risk

The trend of burnout within the physical therapy profession is higher now than ever before. Why add fuel to the fire when we could be offering strategies and solutions to enhance the experience of working within the clinic. We could offer new evidenced-based treatment technology, dictation or scribing services for documentation, remote therapeutic monitoring (RTM) support for patient engagement, and plan of care management.     

Minimal Return on Investment

The goal of peer documentation reviews should be to improve compliance and note quality, but the actual benefits often don’t justify the effort. If a clinic is already conducting internal audits or has an experienced compliance officer reviewing documentation, peer-to-peer reviews become redundant. Instead of providing valuable insight, they may lead to subjective feedback that doesn’t necessarily align with regulatory requirements.

Can Lead to Bias and Inconsistencies

Not all therapists document in the same style, and what one therapist considers detailed and thorough, another might view as excessive or insufficient. This can lead to subjective critique rather than substantive improvements. Additionally, colleagues may be hesitant to provide critical feedback, either to avoid conflict or because they don’t feel confident in assessing someone else’s documentation. Oversight of this process also takes time and energy to ensure a high level of consistency—scarce resources that therapists may not be motivated to commit.

Better Alternatives Exist to Peer-to-Peer Reviews

Instead of spending time on peer-to-peer reviews, clinics can implement more effective strategies such as:

AI documentation audits: 

AI platforms have already been proven to be effective with significant levels of transparency without reviewer bias.

Role-based training sessions: 

Keep staff up-to-date with documentation best practices, including student training.

Mentorship programs: 

Senior clinicians guide newer therapists in proper documentation techniques.

External manual compliance audits: 

Ensure accuracy and regulatory adherence by certified healthcare auditors without the risk of internal bias.

Final Thoughts

While peer-to-peer documentation reviews might seem like a good way to ensure quality and compliance (because that’s what we have been told forever), they often lead to inefficiencies, workflow disruptions, and minimal improvement in documentation standards. Clinics would be better served by focusing on streamlined, tech-driven solutions and meaningful compliance training to enhance documentation quality without sacrificing valuable clinical time.

By prioritizing patient care and using smarter documentation strategies, physical therapy organizations can ensure both compliance and efficiency—without the added burden of peer-to-peer reviews.

Daniel Hirsch PT, DPT, CHA, OHCC, COCA is a licensed physical therapist with over 15 years of risk management and compliance experience. He is CEO of Risk & Compliance Analytics LLC, a comprehensive compliance solution for outpatient therapy practices. He has experience in both Property & Casualty and Life & Health Insurance, has served as the Chief Compliance Officer for large multi-state Physical Therapy practices, is an educator on Therapy Ethics and the Profession, and has numerous compliance and ethics certifications.

You can find Daniel on Linkedin: https://www.linkedin.com/in/daniel-hirsch-dpt/ 

Follow his company page on LinkedIn: https://www.linkedin.com/company/risk-compliance-analytics-llc/