Should you have the right to know whether your doctor is or has been on probation? More specifically, if you were to discover that your primary care physician was once disciplined for sexual misconduct, or was accused of drinking on-the-job, or was known to have over-prescribed medicine to the point where a patient died — would you want to know that information?
Most people would. But to the powerful interest groups in the healthcare industry — that’s privileged information. And you – the patient – don’t get to have it.
As the laws now stand, there is nothing requiring doctors, hospitals, and health insurers to notify patients of the probationary status of their doctors. Worse yet, that information is closely guarded by the powers that be. And they aren’t about to hand it over.
A Laundry List of Fireable Offenses
According to a recent Consumer Reports investigation, thousands of doctors in the U.S. have been allowed to continue practicing after being disciplined for a distressing array of dangerous, and sometimes criminal – or deadly – offenses. Some of them include: sexual harassment of patients, drinking on the job following a DUI arrest, gross medical negligence that led to the amputation of a patient’s leg, unnecessary invasive endoscopy procedures, forging of drug prescriptions, medical incompetence, fraud, lying… the list goes on.
One California primary care physician was found to have ordered more than 4 million pills of a prescription painkiller containing a controlled substance, but investigators from the Drug Enforcement Agency (DEA) "could account for only 167,000 tablets.” Another neurologist in the same state was sanctioned for allowing unlicensed assistants to administer a dangerous painkiller, which resulted in the death of at least one patient.
The scariest part is that these are all real examples of medical misconduct, but not one of the offending doctors had their medical license revoked. They were each allowed to continue practicing, performing surgeries, and giving advice to their patients. Worst of all, they were not required to notify their patients about their past misconduct.
The Database of Secrets
The Consumer Reports investigation revealed how state medical boards do not require doctors, hospitals, or insurers to notify patients of their doctors’ probationary statuses — let alone why they might have been sanctioned in the first place. All of that information is locked away in a database managed by the U.S. Department of Health and Human Services (HHS). It’s called the National Practitioner Data Bank (NPDB), and the only groups who have access to it are hospitals, doctors, law enforcement agencies, and insurance companies.
The American Medical Association (AMA), a monopolistic interest group, has actively lobbied against public access to the NPDB. They claim such information is unfair to physicians, and that patients should seek out this information themselves, using one of the 50-odd state medical board websites.
But according to one legal expert interviewed by Consumer Reports, all of the information patients would want to know is buried in lengthy transcripts, legal jargon, and data streams that are unintelligible to most people. Some websites even charge a fee to access the data. It’s quite clear that the powers that be have no interest in making this information readily available. Why? To protect doctors at the expense of their patients.
Robert E. Oshel, a patient-safety advocate who used to be the NPDB's associate director for research, has been working for years to make this information more available to patients. He told Consumer Reports how state medical boards are mostly run by doctors, and they’re often reluctant to take action against fellow physicians unless they’re pressured to by the press or another legislative body.
“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 added.
How Valuable Is Public Opinion?
Even if you take the AMA at its word, the idea of keeping this information from patients doesn’t really jell with the American public — the actual patients. According to a recent survey, 82 percent of Americans favor the idea of requiring doctors to tell their patients if and why they’re on probation. A somewhat smaller majority (66 percent) would like to see laws preventing doctors from seeing patients until their probation is up.
“The onus shouldn’t be on patients to investigate their physicians,” said Lisa McGiffert, director of The Safe Patient Project, in a press release. “Doctors on probation should be required to tell their patients about their status, and explain the reasons behind it.”
To say that the NPDB and the information it holds is outright dangerous and unhelpful to patients, as current AMA president Steven J. Stack says it is, denies the prospect of any compromise on the matter. If the AMA doesn’t wish to open up the NPDB to the public, why not at least offer some of it when relevant?
How to Find a Doctor 2.0
Because it’s still so difficult to access disciplinary information about doctors, one will have to rely on one’s own due diligence when finding a new one. Here are 3 of the most important factors to consider:
- Make sure any potential doctor is compatible with your insurance, budget, and location. You can use Medicare’s physician compare tool to pore through prospects.
- Visit org, which is run by the Federation of State Medical Boards. This site may have information on a potential doctor’s past disciplinary action — but don’t rely on that source alone. The Informed Patient Institute maintains a thorough list of physician report cards to further inform your decision.
- Is the doctor or care center you’re looking at being influenced by drug or medical device companies? If so, note that such companies will pay medical practitioners to prescribe their products to patients. Large sums of these payments probably suggest doctors are influenced more by money than by their patients’ health.