Dangerous Doctors Allowed to Keep Practicing

*USA Today* includes an extended article: "Dangerous Doctors Allowed to Keep
Practicing; Thousands of doctors practicing despite errors, misconduct" by
Peter Eisler and Barbara Hansen.

Here are some excerpts:

[begin excerpts]

Despite years of criticism, the nation's state medical boards continue to
allow thousands of physicians to keep practicing medicine after findings of
serious misconduct that puts patients at risk, a USA TODAY investigation
shows.

<snip>

State and federal records still paint a grim picture of a physician
oversight system that often is slow to act, quick to excuse problems, and
struggling to manage workloads in an era of tight state budgets.

USA TODAY reviewed records from multiple sources, including the public file
of the National Practitioner Data Bank, a federal repository set up to help
medical boards track physicians' license records, malpractice payments, and
disciplinary actions imposed by hospitals, HMOs and other institutions that
manage doctors.

<snip>

The research shows:

? Doctors disciplined or banned by hospitals often keep clean licenses: From
2001 to 2011, nearly 6,000 doctors had their clinical privileges restricted
or taken away by hospitals and other medical institutions for misconduct
involving patient care.  But 52% -- more than 3,000 doctors -- never were
fined or hit with a license restriction, suspension or revocation by a state
medical board.

? Even the most severe misconduct goes unpunished: Nearly 250 of the doctors
sanctioned by health care institutions were cited as an "immediate threat to
health and safety," yet their licenses still were not restricted or taken
away.

<snip>

? Doctors with the worst malpractice records keep treating patients: Among
the nearly 100,000 doctors who made payments to resolve malpractice claims
from 2001 to 2011, roughly 800 were responsible for 10% of all the dollars
paid and their total payouts averaged about $5.2 million per doctor. Yet
fewer than one in five faced any sort of licensure action by their state
medical boards.

<snip>

The state boards "take their responsibility very seriously in taking
actions, being thoughtful, and ... protecting the public," [says Lisa Robin,
chief advocacy officer at the Federation of State Medical Boards}

DECADES OF CONCERN

Concerns about medical boards' accountability date to 1986.

That year, the Inspector General at the U.S. Department of Health and Human
Services reported that the boards, typically comprising doctors and a lesser
number of laypeople, imposed "strikingly few disciplinary actions" for
physician misconduct...but the reviews ended in the early 1990s after the
Justice Department declared that an Inspector General would have no
jurisdiction over state boards that are not funded or regulated by the
federal government.

Some lawmakers disagree.

"If (medical boards) don't have proper oversight, patients will get hurt and
taxpayers will get hurt," says Iowa Sen. Chuck Grassley, senior Republican
on the Senate Finance Committee, which handles Medicare and Medicaid.

Early last year, Grassley and a bipartisan group of senators asked the
Inspector General for a "comprehensive evaluation" of state medical boards'
performance.

But there's been no report, and the IG's 2013 work plan doesn't mention it.

Concerns about the boards resurfaced in a 2011 study by consumer watchdog
group Public Citizen.

The report was based on the same National Practitioner Data Bank records
reviewed by USA TODAY, and it reached a similar conclusion: Medical boards
"are not properly acting on (clinical privilege) reports after becoming
aware of them."

<snip>

Physicians with records of serious misconduct are clearly still practicing:

? A California doctor made eight payments totaling about $2.1 million to
resolve malpractice claims from 1991 to 2008. The doctor's hospital
privileges were restricted twice in 2007, once for misconduct that posed an
"immediate threat to health or safety" of patients, and surrendered for good
in 2008. No action has been taken against the doctor's license.

? A Florida doctor made six payments totaling about $1.1 million to resolve
malpractice claims from 1993 to 2009. In 2004, the doctor was hit with an
emergency suspension of hospital privileges for misconduct that posed an
"immediate threat to health or safety" of patients, and a managed care
organization took similar action in 2005. He also kept a clean license.

? A Louisiana doctor made nine payments totaling about $2.7 million to
resolve malpractice claims from 1992 to 2007, and at least five payments
involved patient deaths, including two young girls. In 2008, a managed care
organization indefinitely denied the doctor's clinical privileges. But the
doctor's license remains unrestricted.

The doctors' names are a mystery: identifying information is stripped from
the Data Bank's public file.

<snip>

The Federation of State Medical Boards has stopped issuing medical board
enforcement data that Public Citizen uses to rank the rate at which
different boards discipline physicians.

<snip>

At the start of 2011, more than 20 years after the National Practitioner
Data Bank was set up, 47% of hospitals had never reported restricting or
revoking a doctor's clinical privileges, according to data from the U.S.
Health Resources and Services Administration, which runs the Data Bank.

Public Citizen reported in 2009 that some hospitals mask cases by giving bad
doctors a chance to resign before investigations are launched, or by
restricting privileges for just under the 30-day threshold that requires
reporting.

But the group also found another grave problem: Hospitals' peer review
committees -- the internal panels of medical staff that oversee and review
complaints against clinical personnel -- often do a poor job.

"Much of the bottleneck in the physician discipline system is in the peer
review committees," says Philip Levitt, a retired Florida neurosurgeon who
served as chief of the medical staff at two hospitals.

"Virtually everything of serious consequence gets balled up or blocked in
the peer review process."

The peer review system is rife with bias, Levitt says, noting that doctors
on the committees often are inclined to protect their colleagues -- or go
after those who cross or compete with them.

That dynamic invites lawsuits from doctors who say they've been treated
unfairly, so hospitals generally are wary of suspending even those doctors
who commit egregious misconduct, Levitt adds.

 Instead, they tend to look for a deal to persuade the doctor to leave
quietly with no misconduct finding.

[end excerpts]

The article is online at:
<http://bit.ly/KenPopeReportOnDangerousDocs>

Ken Pope

RESOURCES FOR THERAPISTS WHO ARE THREATENED, ATTACKED, OR STALKED BY
PATIENTS:
<http://bit.ly/KenPopeResourcesForVulnerableTherapists>

"Never, never be afraid to do what's right, especially if the well-being of
a person or animal is at stake.  Society's punishments are small compared to
the wounds we inflict on our soul when we look the other way."
--Martin Luther King Jr.

_{Source: http://www.fairassociation.ca}