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Cleaning house in the health professions.


In spite of some statistics comparing various aspects of health care among the more advanced countries of the world (Sweden, for example), Americans enjoy an overall unsurpassed standard of health care. The reason is simple - on the whole, our doctors, nurses and most other health personnel receive training that is the rest of the world's envy. Because of our size and system of licensure, however, we have a serious problem within the health professions, particularly with doctors and dentists.

When an M.D. or a D.D.S. is found to be incompetent by reason of alcoholism, drug abuse, mental illness or malpractice, his license may be suspended or revoked. In 1987, the latest year for which figures are available, 534 physicians permanently lost their licenses, 644 were placed on probation, and 379 had their licenses temporarily suspended. Because each state controls licensure, however, the defrocked practitioner may simply move to another state to practice. Many doctors and dentists have licenses in more than one state by reason of previous moves, and if not, it is usually not difficult to obtain one by simply moving to another state and falsifying one's application for licensure.

Even more of a problem is the incompetent practitioner who may not lose his license but simply moves from hospital to hospital when his shoddy medical care begins to manifest itself and his colleagues do not report him to the licensing authorities. In recent years a number of cases of interstate malpractice have made the headlines, the most notorious of which, perhaps, was the Navy surgeon practicing in the prestigious U.S. Naval Hospital in Bethesda, Md., where the president himself receives hospital care. This surgeon was responsible for several deaths before his incompetence finally came to light.

The problem relates to our highly mobile society and the great numbers of physicians and dentists who move from state to state or hospital to hospital (the vast majority for perfectly legitimate reasons). To alleviate the problems of keeping track of the bad apples, the U.S. Public Health Service has set up a National Practitioner Data Bank to begin operation this April. The data bank will receive mandatory reports of disciplinary proceedings and malpractice actions against doctors and dentists from a variety of sources and will accept reports of such actions against other health personnel.

The federal law that established the registry requires insurance companies to report to the data bank, as well as to the appropriate state licensing board, every payment made by them to any plaintiff in a malpractice suit, whether awarded by the court or settled out of court. Likewise, state licensing boards and professional organizations must report disciplinary actions taken by them. In turn, hospitals are required to check with the registry on every prospective employee and, at least once every two years, on every practitioner who uses their facilities. Confidentiality of information in the registry is, of course, a major concern, and neither the public nor the press will have access to it. Attorneys handling malpractice cases may, under certain circumstances, obtain data from the bank, and all health practitioners will be able to check their own records in order to correct any errors that may creep in.
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Title Annotation:malpractice regulation, National Practitioner Data Bank
Publication:Medical Update
Date:Jan 1, 1990
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