DOCTOR DISCIPLINE: Are Hospitals Covering Up Physicians’ Mistakes?

      Following a series of recent probes into physician misconduct, California investigators and consumer advocates have criticized hospitals for ignoring requirements to report "problem doctors" to state regulators, the San Francisco Chronicle reports. Critics argue that the tactic shields hospitals from legal and public scrutiny, but also "puts public health at risk." Julianne D'Angelo Fellmeth, an attorney with the University of San Diego's Center for Public Interest Law, said, "(Hospitals) are not complying, and nobody's doing a damn thing about it." Since 1995, the California Medical Board has fined hospital administrators in 11 cases for failing to file "805" reports, documents that reveal any disciplinary actions, such as a reduction or suspension of clinical privileges, taken against "questionable" physicians. After hospital officials file an 805 report, they must notify the state medical board and the National Practitioner Data Bank, a federal database that houses records on the disciplinary actions against doctors. The medical board investigates about 90% of the disciplinary reports it receives, with half of those inquiries leading to suspension or revocations of physicians' licenses. Regardless of an investigation's outcome, 805 reports are maintained in the national database. Although the database is sealed from the public, physician advocacy groups argue that including all reports could "unfairly" sabotage a doctor's career. California hospitals filed only 82 disciplinary reports last year, a decline from 282 a decade ago, leaving many state investigators questioning "how many more cases ... are out there." CMB spokesperson Candis Cohen said, "The mind kind of boggles at how much the state doesn't know." Fellmeth added, "If the hospitals don't comply, then the medical board will never know, and those physicians are free to roam about and hurt all of us."

Questionable Integrity?
     According to California Health Care Association President and CEO Duane Dauner, however, fewer 805 reports "may actually be good news." He noted that hospitals have placed "great emphasis" on correcting mistakes and "potential incidents that damage patients" in recent years, which may preclude filing 805 reports. Fellmeth disagreed, arguing that hospitals do not report violations to avoid potential lawsuits from physicians and former patients. In addition, she said that physicians are "loath" to implicate their colleagues. Fellmeth said: "[I]t is difficult to be a physician and have to tell one of your colleagues ... 'I'm sorry, you're gone, I'm going to report you to the medical board.' But that's ... their responsibility." But Dr. Richard Frankenstein, a board trustee with the California Medical Association, defended the integrity of doctors. "If the individual is indeed not qualified and could harm patients, you will not find anyone in the medical establishment (who would object to the filing of an 805 report)," he said (Wells, 8/9).