The Loss of a Valuable Journalistic Tool

Friday, October 07, 2011

Transcript

For years, health care reporters have employed a government database called the National Practitioner Data Bank, containing information on malpractice payouts.  The public version of the database hides the names of physicians, but after a reporter was able to identify an anonymous doctor, the public database was taken offline.  Bob talks to Charles Ornstein of the Association of Health Care Journalists about why the database is important, and attempts by journalists to regain access to it.

Comments [4]

Caroline from Anchorage, AK

The right to know has not increased at the same level as the need to know. The one doctor in the small town may have been my experience; it did not necessarily apply to anyone in a large city. If you want to know if any action against the license of a doctor has occurred, you need to contact the medical board in each of our 50 states (not sure if that covers Puerto Rico).

So when Florida, my original home state, passed a “Tort Reform” bill some years ago, many of the worst doctors throughout the nation had a place to call home. One of the provisions of that bill stated that anyone bringing a malpractice suit had to be a dependant of the patient against whom the alleged malpractice was committed. This would not be an issue if the patient were able to sue for them self. Taking actions that resulted in the death of a patient was a free pass.

About the time that Howard Dean, a former pediatrician, was running for the Democratic Party’s nomination for President and advocating a national registry of a doctors’ record of practice, another doctor created a web site that advocated the blacklisting and denial of medical care to anyone who had ever brought a malpractice suit, no matter the outcome of that suit. The web site was taken down as was Howard Dean’s efforts to become president and create needed reform of our medical care as he did as Governor of Vermont.

Oct. 10 2011 10:26 PM
ClevelandClinicVictim from Ohio

Tort reform and $500M spent by the medical lobby to prevent patients from learning the findings of a medical board, insurance company, joint commission, or any other investigation into injury and malpractice. Medical documents can be altered and frauded and even destroyed with little fear of litigation by the injured patient. Hospitals such as the Cleveland Clinic where I and so many other patients were injured by a staff surgeon, and department head, are protected by a legal staff paid for from $1.8B annual patient revenue. Patients have little chance to outlast such deep pockets in litigation. On top of this, tort reform caps of $500K in Ohio are eaten up by years of costly litigation so it is again, nearly impossible, for injured patients to "outlast" the deep pockets of medical corporations. Dr Jihad Kaouk has had many cases filed against him by permanently injured patients, some critically. He is a foreign medical school graduate with NO board certification. The Cleveland Clinic admits they customarily let residents do surgeries without patient consents. In my case, my consent form was "disappeared." The Cleveland Clinic and the doctor refuse to respond to court requests for his credentials leaving the victim costly litigation to learn what should be in the public domain. Congratulations on this story showing how doctors and the medical lobby do every thing possible to conceal wrong doing and malfeasance, not just malpractice, by doctors and corporate medical institutions--and how the government is assisting them by sealing access to records.
Thank You, PROPUBLICA

Oct. 08 2011 04:38 PM
Charles B.

(CONTINUED)

For anyone who has a hard time with this topic, I can assure you; malpractice settlements have practically nothing to do with a physician's quality and reliability. I know of some of the most eminently-qualified, capable, professional, caring and skilled department chairmen at university medical centers who, because they take on the toughest of tough cases where outcomes might be very bad, have been through handfuls of litigation cases.

And remember that malpractice claims in almost all states are not the product of any sort of peer-reviewed process to establish any actual professional wrongdoing. Rather, a malpractice case usually depends upon the work of just one lawyer, who retains just one expert (sometimes more) who renders a single opinion about a breach of the standard of care. That's all. Essentially, one doctor's opinion. Often times at review and testimony rates of $500 to $2000 per hour. That is all that it takes to start a malpractice case.

Settlements, moreover, are often made on bases of information far afield of actual malpractice. Risk managers and professional liability insurance adjusters make risk-aversive decisions based on how they think litigants might appear at a trial. An unusually sympathetic plaintiff might garner a somewhat higher settlement figure. An unsympathetic defendant might have the same result on a settlement. Do we wish to have an environment in which settlements that might be based on a physician's race or ethnic background or national origin or accented English (any of which might be taken into account by a sophisticated risk manager in calculating civil trial risks) could be used in a newspaper report implicating the doctor's competence?

Good doctors sometimes get sued. Some bad doctors might never get sued, or might never make settlements. The National Practitioner Data Bank is lousy information for a reporter's purposes, and the data was never meant for reporters or the public.

Oct. 07 2011 07:07 PM
Charles B.

I am a lawyer with more than 25 years' experience in medical malpractice litigation.

This story is a complet failure.

First, the basics. As Bob Garfield correctly said, the NPDB was created NOT to help the public track and expose malpractice settlements. Settlements should never be equated with malpractice. Settlements are risk-management maneuvers by insurers. Trial verdicts, on the other hand, are never secret (they are public affairs and are reflected in public court files).

The Data Bank was, as Bob suggested, meant to be used by risk management professionals and professional peer review and credentialing committees of hospitals and other health care institutions. Again, for good reason.

I credit Bob Garfield for one particularly good question, to which he got a really crappy answer from Charles Ornstein. That is, if reporters are using the Data Bank as a Rosetta Stone or as the final puzzle piece to help them confirm private medical malpractice settlements and to then relay that information to the public through the press, then that is, on its face, a misuse of the Data Bank, by the very terms under which the Data Bank was established.

I'd be happy to debate Charles Ornstein on this subject any time he'd like to meet me.

And while Bob Garfield asked some pretty good questions in this segment, his sensibilities clearly seemed allied with the press.

This seems to be a rather selective "right to know" exercise. In the abortion context, we know from past cases that the pro-choice movement has exploded in litigation whenever private medical records were threatened with disclosure, even when patient names were redacted, with or without substituted alphanumeric identifiers. In those cases, the name-substitutions were seen as inadequate defenses, and so the disclosures should (it was argued) not be made at all.

(TO BE CONTINUED)

Oct. 07 2011 07:05 PM

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