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THE LAW GOVERNING medical staff peer review at California hospitals has changed dramatically over the last thirty years. The days when a hospital could make arbitrary credentialing decisions without affording physicians any recourse are long gone. Primarily as a result of appellate court decisions and legislation, there has been a steady movement toward the formalization of peer review. This article examines the development of peer review law at California hospitals.' It also identifies a number of shortcomings in the current system and suggests solutions to these problems.