Many Hospitals Do Not Report Action Against Doctors to Database
Many U.S. hospitals do not take sufficient disciplinary action against physicians for poor conduct or medical incompetence and fail to report such cases to the National Practitioner Data Bank, according to a Public Citizen report released Wednesday, the Contra Costa Times reports (Kleffman, Contra Costa Times, 5/27).
Congress established the databank in 1990 as a central repository for information about physicians whose hospital privileges had been withdrawn or limited for more than 30 days. The bank is closed to the public.
For the report, Public Citizen's Health Research Group analyzed studies by the HHS Office of Inspector General and the Citizen Advocacy Center, as well as medical journal articles and recommendations made during an October 1996 meeting on under-reporting by hospitals (Stark/Hallihan, ABCNews.com, 5/27).
According to the report, nearly half of U.S. hospitals did not submit one physician's name in 17 years to the databank.
In California, about 32% of facilities did not report a physician to the databank from 1990 to 2008.
The Times attributes California hospitals' higher reporting rate to state laws that let California fine hospitals that do not report some disciplinary actions to the California Medical Board.
Under the initial expectations of the databank, federal officials estimated that at least 5,000 disciplinary cases would be reported annually. However, on average, about 650 reports have been made annually since the databank was created, the report found.
On Wednesday, the group sent a letter to HHS Secretary Kathleen Sebelius that included recommendations to improve the efficacy of the databank. The letter said that the reporting numbers are "unreasonably low, compared with what would be expected if hospitals pursued disciplinary actions aggressively and reported all such actions."
The letter urged Sebelius to ensure that hospitals are conducting necessary peer reviews and oversight of physicians, taking proper disciplinary actions and reporting them to the databank so that physicians' track records are available to all hospital administrators.
Penalties also should be established for hospitals that fail to comply with the reporting requirements, the group said (Contra Costa Times, 5/27).
Public Citizen also called on the Obama administration to push for legislation permitting fines for each case in which a hospital does not file a report (Clark, HealthLeaders Media, 5/27).
Al Levine, the author of the report, said some hospitals had found ways to avoid their physician reporting responsibilities, such as by limiting hospital privileges to fewer than 30 days or giving physicians a "leave of absence" in place of suspending their privileges. Levine said, "Even in states with high levels of reporting," it "seems to be concentrated in a few facilities" (Contra Costa Times, 5/27).In a statement responding to the report, the American Hospital Association said, "The premise that the number of reports received by the National Practitioner Data Bank correlates to jeopardized patient care is inaccurate," adding, "Hospitals are actively involved in a wide variety of efforts to continuously improve care and talk publicly about the care we provide" (ABCNews.com, 5/27). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.