Posted by Bill Sandweg.
I always advise people looking for a doctor or getting ready to have surgery to check the web site of the state medical board to see if the doctor has been disciplined and, if so, for what reason. Unfortunately, this is only an effective strategy if the medical board is diligent about tracking and publishing information about doctor misconduct or malpractice and many state boards are less than diligent.
Last week I wrote about the problem of medical boards being reluctant to discipline doctors for malpractice or other bad conduct. When they do finally discipline a doctor, it is not uncommon for that doctor to just pull up stakes and move to another state, where she or he can practice with a clean license. This should not happen, but many state boards do not do a good job of checking the backgrounds of doctors moving to their states. As a matter of fact, they don’t do a good job of checking on the behavior of the doctors who have been in their states for years. These boards pretty much operate on the honor system and bad doctors take advantage of that fact.
Many doctors are licensed in more than one state and keep those licenses active, even though they do not live or practice in all of the states in which they are licensed. This makes it easy for these doctors, if they are face trouble in one state, to move to another state in which they are already licensed and start over. Any member of the public who checks the doctor’s history in the new state will likely find a clean slate. An investigation by USA Today a few years ago found at least 500 doctors who had been disciplined in one state just went to another state and practiced there without limitation. Of those 500, half had actually surrendered their licenses to their old states rather than complete the discipline process. They were still able to practice in their new state with an unblemished record.
Most states require doctors to self-report criminal convictions, malpractice suits, and other bad behavior. Some only require this kind of self-reporting every year or two, which means a doctor could have a conviction that would merit suspension of his license and not have to report it for as much as two years.
Depending on the state, the medical board may independently search for information about the doctors whom they license. The resources given to the medical board by each state varies from state to state. Boards with few resources may not be able to keep track of their doctors even if they wanted to. Some don’t even use the tools readily available to them.
Congress has established the National Practitioners’ Data Bank. Insurance companies making payments in malpractice cases involving a doctor are required to report those payments and a brief history of the facts to the Data Bank. Medical Boards are required to report discipline actions and hospitals must report, if they take away a doctor’s hospital privileges. Medical Boards can inquire of the Data Bank if it has any records relating to the doctors in the state. The investigation by USA Today found that very few ever do, despite the ease of making an inquiry. Surprisingly, USA Today found that half of the states checked the Data Bank less than 100 times over the course of a year. Thirteen didn’t check it even once. Given the wealth of information kept by the bank, every state board ought to be checking it for all of their doctors at least a couple of times a year. USA Today found that two states, Florida and Wyoming, made almost 2/3 of the inquiries in one year as both states have automated inquiries that flag any changes in the records of the doctors whom they supervise.
I am sorry to sound like a broken record, but the public has a right to know if a doctor has a history of discipline and for what reason. A patient’s life is literally in the hands of the doctors who are licensed to practice in a state. The state medical board has an obligation to create rules and procedures to accurately track the doctors it licenses, including their conduct in other states. Once it has created effective rules, it must enforce them. The public the board serves deserves nothing less.