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    Saturday, May 30, 2009

    Do Doctors Get Disciplined?

    I hear comments all the time that doctors don’t really get disciplined by their peers.

    But, that’s not true. State medical boards across the country took 60 more disciplinary actions against physicians in 2008 than they did in 2007 reports K. B. O'Reilly, [AMNews], and nationwide, there were 5,379 disciplinary actions against physicians in 2008.

    “That increase -- less than 1% -- was not enough, however, to silence critics,” says O’Reilly. These critics argue the medical discipline boards are not doing enough to protect patients from bad doctors.

    There may be some truth to this. An analysis of disciplinary data by Public Citizen, a consumer advocacy group, said "there is considerable evidence that most boards are under-disciplining physicians."

    State medical boards maintain that staffing levels and funding affect a medical board's ability to address complaints against physicians quickly and fairly.” One example Kansas, an 11% budget increase last year helped the state board begin to address a case backlog resulted in more than double the number of disciplinary actions.

    As we’ve seen in another of my articles on this subject only about 5% of doctors are responsible for about 50% of medical malpractice cases in the US. Enough money must be found to fully staff Medical boards to do their job. In the meantime the suggestions from consumer advocacy groups that medical malpractice insurance premiums should be markedly increased for medical malpractice recidivists.

    On another front Physicians can expect to see more information about their malpractice payments, disciplinary actions and other identifying data being made easily accessible online, because Medical boards now push transparency as reported also by AMNews

    More than a decade ago, Massachusetts became the first state to mandate its medical board to post physician profiles online. With the click of a mouse, patients could find a physician's hospital affiliations, hospital and medical board disciplinary actions, medical malpractice payments and other data. Many physicians were skeptical in the beginning. "But it has worked out reasonably well," says the Massachusetts Medical Society.

    "It is an opportunity for patients to step up and see information such as where a physician has received training, whether they are board certified, whether they have malpractice suits against them and whether or not the suit falls in what one might expect in that specialty. A spokesman for the Massachusetts Board of Registration in Medicine, said the program has been a success from the board's perspective as well. There are about 6.5 million visits to the 31,000 physician profiles in a given year.
    65 of the 70 U.S. medical boards post physician profiles online.

    Today, 65 of 70 boards in the United States put physician profiles online, according to the Federation of State Medical Boards. But what is included in those profiles varies. Most states post licensure status and disciplinary history on the Web sites. The more detailed sites, though, include items such as medical malpractice information and criminal convictions, with only 16 and 17 boards, respectively, posting that information.

    It makes online physician profiles an evolving arena, especially as consumers continue to demand more and more about doctors.In many states, before information was posted online, physicians were concerned that patients would not be able to put material such as medical malpractice data into context. As physicians have worked with many state medical boards and legislatures to make sure that the postings were fair, accurate and in context, their earlier fears have not been realized. In South Carolina, the board made disciplinary actions public.

    In New Jersey, the state board's Web site tells a visitor how many malpractice payments the physician has made, how many physicians are in that physician's specialty, and how many physicians in that specialty made malpractice payments in the past five years. It also shows how many total malpractice payments there were in the specialty and whether the physician is below average, average or above average compared with other physicians in the specialty. A report by consumer advocacy group Public Citizen ranked how state boards' Web sites fared in disclosing physician information in eight categories, including board disciplinary action, malpractice data and criminal convictions. The median score for state MD and DO boards was 42.2 of a possible 100. New Jersey scored the highest at 83.7 points.

    The trend toward transparency is expected to continue."People expect transparency," said the CEO of the Washington, D.C.-based Citizen Advocacy Center, which offers training and research for members of health care regulatory, credentialing and governing boards.

    In summary among the 70 state medical boards authorized to regulate allopathic and osteopathic physicians:
    65 have online physician profiles
    62 include licensure information
    56 include disciplinary history
    34 include medical education information
    24 include medical specialty information
    17 include criminal convictions
    16 include information on medical liability cases

    Source: "State of the states: Physician regulation 2007," Federation of State Medical Boards, April 2007 ( 2007 state of states report.pdf)

    1 comment:

    1. I wish more physicians thought like you and wanted to rid the profession of the bad apples.
      Dr. Peter Jannetta did a Jannetta procedure on me for trigeminal neuralgia. He paralyzed the left side of my face after assuring both my parents and I, in separate conversations, "I promise (you) your face will not be paralyzed." There was evidence of 'ghost surgery', a practice he has admitted to in his biography (Working In A Very Small Place, Mark Shelton).
      He also ignored a defensive pre surgical test that showed the chances of paralyzing the face were greatly increased, he ignored his own texts writing that resurgery did not have good outcomes (mine was a resurgery) and the Pa. Superior Court called him a perjuror stating about his testimony ""We have little difficulty in concluding that Dr. Jannetta's testimony at deposition was different than, or inconsistent with, the testimony at trial." Levy v Jannetta, CCP Allegheny County, GD 81-7689; appeal -J. A370017/92 Levy v Jannetta et al, No. 00150 Pittsburgh, 1992. settled, 1995" and yet he was never sanctionjed by anybody, despite my writing to the medical board as well as a number of neurosurgical societies. In fact, instead, 3 weeks after my laywer forced me to settle, for bupkis, (does not even come close to covering my lifetime medical expenses) he was named secretary of health nominee for Pa (under Gov. Ridge.) A letter was sent to the governor and ignored until after confirmation - when his aide wrote that the governor had "full confidence" in Dr. Jannetta (Pa. sec't of health 1995 - 1996.
      This man has numerous cases against him, many of which were not even able to get into the court house door, apparently because of the power this doctor wields and the cachet of his name.
      Pa does not have a medical malpractice "crisis" as many of the doctors here claim. They have a problem of nt sanctioning and cleaning out their ranks of the bad apples. Do that and the rate of malpractice, claims and suits will go down greatly.
      Thank you.
      Carol Levy
      author, A PAINED LIFE, a chronic pain journey