Medical Board Says Hospitals Fail to Report ‘Bad Doctors’
Based on the "steep decline" in the number of reports made by hospitals detailing the disciplining of physicians, the Medical Board of California believes that "hospitals are purposely not filing" such reports, thereby "putting patients at risk," the San Diego Union-Tribune reports. Under state law, hospitals must file a report -- commonly known as an "805" -- when they "revoke or curtail the privileges of one of their physicians over patient care issues." The purpose of these reports is to "extend disciplinary action" to any hospital in California in which a particular doctor may practice. In 1989, 282 reports were filed with the medical board, but that figure dropped to 83 in FY 1999 and 110 in FY 2000. Since the state has roughly 600 hospitals and 80,000 doctors, the numbers are "unquestionably lower than what might be reasonably expected," according to Ron Joseph, executive director of the medical board. In addition, the Union-Tribune reports that the number of patient complaints against doctors received by the medical board increased by 50% in the past decade. Still, only 56% of California hospitals "had ever reported limiting privileges of a doctor because of clinical reasons."
Critics of the current reporting system believe that many hospital administrators decide not to file reports for "fear of bad publicity" and a corresponding loss of revenue. In addition, critics say that the system is "too collegial." To toughen the review process, state Sen. Liz Figueroa (D-Fremont) introduced legislation last fall that would "increase penalties" on administrators who fail to file 805 reports when appropriate. Figueroa also suggested establishing an education and training pilot program for physicians regarding error reporting and granting the medical board the "power to perform random audits of hospital peer review reports."
Physicians and hospitals dispute allegations of "rampant" cover-ups for doctors who commit medical errors, and say that the current 805 figures simply reflect an increase in the quality of care. In testimony before the state Senate Business and Professions Committee last fall, the California Medical Association said that "focusing on the number of 805 reports makes little sense. There is no standard to judge how many or how few reports one should expect overall or in any given setting." And Dr. Robert Hertzka, chair of the CMA committee that examines actions taken by the state medical board, said, "Given that doctors have to be board-certified and go through rigorous training and retraining, the numbers should be low." In addition, physicians say that the closed peer review system helps to "shield" them from malpractice suits, "encouraging a more honest and open peer-review process." Therefore, hospital administrators will often try to resolve a physician problem in-house before filing an 805. Physicians also worry that an 805 could "torpedo" their careers, as a copy is sent to the National Practioner Data Bank (Fong, San Diego Union-Tribune, 2/18).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.