In the mid-1980s, incompetent and negligent doctors were moving freely between states, with state licensing boards and hospitals largely oblivious to lawsuits or disciplinary actions in other locations that might have flagged bad providers.
In response, Congress passed the Health Care Quality Improvement Act of 1986, which created the National Practitioner Data Bank, a repository of information that includes malpractice payments, license revocations and loss of clinical privileges for physicians, dentists, nurses, pharmacists, physical therapists and other professionals . “The NPDB is primarily an alert or flagging system intended to facilitate a comprehensive review of health care practitioners’ professional credentials,” says the Department of Health and Human Services, which maintains it.Members of the public can access statistical portions of the NPDB. Thanks to lobbying by the American Medical Association, however, the law blocks public users from pulling up histories of individual doctors or other health care professionals. Only authorized users such as hospital administrators can do that. A physician can see only his or her own record.
Sidney Wolfe, director of the Public Citizen Health Research Group, said “Congress rolled over” when it agreed to restrict public access to the HHS database. “One of the most important benefits of the databank has gone wasted,” Wolfe said. “Unfortunately, there’s been no effort that’s come close to succeeding in opening this up.”
An AMA spokeswoman said the organization opposes making providers’ names public because the database “is riddled with duplicate entries [and] inaccurate data.” Information about physicians’ credentials and disciplinary histories is available through “state-based systems already in place,” AMA spokeswoman Katherine Hatwell wrote in an e-mail. “These state-based systems are linked through the Federation of State Medical Boards website, so information on physicians can be easily located even if the physician has moved from another state.”
The state medical board federation’s public site has physician-specific data on disciplinary actions and licensure history, among other things. But it lacks some information contained in the NPDB – e.g., malpractice payments – and it charges $9.95 per name search. A sample provider profile is shown here.
A fact sheet listing what’s available within the NPDB is here.
Data Mine thanks Barbara Feder Ostrov, deputy editor of ReportingonHealth.org, the website of the USC/Annenberg California Endowment Health Journalism Fellowships, for calling our attention to the NPDB controversy. ReportingonHealth.org’s William Heisel did two blog posts about the database last year.
ABOUT THE DATA:
What: National Practitioner Data Bank
Where: Department of Health and Human Services, Washington, D.C.
Availability: Portions of database open to the public, but not providers’ names
Format: ASCII text or SPSS portable data file (Public Use Data File only)
Usability: Statistical data available to public researchers
Send your tips on government data sets that you think should be made more accessible or user-friendly to datamine@publicintegrity.org. You can also message us on Twitter or discuss the project on our Facebook page. We’re eager to hear what you turn up — full credit and links will be provided to individuals whose suggestions we use in our series.
This report was first published on the website of the Center for Public Integrity.
The Data Mine is a joint project of the Center for Public Integrity and the Sunlight Foundation.
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Recently I took my son to the ER for severe nausea, vomiting and abdominal pain. We arrived at the ER around 3 pm and he was triaged immediately. He spent four and half hours on a gurney in a hallway while blood tests and urinalysis’ were being run and everything came out clear. The nurse was required to give him two separate doses of morphine and nausea medication. The doctor (who I will not name) tried to or actually insisted that it was a stomach virus and wanted to send him home. Thankfully I have enough medical training that I knew it wasn’t and insisted on a CAT-SCAN, the doctor made the order but was really non-chalant about it with the word “if you insist” my reply was “Just to make sure”! The Cat-Scan was performed but we had to wait nearly 2 more hours for the results, I finally told the ER nurse to get me his Discharge papers and I would take him to another hospital. Within fifteen minutes they had the surgeon on the phone and on his way. He had acute appendicitis (which was my first suspicion) and had to have an appendectomy. I had asked for the CAT SCAN when he was taken to the gurney in the first place. While this doctor practically ignored my concerns and tried to send him home in that condition….. Everyone should be able to know what a doctors history includes. Since that happened I have spoken to quite a few people who have had similar situations with this same doctor. She still has her job!! I wonder how many children will die in her care before someone does something about it. I am making it my mission to save other parents and patients from that kind of negligence. Oh, just so you know on my sons discharge paper “Nausea and Vomiting” is listed as the diagnosis those are not diagnosis’ they are symptoms!!!
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I hired doctor Richard Scott Kaplan Union town Pa. to perform an IME via records. I sent him 30 years of medical records and $ 350. The doctor responded with a two line evaluation. The two lines made no since. He then destroyed all my medical records. The doctor is a pure con artist.
Marwan Baghdan, M.D.
Internal Medicine
Office in Hazel Crest
Advocate South Suburban Hospital
he killed my mother she was diagnosed with gall bladder problems and she ended up dying of cancer of the colon. She was let go to a rehab too early and died there witin 18 hours.
Please post opinion on my blog
Who put the Lyme in his coconut?
Not that I think I could ever convince you, Gary, because the belief in chronic Lyme’s is as strong as the most intense religious fervor, but for the record:
chronic Lyme’s is a concept scientifically refuted by mainstream infectious disease specialists and is actually a self reinforcing cycle of patients suffering from a nonorganic condition which is reinforced in patient-doctor interaction – fringe doctors who feel encouraged to treat chronic Lyme’s by patients thankful for a dangerous placebo treatment, patients who usually pay out of pocket. There is an excellent NYT magazine story that I encourage everyone to read.
http://www.nytimes.com/2001/06/17/magazine/17LYMEDISEASE.html
“chronic Lyme disease after standard ABx treatment), patients getting interested into superfluous tests or treatments … this happens every day but is not newsworthy and therefore largely unknown.”
Rbar,
I know of a person who has chronic Lymes Disease. It took several Doctors 2 Years to decide what he Had. Many Doctors duplicated and Duplicated testing and some simply refused to look at Chronic Lymes diseases. This 27 year old has been bed Ridden for three years so far. Taking Chemical Therapy and a host of other Treatments that are being performed by a licensed Doctor that Has No Contract with any Insurance Company.
Why! Insurance does not recognize Chronic Lymes!!!!!!!
Doctors who went against Insurance have had their License revoked on Chronic Lymes because they have put the Patient Before their Insurance dictator. Matter of Fact: A doctor can have a license revoked quicker with Health Insurance than any Patient.
This is a small example of the self serving idealogy of America”s Insurance and Health Care.
Why should Patients Have Transparency in Medical Errors and HAI’s? These are events that for the greater Part; are preventable! Accidents do Happen,but if they become greater than a Rare Occurrance; The People Have a right to Know! Medical Boards serve better as fraternities than peer review.Also it seldom provides insight to the public unless a judgement is Made. In many cases these judgements are also outside of Public Peer Review.
Why reward Medical Professionals who do not perform in an acceptable Manner and meet the National Average Standards?
Why reward Hospitals and Institutions that Do Not address Preventable Errors and permit the Hospital Acquired Infections to Spread unchecked?
Oh, But the GateKeepers of these institutions want to reli on this premise of a secret cult the performs in a manner that incites the ire of the public at Large.How can you learn from your Mistakes when the Gatekeepers fail to acknowledge that one has been Made?
It is elitist to believe that everyone of your (neantherhal) Patients would mis-use any information on negative outcomes. So Must I add that you are Protecting The Key Master! The Insurance Giants! What would Happen if Insurance was unable to Control the Facilities that Patients prefer to use?
Let me tell you. It will incentivize real changes in Health Care Services. Lawsuites are often the only choice because of the Cartel has failed to provide any Transparency or accountability.
Private Industry Faces these Market Driven Forces everyday and I will tell you that Saving Face is not as nearly as important as saving a Life!
Doctors should be just as transparent as Congress!
rbar, as usual, has some good points. I do not know about other states, but I do know that in Va. I was able to discover from the Board of Medicine site that my crazy neighbor, a “doctor” but not M.D., had in fact had his license suspended for insurance fraud (with exact details and dates of the case) and later let it expire. And that was after another, non-physician neighbor, had already discovered it. The information is out there, in my opinion.
“I’m sorry that you feel that open information is more harmful than a lack of information.”
I think there is a great misconception that is widespread in THCB and elsewhere: that the fundamentally increased availability of health care info via the internet is a net benefit. That remains to be proven. No doubt, there are enough stories of patients getting valuable, maybe even lifesaving information independently from the internet. However, the downside of patient driven internet research is rarely discussed: patients fearing a diagnosis for no good reason (usually conditions that go along with a large variety of symptoms, esp. nonspecific ones), patients being attracted to a nonscientific diagnosis (e.g. chronic Lyme disease after standard ABx treatment), patients getting interested into superfluous tests or treatments … this happens every day but is not newsworthy and therefore largely unknown.
Lay reviews of NPD data and discussions with physicians about past MP incidents are unlikely to benefit anyone. I would accept the point that transparency is a good thing per se and and always good policy, but … I believe it will do more harm than good. What are the dept. of licensing and medical specialty boards for? To sort out truly negligent or truly incompetent docs in order to protect the people. Have them set higher standards and prevent disciplined physicians to travel from state to state, and we will make real progress.
Anonymous,
Spare me the caps. The parties to a settled care are not at liberty to discuss the settlement. It is a pretty much standard for the court to order neither party discuss it.
As i review my entry I see nothing where I said I was against open information. The existence of the data bank is itself an intimidation of physicians.
I asure you, I am in it. I settled a case in 1995; an alleged wrongful death. I have found that juries are smarter than they are credited. Retrospectively I would have gone to court. I won a case in 2005. The trial lasted two weeks.
I hear Angie’s List is a clearing house of gossip that should help you steer clear of doctors that have pissed off patients. I have not looked to see if I am on it or not. I also asure you I have pissed off a lot of patients. (comes with the territory).
MD as HELL,
I’m sorry that you feel that open information is more harmful than a lack of information. I disagree. When I read book reviews on Amazon I have to make a decision about whether the author of the review is making good points or not. When I leave the house I have to decide whether to put a raincoat on based on the weather outside my window. The information that I get isn’t always valid and I have a responsibility to know the problems with what I am looking at. The weather may change. Taste in books differs. I want as much information about my doctors as I can get so that I can make a decision OR AT LEAST ASK THE DOCTOR TO EXPLAIN. Is that too much to ask?
It is easy to get sued. Doctors who never have to make a decison never get sued. I’m an ER doc. ER docs make fast decisions with limited information in real time. Sounds like EHR would help. It might if it is really accessable and is not cluttered with a lot of fluff. Even in my own hospital HIPAA has been a problem with accessing some information.
The headline for this post clearly illustrates why the NPBD is not for general access; the doctors are not “bad doctors” simply because they are in there. To infer otherwise is to do a disservice to the patients of these doctors and to the doctors themselves. Your prejudicial headline speaks worlds about your general attitude towards doctors.
Lisa,
I like your correction better than my original statement; thanks. I am not defending any point of view (I am retired so actually I am more a patient now than doc); just putting forth the objections as I remember them when the NPDB was first established. I think Anon has a good point.
Why not allow public access along with giving the physician an opportunity to add a comment (also public) to any of the legal actions reflected on the NPDB record? The AMA needs to realize that lack of transparency taints all physicians with the presumption that they have something to hide, and not that the vast majority of them have good to excellent track records.
Unfortunately, I have seen many a story–both written and reported on TV–that will state, “dr. x has 3 suits against him or her, etc,” when in fact, dismissals and the like as Bev MD describes were the occurence. Lisa, I wish I could trust that good folks like yourself would all make the distinction, but frankly, I dont believe it.
Having said that, I do believe you are correct in the transparency regard. People have a right to know. It is just finding appropropriate balance.
“Suits are often settled at the behest of the malpractice insurance company to save $$, rather than because the physician is guilty of malpractice. Doctors felt that inclusion of settled suits would give them a bad name unfairly.”
Why? Patient’s shouldn’t have access to complete historical information because we’re not smart enough to figure out sometimes frivilous lawsuits are filed? Because we’re so dumb we automatically conclude a doctor is incompetent because he was named in a lawsuit? And if a patient doesn’t want to be treated by Dr. X for the sole reason he or she was associated with X number of lawsuits, SO WHAT!? That should be the patient’s decision to make. We do dumb things all the time. Sometimes we decide we don’t want to be treated by physician X because his front office staff is rude, or the parking lot to their facility is too expensive. There’s an entire host of dumb, illogical, irrational, nonsensical reasons why a patient may or may not want to be treated by Dr. X. Their practice history seems more relevant than their parking lot.
By the way I would correct the statement to read: “Lawsuits are often settled at the behest of the insurance company, regardless of whether or not the physician is guilty of malpractice.”
@bev M.D.
Surely it would be better to have a ‘settled at the behest of the malpractice insurance company’ note next to the suit rather than uniformly block peoples’ access to the info…
Transparency is far better than secrecy in these matters.
I haven’t visited this issue in several years, but as I recall one big concern of practitioners was the inclusion of settled malpractice suits (as opposed to ones where the physician lost the suit at trial) in the data base. Suits are often settled at the behest of the malpractice insurance company to save $$, rather than because the physician is guilty of malpractice. Doctors felt that inclusion of settled suits would give them a bad name unfairly. Someone would have to check my facts but I believe settled suits are included.
This issue of patient perceptions came home to me when my brother googled his shoulder surgeon recently and was alarmed to see his name associated with 2 malpractice suits. When he investigated further, it turned out the physician was a fact witness in one case and an expert witness in the other,and was named in neither. It is lucky this latter information was even available online; I do not believe that is uniformly true.