< The Loss of a Valuable Journalistic Tool

Transcript

Friday, October 07, 2011

BOB GARFIELD:

For years health care reporters looking for information on medical malpractice payouts and disciplinary cases have used a government database called the National Practitioner Data Bank. It's primarily used by health care institutions, but a public version is available with physicians' names replaced by an alphanumeric code making them anonymous.

Nevertheless, by overlaying other records obtained through old-fashioned digging, journalists have been able to pair incidents from the database with actual doctors. And the reporting has been eye opening.

But last month, in response to complaints from at least one physician databased into infamy, the US health Resources and Services Administration, or URSA, took the public version of this database offline.

Charles Ornstein, the director for ProPublica and president of the Association of Healthcare Journalists, has partnered with the Society of Professional Journalists and investigative reporters and editors to condemn this action in an open letter to the White House. Charles welcome to the show.

CHARLES ORNSTEIN:

Thanks Bob, great to be here.

BOB GARFIELD:

Let’s start with the case that really brought this issue to a head. It was a story reported in The Kansas City Star.

CHARLES ORNSTEIN:

Reporter Alan Bavley of The Star was looking into a situation involving a doctor there who had been accused of malpractice a number of times. And he was able to use the National Practitioner Data Bank in order to determine just how many cases he had involving his license.

The physician had his lawyer call up the Health Resources and Services Administration to complain that Bavley had taken this out of the National Practitioner Data Bank, when, in fact, given the research he had done on the doctor already, he knew who the doctor was. But the database was able to provide additional information.

BOB GARFIELD:

There have been several stories elsewhere in which reporters depended on the Practitioner Data Bank to get to the bottom of who was creating a trail of malpractice, without being sanctioned by their state and local medical boards.

CHARLES ORNSTEIN:

No question. I mean, here you have a data bank you can directly say that it enabled reporters across the country to write stories that exposed serious problems with patient care and patient safety, and many of these stories led to new laws being passed,  increased transparency to the public of malpractice suits against doctors, a greater attention by medical boards to overseeing doctors. So these reporters had a direct hand in making patient care safer in their states, which is why it's all the more troubling that this resource is now not available anymore.

BOB GARFIELD:

So what happens next, at least in the Missouri case, is the lawyer for the doctor who was at the center of the story said this National Practitioner Data Bank is being misused by journalists, so you got to take this thing down. And the Obama administration said — okay.

CHARLES ORNSTEIN:

Right. I mean, what's so frustrating is this is one complaint by one doctor's lawyer, and the administration responds by taking the entire file down. The Data Bank does not identify physicians. There are no names, no addresses, no dates of birth, no social security numbers.

But what you had was reporters who spent weeks or months. They already knew who they were looking at. They were filling in the blanks by talking to staff members at hospitals, by looking at court records, by calling different states to get their discipline files.

And so, they had so much information that they were able to take some of the records in the Data Bank and identify who the physicians were. But that's quite, quite different than either manipulating the data bank or the databank identifying the physician.

BOB GARFIELD:

All right Charles. Fair enough. However, if the US Health Resources and Services Administration knew that the Data Bank was gonna be a kind of Rosetta Stone for snooping reporters, maybe they never would have put it up there for public consumption to begin with.

CHARLES ORNSTEIN:

I don't believe that's the case at all. It's clear that they knew exactly how it was being used. And in certain situations they were even helping reporters on how to use the public use file to identify trends and identify outliers. And they took the legal interpretation that it wasn't a violation so long as the Data Bank itself did not identify those doctors, which it did not.

BOB GARFIELD:

You know, there's a development here that kind of made me gasp. Not only did the Obama administration take down the Data Bank. It sent along a sharply worded letter to the Kansas City reporter informing him that he had subjected himself to civil penalties for abusing the data in the Data Bank.

CHARLES ORNSTEIN:

It is mind boggling. But beyond that, you know the precarious state of media organizations today. And many newspapers or TV stations would have gotten a letter like that and essentially killed the story. But, to his credit, Alan Bavley and The Kansas City Star, they ran their story and it really opened people's eyes.

The government now says that they have no intention to fine him, which is great, but they shouldn't have threatened him in the first place.

BOB GARFIELD:

Your organization, Association of Health Care Journalists, itself sent out a letter to the Obama administration, saying, in essence, what is up with that. What was the reply?

CHARLES ORNSTEIN:

They essentially told us to, in nice words, take a hike. They told us that they were committed to the same level of transparency as we were, but they did not commit to putting this database back online. It seemed as if we were essentially ignored.

BOB GARFIELD:

Since the initial exchange of correspondence, you've had more and more organizations take common cause with you. Is there any sense that the administration is going to reverse itself on this?

CHARLES ORNSTEIN:

It's unlikely it will reverse itself. They say that they may put together some form of a public use file that could go online in six months or so, but it won't contain the same information.

In the meantime, though they’re saying that reporters can submit a research request to the government, to this agency, explain what it is that they want to write about and what data fields they want, and the agency will determine the validity of the story and what data fields the reporter needs in order to write that story. That's pretty chilling.

BOB GARFIELD:

Charles, thank you very, very much.

CHARLES ORNSTEIN:

Thanks for having me on, Bob.

BOB GARFIELD:

Charles Ornstein is president of the Association of Health Care Journalists and a senior reporter for ProPublica.