Aug 26 2013

When Incompetence Is The Status Quo For Medicine

Andrew Barovick, Esq., http://www.thenewyorkmedicalmalpracticelawblog.com, shines light on a recent medical malpractice investigation.USA Today ran a disturbing article with a dramatic title earlier this week: Dangerous Doctors Allowed To Keep Practicing.  

Before you stumble backwards, reeling from shock, be assured that the article is talking about a minority of doctors. Most physicians are solid, well-trained and educated professionals who are dedicated to providing optimal care to their patients.

Like any group of professionals, there are a few bad apples among them.  The problem, and the focus of the USA Today article, is that the medical industry does such a poor job of disciplining its incompetent doctors that innocent patients remain vulnerable to their errors.  That is the tragedy that continues to go unaddressed.  Hospital administrators,  heads of disciplinary boards, and the insurance companies that provide malpractice insurance to doctors know which doctors have provided substandard care in the past, and therefore, which of them are likely to injure or kill patients in the future.

And they usually fail to corral such wayward doctors, unless a particular case attracts enough negative press to force their hands.

USA Today’s investigation found:

“the  nation’s state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct that puts patients at risk”; and that “[e]ven the most severe misconduct goes unpunished: Nearly 250 of the doctors sanctioned by health care institutions were cited as an ‘immediate threat to health and safety,’ yet their licenses were not restricted or taken away.”

And transparency is not something the medical establishment is particularly fond of. While there is a public file, the National Practitioner Data Bank, that is supposed to receive reports whenever any of the nation’s doctors face “adverse actions,” the public cannot view any identifying information about a particular doctor.  Perversely, the only people who have full access to such information are part of the very medical boards and hospitals that are supposed to be protecting the public from incompetent doctors, and who continue to fail to do so.

Not surprisingly, it’s only getting worse, as is illustrated by the stonewalling being encountered by Public Citizen, one of the most tenacious consumers’ rights groups in the country.  USA Today found that the “Federation of State Medical Boards has stopped issuing medical board enforcement data that Public Citizen uses to rank the rate at which different boards discipline physicians.”

Why does this sad state of affairs continue?

The reasons given in the article are disturbing: red tape, hospital politics, the chronic failure to report doctors to the Data Bank. In my own experience, while I was still working on the defense side, I recall multiple lawsuits filed over multiple poor outcomes following surgery by a “renowned” surgeon who attracted big business to a particular hospital. He may have once been excellent at his job, but the facts suggested that if there had been such a period, it was far behind him. Yet he was kept on, and even celebrated by the hospital, in its ad campaigns. If I were as cynical as my friends and family think I am, I might suggest that the medical industry can be a profit-driven business like any other, and that cash flow is sometimes valued over patient safety. But I would never suggest such a thing.

What can you do? Given the current news headlines, there have been few more opportune times to call for greater transparency from the medical industry.  Sure, transparency in government, and in the NSA is valuable.  But so is the transparency that would allow U.S. consumers of medical care to protect themselves from avoidable, predictable injuries and deaths.

 

2 Comments on this post

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  1. Michael Kirsch said:

    Interesting post. Valid points raised. I don’t believe that the current med mal litigation is a fair and reasonable antidote to the deficiencies you highlight. Readers should be aware that settlements against physicians are entered into the NPDB. A settlement or even a verdict does not mean that actual medical malpractice has occurred.

    September 5th, 2013 at 2:15 pm
  2. Andrew Barovick said:

    Thanks for reading, and responding, Michael. I do not think that med mal litigation is the holy grail, by any means. I wish more hospitals would undertake serious efforts to improve patient safety, because they work. For example, at NY’s Columbia Presbyterian Medical Center, infant morbidity/mortality rates, and the related med mal suits, were cut down to record lows after a big push for improved care. But last time I checked, very few hospitals have been willing to do the same. And with individual MDs, it too often is the same few making the same mistakes, which continue for reasons discussed in the USA Today article.

    September 6th, 2013 at 9:53 am

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