A decision by Health Resources and Services Administration (HRSA), an agency of the US Department of Health and Human Services (DHHS) to remove an online database of physician discipline and malpractise has provoked outrage from three journalist organisations.
DHHS have threatened to prosecute a health journalist planning to publish an article republishing information from the databank. The violation of the National Practitioner Data Bank (NPDB) confidentiality provisions contained in Federal Law could lead to a penalty exceeding $11,000 being imposed on the journalist.
The Journalist in question ended up publishing the article titled ‘Doctors With Histories Of Alleged Malpractice Often Go Undisciplined“.
The Federal database does not reveal the personal identities of Doctors. As Reporters do, the Reporter in question had merely undertaken research of publicly available court records, state agencies and cases involving hospitals to discover the identity of the Doctors concerned in egregious conduct.
Reporters have used public records to confirm allegations of patient harm to publish similar articles arising from breaches of professional ethics and misconduct, including four cases involving a hospital neurosurgeon Dr Stefan Konasiewicz, some of which have led to quadriplegia and death.
Investigations revealed that colleagues had endeavoured to warn hospital officials of the risk the highest-paid high profile Doctor posed to patients, however despite these warnings, the hospital continued to allow him to practise.
The NPDB, created in 1986, and is operated by HRSA. The Association of Health Care Journalists are requesting that the Public Use File for the National Practitioner Data Bank be republished online.
The Public Use File of the data bank, doesn’t publish the names or addresses of physicians, but has provided a valuable repository of information for researchers and reporters conducting investigations into the poor oversight of medical conduct, trends in disciplinary actions and damages awards rendered in malpractice actions. Doctors listed in the public section of the database are identified by their state, the decade in which they graduated and an age range spanning ten years.
The Public Use Data File contains information reported to the NPDB concerning payments in medical malpractice cases and settlements, licensing actions taken against Doctors by drug enforcement agencies, exclusion from Medicare and Medicaid, criminal convictions, Doctors’ clinical privileges, and their membership in professional societies.
Health journalists and research organisations have expressed their disapproval that such a valuable resource to the media and general public, which was provided online has been taken down. The Public Use Database allowed a person to check on the credentials of Doctors.
It has been used to monitor the functioning of state medical boards
and hospital disciplinary systems promoting greater transparency and oversight of the operation of the regulatory apparatus when it fails the public and leads to patient harm.
The publication of such incidents by reporters who have utilised the data to identify flaws in the system has had beneficial effects, resulting in the enactment of legislation and medical boards acting to investigate the activity of problem Doctors.
The availability Public Use File online made information available to the public whilst protecting the privacy of Doctors..
HRSA made a decision to remove the Public Use File from the website of DDHS after being contacted by a doctor who reported concerns that a reporter had derived information from the full data bank as opposed to merely the Public Use File. The Reporter maintains that the material they propose to use to publish the article has been accessed from the Public Use File.
The decision to remove the data bank was greeted favourably by the powerful American Medical Association (AMA), as it long argued that the data provides an unreliable source of information on the credentials and adverse actions on licensure.
AMA President Peter Carmel claims “duplicate entries, inaccurate data, and inappropriate information in the NPDB provide, at best, an incomplete and haphazard indicator of a physician’s competence or quality.”
The DDHS claims they are considering reviewing procedures for disclosing information in a form and re-instating the data bank after amendments are made which reduce the likelihood of the identification of any particular health care entity, health care practitioner, or patient.
HRSA deny that the publication of reports and articles revealing instances of professional misconduct, due to problem doctors and a failure in regulation was a factor in the removal of the data bank.
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