Is It Time to Consider a New Way to Discipline Doctors?

I have written in the past about the “frequent flyers,” the few doctors who malpractice repeatedly.   Studies have shown that as few as 1% of the doctors in the United States are responsible for over 30% of malpractice claims.  How can that be?  How can the medical profession allow these doctors to continue to harm patients over and over and over again? They know who they are; there is no secret about their identities.

Virtually every state has a medical board which is charged with licensing and disciplining doctors.  Arizona has two:  The Arizona Medical Board, which is responsible for licensing and disciplining MD physicians; and the Arizona Board of Osteopathic Examiners, which has similar responsibilities for DO physicians.  Patient complaints, judgments, settled lawsuits, hospital complaints and complaints by other physicians are referred to these boards.  They have the authority to summarily suspend the license of a physician and often do when there is evidence of substance abuse.

While the boards do a good job when the issue is substance abuse, and that is indeed an important issue with real implications for patient safety, they do not do as good a job when the question is physician competence.  The process by which questions of competence are resolved is hit and miss.  The board usually chooses a physician in the same specialty as the physician whose care is in question and sends him or her the chart or charts for review. If that physician sees no problem with the charts, that is pretty much the end of the matter.  In the meantime, the doctor who has been notified of the complaint has usually lawyered up and hired his own doctor expert to testify how good his care of the patient was.  Even when discipline is imposed, it is usually only a slap on the wrist involving taking some more medical education classes.  It is a rare occurrence indeed when a doctor loses his or her license because of medical malpractice that does not involve substance abuse.  So even when malpractice is found to have occurred, the doctor is almost always permitted to continue to treat and mistreat patients.

Given the statistics noted above, letting the 1% return to practice with a slap on the wrist is not preventing still more patient injuries.  Some of these physicians are not good doctors and should be removed from practice.  That does not happen under the current system.  Doctors have shown that they cannot successfully oversee other doctors and weed out the bad doctors.  It is time for a change.

 

Posted in Arizona Medical Board, disclosure of medical mistakes, Doctors, Lawsuits, medical errors, Medical Malpractice, medical malpractice cases, medical malpractice claims, medical malpractice lawsuits, medical mistakes, Medical Negligence, Secrecy |