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Incompetent Doctors Go Unreported

Federal program fails to protect patients because HMO's don't file complaints

A government program designed to protect patients from incompetent or unethical doctors has failed. The investigative branch of the U.S. Department of Health and Human Services lays much of the blame on managed-care organizations and hospitals, which seldom report doctors who have been disciplined as required by a law passed in 1986.

A recent report from the HHS Office of the Inspector General heaped harsh criticism on the National Practitioner Data Bank -- and on HMOs, in particular, for failing to file reports of medical incompetence and misconduct. The database was designed primarily to allow hospitals and other health-care organizations to spot or stop doctors or dentists who had been censured from setting up shop in another state.

The public has no direct access to the database, although lawyers can search for records of physicians or dentists involved in lawsuits. Ironically, health-care organizations submit the most requests for information to the database and yet they file almost no disciplinary claims.

The inspector general's report states that "with close to 100 million individuals enrolled in these organizations [HMOs] and hundreds of thousands of physicians and dentists associated with them, fewer than 1,000 adverse action reports over nearly a decade serves for all practical purposes as 'nonreporting.' " Browsers equipped with the free Adobe Acrobat plug-in can read the full report.

The New York Times states today that reportable offenses include: performing unnecessary surgery or surgery on the wrong side of the body; giving a patient a fatal drug overdose; having sex with patients; self-prescribing narcotics; and billing for services never provided.

Despite the failure of the National Practitioner Data Bank, there are physicians who want to make sure that bad doctors don't continue to practice. The non-profit Federation of State Medical Boards created its own database of disciplinary actions taken by state medical licensing boards. Unlike the federal database, the Physician Data Center has records dating back as far as the 1940s and anyone can access the information for a $9.95 fee per request. A Los Angeles Times feature reprinted in the Boulder, Colo., Daily Camera explains how it works.

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