Fw: A Free Ride for Bad Doctors NYTimes

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----- Original Message ----- From: ilena rose

Sent: Friday, March 07, 2003 5:38 PM

Subject: A Free Ride for Bad Doctors NYTimes

http://www.citizen.org/publications/release.cfm?ID=7232A Free Ride for Bad Doctors (HRG Publication #1655)This Op-Ed by Sidney Wolfe, M.D. appeared in the March 4, 2003 editionof the New York TimesA Free Ride for Bad DoctorsThe death of Jésica Santillán, the 17-year-old given a heart and lungtransplant last month from an incompatible donor, has become thelatest argument in Congress against President Bush's plan to limitmalpractice damage awards. With doctors in several states staging workstoppages to protest the soaring costs of premiums, the plan to putcaps on pain-and-suffering payouts had been picking up steam.Yet in all the discussion of tragic case s and dollar amounts, a majorcause of the malpractice problem is ignored: the failure of statemedical boards to discipline doctors.The fact is, only a small percentage of doctors account for most ofthe money paid out in malpractice cases. From 1990 to 2002, just 5percent of doctors were involved in 54 percent of the payouts —including jury awards and out-of-court settlements — according to theNational Practitioner Data Bank of the Department of Health and HumanServices. (The data bank allows hospitals and medical boards to seethe records of individual doctors but, thanks to pressure from theAmerican Medical Association, Congress forbids it to releaseinformation to doctors or the public.)Of the 35,000 doctors with two or more payouts during that period,only 8 percent were disciplined by state medical boards. Among the2,774 doctors who had made payments in five or more cases, only 463 —one out of six — had bee n disciplined.Is it any coincidence that the states least likely to disciplinedoctors are among those with insurance crises? Pennsylvania — wherethe governor had to intervene to keep doctors from going out on strikeover malpractice insurance costs — has disciplined only 5 percent ofthe 512 doctors who had made payments in malpractice suits five ormore times, the lowest percentage of any state. (Arizona, for example,has disciplined nearly half of the doctors in this category.)And while Pennsylvania has 5.3 percent of the doctors in the UnitedStates, they make up 18.5 percent of American doctors with five ormore malpractice payments. One doctor there paid 24 claims between1993 and 2001 totaling more than $8 million (one was for operating onthe wrong part of the body; another was for leaving a "foreign body"in the patient) yet was never disciplined by Pennsylvania authorities.The state with the next highest ove rrepresentation of doctors withfive or more payouts is West Virginia, where doctors went on strikelast month. It has 0.57 percent of the country's physicians, but theymake up 1.69 percent of American doctors who have had made malpracticepayments five or more times. Only one-quarter of the state's doctorswith five or more payouts has been disciplined by the medical board.In New York, another state with a pending malpractice crisis, thenumber of doctors who have had five or more malpractice payments istwo and one-half times higher than would be expected from the numberof doctors licensed. Yet only 15 percent of these 698 doctors havebeen disciplined by the state board.Amid the uproar about malpractice premium increases, there is a deadlysilence from physicians' groups on the crisis of inadequate doctordiscipline. The problem is not the compensation paid to injuredpatients, but an epidemic of medical errors. If med ical boards, whichare state agencies, are unwilling to seriously discipline doctors whorepeatedly pay for malpractice — including revoking medical licensesfrom the worst offenders — then legislatures must step in and changethe way the boards operate.Congress should also rethink the secrecy surrounding the practitionerdata bank. While a few states release some data to the public, mostAmericans have no way of finding out their doctors' backgrounds. Whatpatient would not like to discover the malpractice history of apotential doctor, especially if he is among the 2,774 in the UnitedStates who have had five or more payouts?____________________Find out how you can help. www.citizen.org/join

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