The board that oversees physician discipline in Massachusetts has yet to deliver on its promise to post more information online about doctors who are charged with a crime or who have a history of negligent care.
Now, doctors whose licenses are revoked or allowed to expire as a result of disciplinary actions are absent from the board’s public database. And information about malpractice cases or board actions is removed after 10 years from the profiles of still-licensed physicians.
Comments
Why can we not get this information on teachers, business people and firemen and police, as well? Why just start or stop with doctors?!! Why not get and keep a list of who has box seats at the red soxs too? I mean, we require that doctors report any and all income and gifts from drug companies. Why do we just limit these requirements to doctors. I would love to know if my insurance agent,non profit CEOs of hospitals and other companies, car dealers or investment banker is taking others out to dinner and using funds to go to games too?!!! Are not crimnal convictions available to the public? Why not organize the convictions by religions and sex too? That way we can identify "cells" of undesirables on a daily basis. I think information used in this manner has lots of uses. this is just the beginning and I think that we will discover a lot of great information to use and re use...abuse...
Given he ability of bad doctors to directly harm people, your post is irrelevant.
@ pvalen : Hear Hear!!
Dear haftastudy:
Well, the minute teachers make as much as doctors, I might agree with you. For police, I actually agree with you now (they really should be watched more closely, and the records of that watching should be public). As well as (perhaps) bankers and hospital CEOs.
It's about power. Doctors have it-when you go to the doctor, you are putting yourself or your child in his or her hands; if they've been soliciting sex from minors, perhaps you'd put yourself there, but not your child. If they've had a string of malpractice cases which look surprisingly alike, maybe you don't want to see him or her at all. Fact is, having a license to practice medicine is a statement from the government that you've met a certain standard; anyone can give you medical advice-if you have a license, your medical advice is theoretically at least this (imagine my hand about shoulder height) good, and you are at least this (so, maybe chest height) trustworthy.
Or maybe you'll trust to luck-lots of people do, including me; I didn't check out my PCP before I went to see her (I have since; she's clean, record-wise). But your taxes pay, in part, to keep an eye on people like me (I am a physician). Don't you want to know what you're paying for? I think lots of people do-and they should get it. Just like in a lot of other states, which do this better than we do. Consider Vermont, which honestly I am not surprised does it better, and Texas, which I am very surprised. Both have searchable databases showing that physicians were disciplined, what they were disciplined for, and showing what remediation they undertook.
(Fascinatingly, Texas in particular seems to focus on remediation rather than punishment, which Massachusetts does only for substance abuse issues. I approve; if you screw up in a way that is fixable with more education, you should be required to get said more education. Also, I have to say I approve of removing ten+ year old malpractice records. Chances are, if you haven't committed more malpractice in 10 years, you're not a bad doctor, even if a malpractice case indicates that you once were. (It's not clear that that's what a malpractice case proves, but for the sake of argument, let's say it did)). This should, I argue, also be a theme, as with the recent Globe editorial on police disciopliinary cases. Professional discipline should be about remediation, retraining, and rehabilitation. If you exceed the malpractice threshold (which should be more than 1 case-that is often random-and more about patterns of practice), then you should be re-examined by the board or their representative. Your deficiencies should be evaluated, and you should be given the opportunity to fix them. I would argue furthermore that this is a chance for feedback to your training program. "Hey, Dr. Chief of Residency (or perhaps even Medical School), did you know this about Dr. X before you graduated him? Could you maybe have fixed this *before* you let him out?". If we don't record and review information like this, we will never be able to improve the entire group of physicians, or the training they get. The armed services seem to get this way more than the rest of us do.
Once again the reporting of The Globe staff shows us a weak link in Massachusetts' health care. We should be the leader instead of the example of a broken system.
This is a hugely complicated topic. First, as to the first two commenters, my take is that there may be more agreement between them than is evident. Hafta's comments seemed to have a flavor of the devil's advocate, and tamo's comments are clearly a reflection of a doc's perspective.
And as far as the Globe's approach to the topic, it's clear that their intentions are good. But there are at least two different topics getting fused together here. Topic 1. is docs who have been unacceptably poor performers in one way or other. Yes, it is good for people to have information about providers so they can make a personal decision about who to see. If someone has a history of criminal behavior, that's important to know. On the other hand, as tamo insinuated, malpractice information is oftentimes ambiguous. Some good doctors get chased by patients who are more of a problem than the doctor ever was. So the type of malpractic info is important, as is how it is used.
The second topic which is melded into the Globe's article here is health control cost containment. That is very much a separate topic from the type of information that is desired in this database. While there are qualitative differences between health care providers, it is simply impossible to collect, verify, and clearly document the type of information which would truly allow a person to say, "I'm going to see provider A because he/she is just as good and is less expensive than provider B". It simply cannot happen like that. Explaining that problem is worthy of a very long article, all by itself. But for starters, much of health care is related to the relationship between patient and provider. Yes, surgery and technical procedures are much less dependent on that. But primary care, mental health, pediatrics, and many other areas of health care are dependent on the subjective experience of the relationship. A computerized database simply cannot address that issue.
Criticism of the Board for not having information on the doctor in question in this case is misplaced. The doctor had a license in MA at some point. He was arrested in Pennsylvania in 2008. The offense did not happen here while he was practicing here. He hasn't practiced here in years apparently. He has been in prison since 2011 it appears. The Board took action to revoke his right to renew his MA license recently, so they preemptively told him not to come back to them when he gets out of prison.What more should they do? What patient is considering seeking treatment from him? If you google his name, his trial details come up and it is a heinous offense by an individual likely never to practice medicine again in any state in the US. It seems that the Globe and the legislature are looking to find a flaw in the Board's actions rather than to set up a system with true value for the public. The original Globe story that prompted profiles changes in the legislature was written by students looking for a story for a journalism class. It focused on the lack of a profile from one of two doctors in a malpractice case and never mentioned the profile of the other doctor who was fully licensed in MA and had the case listed. Profiles did what the law at the time required. The other doctor didn't practice here and had no local profile because the law applied to licensed MA physicians. Blame the legislature not the Board. There are plenty of areas where state govt. has room to improve and the Board is included but please write about real issues of impact to the public.
Again Patrick is showing us his incompetence and mismanagement of this State.
And again you're showing your ignorance.
The State is simply covering up or protecting those who it sees as credibly bringing benefit to the Commonwealth or the industry of medicine (including pharma, insurance etc). Doctors are like gods here in the Commonwealth so G-d forbid we should offend them. Simply the powerful protecting their own interests, not equal justice for all.
Well, the real problem is that doctors oversee doctors, just like lawyers oversee lawyers. Everybody has a vested interest.
Real regulation would involve descisions made by non-doctors only. There's no valid reason that the composition of the board be mostly M.D.'s, and there are a myriad of reasons that it should not.
We all know what happens when Wall Street is left to regulate itself. We have the same situation in medicine. It's very likely that what we see here is foot dragging by people who aren't at all enthusiastic about the information being available. If you want to see an example of that, read the post by LawyerInMass.
Our Medical Licensing system in this country is a bit like the Catholic Church. If you lose your license in one state you can always go practice in another. Until the medical community begins functioning openly and honestly with the public and leaves off the "old boy" mentality we will continue to have a contentious relationship with each other.
Sad, but true.
The "old boy" mentality indeed.
This is really not that complicated, and in the grand scheme of databases, the data set is small. In 2006, there were 23,548 licensed physicians in the state (http://www.massmed.org/AM/Template.cfm?Section=News_Releases&CONTENTID=15224&TEMPLATE=/CM/ContentDisplay.cfm)
If we round up to, say, 25,000 today, that is still a very small data set. California, which gets almost NOTHING right, has a wonderful registry that allows access not only to disciplinary actions, but to detailed transcripts of the decisions as well. Massachusetts has a history of incompetant elected officials and appointed bureaucrats, which given not only tje native talent pool but the number of people (I among them) who want to live in the state is inexcusable. but until there is a culture of excellence and accountability from the top down, there will be no substantive changes.
The assertion that this is not complicated sounds like it is coming from a member of the computer community. Sure, numbers mean nothing to a computer. They can track endless numbers. They can store endless data. But knowing which data to collect, how to frame it, and what kind of decisions can be intelligently made from it is nothing if not complicated.
DJM71-The database does not have to be built from whole cloth. The structure for the DB and the algorithms and queries have already been written for at least one other state, that is, CA. I don't know if they created their own or if they use a provider, but you clearly know nothing about DBs. This is not groundbreaking new work, and any professional worth their salt would already be in contact with other state regulators to explore possible solutions. Massachusetts tends to use words like 'complicated" as smokescreens for laziness, incompetance, or other, more nefarious motives.
http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHAUL_PRE_EXISTING_CONDITIONS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT
Speaking of HealthCare, here's some news that the Globe FORGOT to report. From the AP last Friday
2/15/13 WASHINGTON (AP) -- Citing financial concerns, the Obama administration has begun quietly winding down one of the earliest programs created by the president's health care overhaul, a plan that helps people with medical problems who can't get private insurance.
In an afternoon teleconference with state counterparts, administration officials said Friday the Pre-Existing Condition Insurance Plan will stop taking new applications. People already in the plan will not lose coverage."
Notice the AP's wording "the Obama administration has begun QUIETLY WINDING DOWN"..I guess that Obama (and HIS name is on this) has decided that you SUCKERS who thought that the "Affordable Health Care Act" is really UNAFFORDABLE. Anybody with a pre-existing condition is OUT OF LUCK.