Medpage Today reports that, “Almost half of U.S. hospitals have never reported a single physician disciplinary action to a national database as required by law, according to Public Citizen, the consumer advocacy group.

“Since 1990, hospitals that revoke or suspend a physician’s admitting privileges for at least 31 days have been required to file a report with the National Practitioner Data Bank (NPDB). (Emphasis added)

“But according to a Public Citizen report, authored by Sidney Wolfe, M.D., and Alan Levine, a former official in the Department of Health and Human Services, 48.9% of the 5,823 hospitals with active registrations have never submitted a report to the database.

“No individual hospitals were identified because the NPDB treats such information as confidential, Dr. Wolfe said.”

What’s Wrong?

Some disciplinary actions can be for administrative reasons, such as a failure to keep patient records current after a specific amount of time.  That is not nit-picking. Without a current record, a re-admitted patient’s doctor would not have all the needed information to treat the patient.

Others are for even more serious problems up to, and including, substance abuse. There is an impaired physicians program in each state. Physicians who voluntarily enter them are not supposed to be penalized.Some doctors, however, are disciplined to get them to participate in the program by making it a condition of keeping their hospital privileges.

These are two very different ways a doctor can face substance abuse. In the first, the doctor takes responsibility and acts. In the second, the doctor is under orders.

Reporting disciplinary action is a very troubling area for everyone: patients, doctors and hospitals. Internet public records can cause an M.D. to appear to be “troubled” in ways he or she is not. Hospitals will err on the side of caution, both for the sake of the reputation of their medical staffs and because the Internet posts represent unknown legal territory for them.

Could a hospital successfully be sued for the fall-out from reporting a doctor’s disciplinary action? Hospitals do not want to find out. What, worse, if the hospital makes an erroneous report? What if there are two doctors with nearly the same names? This is not a case for evading the law.  It merely illustrates some of the hazards to the reporting facility and those who admit patients to it.

At the same time, patients have a right to know what reliable reports can tell them about a physician.

This law does not appear to advance the goal of transparency among patients, doctors and hospitals.

This law needs to be made workable for all parties, with patients’ concerns foremost.

Source: Medpage Today, May 27, 2009

Citation: Public Citizen Report, May 27, 2009