Public Citizen, a consumer “watch dog” founded by Ralph Nader in 1971, recently issued a report critical of state medical boards for their failure to follow up on physicians disciplined by hospitals and reported to the National Practitioner Data Bank. Public Citizen did a study of 10,672 physicians “banked” during 1990 through 2009 from data provided by the NPDB. There were a total of 10,672 physicians reported during the period, but only 45% of those had one or more state licensure action as well.
That left 5887 physicians or 55% with no state licensure action. Of those 220 were determined to represent an immediate threat to public health or safety. 1119 of the 55% were found to have been incompetent, negligent or to have committed malpractice. 2071 or 35% of the 55% reflected conduct that fell into the most serious categories.
In New Mexico a physician with 26 malpractice reports to the data bank was never called before the state licensing board. Indiana had a similar situation with a doctor with 20 cases. Interestingly, 23 of the complaints to the NPDB involved physicians with criminal convictions. Public Citizen calls for tighter interplay between the NPDB and state licensure boards. While that may be called for, the Public Citizen report neglects to discuss the fact that every hospital at which a physician subsequently applies for privileges must access the data bank and having a report there is often tantamount to “having a record.” There are also more than a few doctors who are in the data bank because their insurance companies opted to settle a case cheaply rather than to spend the money to defend it. This makes financial sense for the insurance company but give the physician “a record.” The data bank regs. indicates that merely being in the data bank because of a malpractice settlement is no indication that malpractice actually occurred, but tell that to the next hospital credentials committee reviewing an application for privileges. There are changes to the NPDB that are necessary and some of them involve the protection of innocent physicians that are the victims of circumstances and lack of leverage with their insurance companies.
For the report: see http://op.bna.com/hl.nsf/r?Open=mapi-8n7lj2.
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