Physician Data Removed from Internet Draws Controversy

How much of your track record as a physician should the public have access to? 

That question is at the core of a dispute between journalists and the government as they spar over the removal of the Public Use Data File of the National Practitioner Data Bank.

The national data bank is used by state medical boards, insurers, and hospitals to review confidential physician discipline and malpractice records. The public file, used most often by researchers and reporters, includes similar information with the exception of physicians’ names and addresses.

The public file is designed to provide data for statistical analysis only. However, a reporter with the Kansas City Star recently compared court records with public file data, which allowed him to identify a physician.

In an article entitled “Doctors with Histories of Alleged Malpractice Often Go Undisciplined,” the reporter referred to the physician by name and wrote that he had been sued at least 16 times for allegedly making medical mistakes.

As a result, in a move which outraged journalists, the Health Resources and Services Administration (which operates and oversees the public file) removed it from the Web.

In a letter to the HRSA, the Society of Professional Journalists, Investigative Reporters and Editors, and the Association of Healthcare Journalists wrote that the public file provides “invaluable information” to the public about the functioning of state medical boards and hospital disciplinary systems.

“Reporters for years have used the data to identify flaws in their states’ regulatory systems that have led to patient harm. As a result of these stories, states have enacted new legislation and medical boards have taken steps to investigate problem doctors.”

But neurosurgeon and lawyer Jeffrey Segal, founder of Medical Justice, an organization which helps physicians prevent, deter, and respond to malpractice suits, told Physician’s Practice via email it was the right choice for the HRSA to remove the public file.

“The data bank was designed to be accessible to limited groups - such as licensing boards, credentialing committees, and malpractice carriers,” he said. “If a journalist is able to take the data bank’s limited public information and turn it into a public data bank, that sidesteps the intent of Congress. So, either Congress would need to amend the statute creating the data bank or the limited public version of the data bank needs to be revamped to conform to Congress’ intent.”

The HRSA is currently reviewing its public file to determine how information can be disclosed without revealing anything confidential.

When asked if he thinks the public data bank should, in fact, exist, Segal said he has “mixed feelings.”

“Some of the public might equate an isolated malpractice settlement or judgment with a talentless clinician,” he said referring to a recent New England Journal of Medicinestudy which found that nearly all neurosurgeons will be sued by age 65. And Segal noted, the same study found that the longer a physician practices, the likelier it is they will face a lawsuit that results in settlement or judgment.

“The public might assume the less experienced practitioner with zero lawsuits is a better doctor than a more experienced physician who accepts high-risk cases his colleagues shun,” Segal said.

For now, physicians and journalists will have to stay tuned to see whether the public file reappears on the Web and how/if it changes.

“Many doctors fight tooth and nail to avoid settling a legitimate claim for negligence precisely because they do not want to be a line item in the data bank,” Segal said. “The effect: these plaintiffs have to fight harder and longer for cases that would otherwise settle quickly and efficiently. That does not serve the interests of either doctors or patients.”