Colorado Program Helps Doctors After Malpractice
The New York Times' "Health & Fitness" section today reports on the Institute for Physician Evaluation, a Colorado program that evaluates and "rehabilitate[s] problem doctors" after they are disciplined by state medical boards. Started in 1990, the institute was the "brainchild of an array of Colorado medical organizations" including Colorado's medical society, the state's major malpractice insurer, and a state program for addicted physicians. Last year the institute "took on national scope when the Federation of State Medical Boards and the National Board of Medical Examiners, the pre-eminent medical testing organization in the country began to sponsor" the institute's efforts. The Times reports that the institute "hope[s] it will be the first in a national network of centers for evaluating a licensed doctor's performance."
After a physician is disciplined by a state medical board, the institute evaluates the physician with a "battery of tests" over two to three days. Because "no single test" can be used to find a "problem doctor," the institute tests for "factual knowledge, common sense, hand-eye coordination, communication skill and writing ability." Also, physicians are videotaped interacting in an office setting talking to actors who impersonate patients. Consultants watch the "proceedings" and review any notes the physician wrote. After the tests, the institute presents a "verdict" on a physician in a report. The program, which is billed to the physician, costs $7,000 for out-of-state doctors, and "slightly less" for Colorado doctors. The Times reports that the institution can provide recommendations to state medical boards, but nothing it offers is "legally binding: final decisions about whether a doctor can continue to practice are the state boards' alone." The institute has evaluated more than 300 physicians over the past decade. George Dikeou, executive vice president of a Colorado-based malpractice insurer said, "We always felt most doctors who fail are salvageable. There is a huge amount of money invested in them -- if they can be saved they ought to be."
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"Only half a dozen states have programs" like Colorado's, the Times reports, and as a "first cautious step toward creating a standardized national network of such programs," representatives from other state medical boards "are being urged by sponsoring organizations to tour" the institute and "inspect its resources." But according to Dr. Sydney Wolfe, director of the Public Citizen Health Research Group, "even a national network may not overcome more fundamental problems with the system." Because state medical boards are "often hamstrung by severely limited budgets or overly close ties to a state's medical establishment," Wolfe said "boards take serious disciplinary action against too few bad doctors." Wolfe said that the institute is "only a drop in the bucket" but that it is a "good idea" because it "leads right to the larger issue of why doctors, once they are licensed, can just continue practicing without having to prove themselves periodically" (Zuger, New York Times, 7/3).