Release date 03/29/2016
YONKERS, NY—Thousands of doctors are currently practicing medicine while being on probation for issues ranging from sexual misconduct and drug addiction to unprofessional and dangerous treatment of patients. But it’s difficult and time-consuming for consumers to find out if their doctor is one of them, according to Consumer Reports.
A survey by Consumer Reports finds that 82 percent of Americans are in favor of requiring doctors to tell their patients if they are on probation and why. And 66 percent lean toward barring doctors from seeing patients until their probationary period ends. But state medical boards and the American Medical Association have opposed efforts to create greater transparency around physicians’ disciplinary actions.
“The onus shouldn’t be on patients to investigate their physicians,” said Lisa McGiffert, director of Consumer Reports’ Safe Patient Project. “Doctors on probation should be required to tell their patients about their status, and explain the reasons behind it.”
The new report, which appears in the May issue of Consumer Reports and online at ConsumerReports.org, details cases like that of an obstetrician-gynecologist in Southern California. The doctor continues to practice medicine despite a report from the state medical board alleging that his errors of medical knowledge, judgment, protocol and attentiveness contributed to the death of two young mothers who had recently given birth to healthy babies.
Consumer Reports’ investigation found that people looking for a new doctor online would have a tough time figuring out whether their doctor was being disciplined.
“What You Don’t Know About Your Doctor Could Hurt You,” available at ConsumerReports.org, is part of Consumer Reports’ ongoing efforts to make it easier for patients to access information about their doctors. The organization is pushing for policy reforms that would make the system more transparent, including requiring doctors to tell patients when and why they are on probation, providing information from state medical board records in a clear and consistent way, and making information from the National Practitioner Data Bank (NPDB) open to the public. The NPDB collects data on physicians’ malpractice payouts and disciplinary records.
“You can find out more about the safety record of your toaster and whether or not it’s going to catch on fire than you can find about your physicians,” said patient-safety advocate Robert E. Oshel, the former associate director for research and disputes at the NPDB.
An analysis of NPDB data done for Consumer Reports by Oshel found that less than two percent of the nation’s doctors have been responsible for half of the total malpractice payouts since the government began collecting malpractice information. In total, some $85 billion has been paid out in malpractice cases during that period. While malpractice is considered an inexact indication of substandard care, Oshel says that multiple large settlements against a doctor “can be a warning sign ... suggesting that if licensing boards and hospital peer reviewers were willing to either get these doctors to stop practicing or get retraining, we’d all be better off.”
Currently, only hospitals, doctors, law enforcement, insurance companies, and a few other select groups have access to NPDB data. Consumers must rely on their state medical board, many of which have complicated websites and require time-consuming processes to get answers about specific doctors’ records. As part of its report, Consumer Reports investigated the state medical board websites in all 50 states and rated them from best to worst. California, New York and Massachusetts websites ranked the highest, with Hawaii’s, Indiana’s and Mississippi’s faring the worst. For complete rankings of all the medical boards, go to ConsumersUnion.org/safepatientproject.
“The system of disciplining physicians needs to be more transparent, reliable and accessible for patients,” said McGiffert. “Consumers need quick and easy access to this information to make educated choices about the physicians they see and the health of themselves and their families.”
What Government, State Boards Should Do
Consumer Reports’ Safe Patient Project is working with consumers across the country to make it easier for patients to learn about their doctors’ disciplinary history. Those efforts are focusing on five areas:
Doctors on probation should be required to tell patients that they are being disciplined and explain why.
The state medical boards, where consumers must go to file complaints about doctors or investigate their records, should present information in a clear, consistent way, including plain-language summaries of why doctors are on probation.
State medical boards should include more consumer representatives. They are now dominated by physicians.
State boards should be more aggressive in pulling the licenses of doctors who are clearly a danger to patients.
The National Practitioner Data Bank, a federal repository that includes disciplinary actions taken by state boards, hospitals, and other healthcare agencies as well as malpractice payments, should be open to the public.
If a patient does suspect he or she has been harmed by a doctor, the person should:
Recognize a cause for action. This obviously includes any kind of physical or sexual abuse suffered at the hands of a doctor, or if the doctor is suspected of practicing medicine under the influence of alcohol or drugs. Poor medical care is less clear-cut. The kind of medical harm that warrants a complaint includes when a doctor overprescribes a drug or prescribes the wrong one, is dishonest, or fails to give the results of a worrisome biopsy or diagnosis of a serious medical problem in a timely way.
Consider contacting the police and a lawyer. To file criminal charges—for, say, sexual or physical abuse—first contact the police. For a malpractice lawsuit, a lawyer will likely need to be convinced of a strong case with the potential of a payout.
Contact the state board. That’s the agency that licenses and disciplines physicians. (To find your state’s board, go to ConsumersUnion.org/safepatientproject.) Some states make it easy to file a complaint against physicians online. If you have trouble navigating the website, call the board for help.
Gather your records. It’s a good idea to send a hard copy of your complaint, along with copies of your medical records and other supporting documents, to the board. Once the board receives your complaint it will assign it to an analyst, who may request additional documents or information. Then be patient: The state board must first determine whether your complaint warrants further investigation. And it can take several months or even longer before the board makes a final ruling.
What Makes a Great Doctor
What does a good medical practice look like? The Peterson Center on Healthcare and researchers at Stanford University’s Clinical Excellence Research Center worked together to answer that question. First, they collected data from 15,000 U.S. primary care practices. To winnow the list down to the most successful ones, they used 41 accepted quality-of-care measures along with data on healthcare spending. They then sent a team of investigators to a sample of the highest-performing practices to figure out what set them apart. The most successful ones shared these characteristics, which all consumers can look out for:
Extended Hours – Flexible schedules help patients avoid trips to the emergency room
Careful About Overtreating – Doctors emphasize spending time with patients before rushing to tests
Open to Complaints – Patient complaints are treated as valuably as compliments
One-Stop Shopping – Top practices perform some relatively minor procedures that other practices often refer out
Like-Minded Specialists, and Only as Needed – Patients are only sent to specialists who share the practice’s philosophies
Two-Way Communication – Medical offices actively follow up through phone calls, repeat visits, or emails
A Team Approach – Teams include an array of healthcare providers, including nurses, nurse practitioners, physician assistants, nutrition counselors, and social workers
A Fair Workplace – Physicians aren’t compensated solely on the number of patients they see
Spend Wisely – Practices tend to avoid expensive, high-tech devices in favor of devices that encourage efficiency