State medical boards are hybrids: part independent regulator, part industry association. They are in charge of handing down professional probations against doctors who do wrong, but the details of which doctors are on probation, and why, are kept from patients.
Until now. Using Freedom of Information requests, Consumer Reports has extracted doctors' probation records for California, assembling them into a searchable spreadsheet.
An accompanying feature highlights the inadequacy of the probation system and the extent to which the medical profession seems more interested in protecting its members than protecting the patients. Doctors who've been put on probation — rather than being prohibited from practicing — have done things like performed surgery while intoxicated, leading to the removal of healthy organs (leaving diseased organs in place). What's more, the medical associations overwhelmingly object to doctors being required to inform their patents if they're on probation, and take steps to block patients' ability to look up their doctors' probationary records.
Sites like Yelp, which include reviews of doctors, don't do a good job of calling attention to doctors' documented misconduct. Doctors who've admitted to sexually assaulting their patients, or botching procedures due to negligence, still score high on online review boards.
Most interesting to me was the small number of doctors responsible for complaints, probation, and malpractice payouts. The normal line about doctors and patients is that ambulance-chasing lawyers have painted a target on the back of every doctor, forcing them to resort to mandatory binding arbitration waivers as a condition of care, and gag orders that patients must sign before being seen.
But the numbers tell a different story: malpractice payouts come from a tiny number of doctors whose negligence is undeniable. If you're a doctor and your insurer is paying out to a patient, chances are it's because you did something really bad. Rather than rooting out this minority and making patients safer and doctors more reputable, the professional associations are providing cover for them, hiding their sins behind obfuscation and official secrecy. It's not that patients are suing and threatening doctors willy-nilly: rather, a tiny number of doctors are ruining the lives of some of their patients, leading to massive payouts, which are nevertheless too little, too late.
A VERY SMALL PERCENTAGE OF DOCTORS have accounted for most of the country's medical malpractice payouts over the last quarter century. That's according to an analysis done for Consumer Reports of the National Practitioner Data Bank, a federal repository that has collected disciplinary actions and medical malpractice payouts since 1990.
Robert E. Oshel, who worked as the associate director for research and disputes at the NPDB for almost 15 years until he retired in 2008, ran the numbers and figured out that less than 2 percent of the nation's doctors have been responsible for half of the total payouts since the government began collecting malpractice information.
Malpractice is considered an inexact indication of substandard care, for many reasons. Cases often settle before trial and without documented findings of wrongdoing. And even the best doctors and surgeons can sometimes face lawsuits.
"Still," Oshel says, "when doctors have multiple large settlements against them, it can be a warning sign … suggesting that if licensing boards and hospital peer reviewers were willing to either get these doctors to stop practicing or get retraining, we'd all be better off."