Tuesday, March 29, 2016

From Malpractice To Doctoring Under The Influence, You’ll Have A Difficult Time Finding Your Physician’s Disciplinary History

Thousands of doctors are investigated and disciplined for egregious errors and ethics violations by their state medical boards each year. While the chances are that your doctor isn’t one of them, you’d have a difficult time actually finding that out. 

A new, in-depth report from our colleagues at Consumer Reports explores the difficulty of obtaining information about doctors that have been disciplined by their state medical boards for things like sexual misconduct, overprescribing controlled substances, their own addiction issues, and various other documented examples of unprofessional or dangerous doctoring.

As part of the investigation, CR filed public records requests with the California medical board to obtain a list of doctors on probation as of late September 2015. While that information is now available on CR’s Safe Patient Project website, the details related to some of those investigations are eye-opening.

In all, about 500 doctors in California are on probation, with offenses ranging from dangerous doctoring or unprofessional behavior, with offenses ranging from practicing medicine under the influence of illegal drugs to sexual misconduct with patients.

There was the family practice physician and her cardiologist husband who ordered more than four million doses of hydrocodone in 15 months, but could only account for a small fraction of the drugs. Or the urologist arrested for a DUI while on-call.

Several cases also involve doctors who have been charged with negligence leading to bungled surgeries and even the wrongful deaths of patients.

One OB/GYN removed the wrong ovary. The issue was only discovered when the patient, still in pain, returned to the hospital. Additionally, there was an orthopedic surgeon was so inattentive to his patient that the man’s fractured thigh-bone resulted in a leg amputation.

These are just a few of the cases that CR highlights in its report. While they may differ in severity, each of the violations and disturbing actions have something in common: most patients don’t know about them.

That’s because, according to Consumer Reports, only hospitals, doctors, law enforcement officials, insurance companies, and select others have access to the National Practitioner Data Bank (NPDB) — the database that collects information on malpractice payouts and certain levels of disciplinary actions for the millions of doctors practicing in the U.S.

An analysis of NPDB data done for Consumer Reports by patient-safety advocate Robert E. Oshel, the former associate director for research and disputes at the NPDB, found that fewer than 2% of the nation’s doctors have been responsible for half of the total malpractice payouts since the government began collecting malpractice information in 1990.

In total, nearly $85 billion has been paid out in malpractice cases during that period.

Again, patients wouldn’t know if their doctor has contributed to that figure. But that doesn’t mean they don’t want to know.

A survey from Consumer Reports found that 82% of Americans are in favor of requiring doctors to tell their patients if they are on probation and why. And 66% lean toward barring doctors from seeing patients until their probationary period ends.

Still, state medical boards and the American Medical Association have opposed efforts to create greater transparency around physicians’ disciplinary actions.

Consumer Reports petitioned the California medical board last fall to require that doctors inform their patients when they are on probation. The board rejected the idea, saying it would put too much of a burden on doctors and damage the doctor-patient relationship.

“You can find out more about the safety record of your toaster and whether or not it’s going to catch on fire than you can find about your physicians,” Oshel tells Consumer Reports.

Consumers determined to find out more information about their doctor’s records can look to their state medical board website.

Even that can be hit or miss, as Consumer Reports explains that the websites vary from state to state, with some important information buried in the minutes of board meetings, while other states may have a separate page detailing actions against doctors.

As part of its report, Consumer Reports investigated the state medical board websites in all 50 states and rated [PDF] them from best to worst. California, New York and Massachusetts websites ranked the highest, with Hawaii, Indiana, and Mississippi bringing up the rear.

“The onus shouldn’t be on patients to investigate their physicians,” said Lisa McGiffert, director of Consumer Reports’ Safe Patient Project, said in a statement. “Doctors on probation should be required to tell their patients about their status, and explain the reasons behind it.

“The system of disciplining physicians needs to be more transparent, reliable and accessible for patients. Consumers need quick and easy access to this information to make educated choices about the physicians they see and the health of themselves and their families.”

To that end, Consumer Reports is working with consumers, medical boards, and government agencies to make it easier for patients to learn about their doctors’ disciplinary history.

More information on doctors’ disciplinary actions and probation, and how Consumer Reports and other organizations are working to ensure patients are informed of these details can be found in Consumer Reports’ May cover story and the organization’s Safe Patient Project.


by Ashlee Kieler via Consumerist

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