What You Don't Know About Your Doctor Could Hurt You

[DokterMom]

Why is no one talking about this?

I subscribe to Consumer Reports but often have a hard time getting around to reading it. So the latest issue has been sitting on my desk for more than a week with the prominent headline:

"What You Don't Know About Your Doctor Could Hurt You"

Despite the attention-grabbing headline, CR is not, by nature, a sensationalizing publication, and the article is well worth reading with an important and well-substantiated premise that I'm surprised no one here is talking about -- in short, that the public is entitled to be able to find out if their physicians have been subject to disciplinary actions by their state medical boards:

http://www.consumerreports.org/cro/...ow-about-your-doctor-could-hurt-you/index.htm'

We all know how long and hard the process is to become a physician, and clearly, no one is in favor of yanking someone's credentials and livelihood lightly. Yet we also know every barrel contains a few bad apples who, in some cases, are a danger to the public.

What should be done? Can we talk about it? Is the medical profession doing enough to police itself? Or must the government step in?

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[gators21]

no...just no

 

[criticalelement]

Why is no one talking about this?

I subscribe to Consumer Reports but often have a hard time getting around to reading it. So the latest issue has been sitting on my desk for more than a week with the prominent headline:

"What You Don't Know About Your Doctor Could Hurt You"

Despite the attention-grabbing headline, CR is not, by nature, a sensationalizing publication, and the article is well worth reading with an important and well-substantiated premise that I'm surprised no one here is talking about -- in short, that the public is entitled to be able to find out if their physicians have been subject to disciplinary actions by their state medical boards:

http://www.consumerreports.org/cro/...ow-about-your-doctor-could-hurt-you/index.htm'

We all know how long and hard the process is to become a physician, and clearly, no one is in favor of yanking someone's credentials and livelihood lightly. Yet we also know every barrel contains a few bad apples who, in some cases, are a danger to the public.

What should be done? Can we talk about it? Is the medical profession doing enough to police itself? Or must the government step in?

What are you talking about? The state medical boards are reprimanding, fining, revoking suspending licenses like crazy.. and it is all public information.. easily found with one click of the mouse.

 

[DokterMom]

What are you talking about? The state medical boards are reprimanding, fining, revoking suspending licenses like crazy.. and it is all public information.. easily found with one click of the mouse.

What click is that? I'm asking about a way for ordinary patients to be able to find this information --

 

[Cinclus]

I believe that most popular physician "review" websites allow users to easily determine if any suits have been won against a doctor and even if a physician has chosen to settle (the latter being kinda messed up to display, because it is often easier and more cost effective to just settle than to do anything further, regardless of your innocence, but it doesn't look great to have that displayed).

 

[NotAProgDirector]

First of all, I think it's a pretty snazzy website layout, with the infographics embedded and clever use of scrolling.

It's a big problem, without a clear solution. Dangerous physicians clearly need to be removed from practice. But the question is, how much of "a second chance" do you give physicians? Substance abuse is a good litmus test. If a physician is addcited to substances, I expect that if they can get clean, they can be a good doc. Is it "fair" to end their career, or give them a second chance? Many medical boards have a process that if the physician self refers for substance issues, they get help and don't get reprimanded and punished -- that encourages people to self report, which is probably best for everyone.

Just posting information online can be unfair. For example, I was involved with a very public medmal case. I had nothing to do with the error involved, but I was involved in the patient's care. Ended up on the front page of the national news. I ended up with an adverse judgment in the NPDB (the hospital settled, it was clearly their fault). But I had to fight to clear out my record. But imagine the damage this would have done if it was completely public, right at the beginning of my career.

There probably is a better balance. Medical boards are probably too lenient for some/many cases. Increased public scrutiny might fix that. I might be in favor of an exception for substance abuse when no patients have been harmed -- allowing physicians to self report, get help and close monitoring, and allowed to continue practicing with ongoing substance monitoring. But the cost will be someone who subverts the system once in awhile -- and makes big news when they do it.

 

[Tenk]

Next thing you know people will come into the ER and threaten to give me a bad Yelp review if I don't write them off work with some Percocet.

 

[Cinclus]

Next thing you know people will come into the ER and threaten to give me a bad Yelp review if I don't write them off work with some Percocet.

I think I heard about this in a song one time...specifically around 1:02-1:08 minutes.

 

[Stagg737]

Why is no one talking about this?

I subscribe to Consumer Reports but often have a hard time getting around to reading it. So the latest issue has been sitting on my desk for more than a week with the prominent headline:

"What You Don't Know About Your Doctor Could Hurt You"

Despite the attention-grabbing headline, CR is not, by nature, a sensationalizing publication, and the article is well worth reading with an important and well-substantiated premise that I'm surprised no one here is talking about -- in short, that the public is entitled to be able to find out if their physicians have been subject to disciplinary actions by their state medical boards:

http://www.consumerreports.org/cro/...ow-about-your-doctor-could-hurt-you/index.htm'

We all know how long and hard the process is to become a physician, and clearly, no one is in favor of yanking someone's credentials and livelihood lightly. Yet we also know every barrel contains a few bad apples who, in some cases, are a danger to the public.

What should be done? Can we talk about it? Is the medical profession doing enough to police itself? Or must the government step in?

If you google 'medical board disciplinary actions' there are multiple links that show how to access physician's disciplinary actions in each state. It literally takes 30 seconds for a patient to figure out how to find their physician's record with the state medical board if they actually want to, and over 40 of those states you can find the info online.

 

[Psai]

What click is that? I'm asking about a way for ordinary patients to be able to find this information --

They post everything about a doctor from their med school and residency to their home address and phone number on multiple sites online. It's not hard for ordinary people to find anything they want

 

[mistafab]

Here is an article on the topic:

http://www.medscape.com/viewarticle/861028

TL;DR - Even if you make board actions more transparent (they already are), you have to deal with huge amounts of variance based on stupid factors, like geography.

Another one (DJ Khaled):

http://www.medscape.com/viewarticle/849453

TL;DR - Gender plays a role in this somehow

...and another one:

http://www.medscape.com/viewarticle/853911

TL;DR - Even fraudulent claims against doctors can end up hurting them

 

[DokterMom]

They post everything about a doctor from their med school and residency to their home address and phone number on multiple sites online. It's not hard for ordinary people to find anything they want

Medical school and residency - sure. Though how much good that would do helping a patient make an informed decision is debatable. Home address? There's just no good reason to publish that...

Next thing you know people will come into the ER and threaten to give me a bad Yelp review if I don't write them off work with some Percocet.

That's also a valid concern -- Though presumably, patients going to the ER for legitimate medical reasons won't really be in a position to do much due diligence prior to their visits. OMG - Is this a heart attack? Better see who's on duty and check them out first...

I believe that most popular physician "review" websites allow users to easily determine if any suits have been won against a doctor and even if a physician has chosen to settle (the latter being kinda messed up to display, because it is often easier and more cost effective to just settle than to do anything further, regardless of your innocence, but it doesn't look great to have that displayed).

The 4-5 popular physician review sites I've seen do NOT show this information, though I suppose there's some that may. You're right that 'nuisance' and 'frivolous' suit information could be unfairly prejudicial, but knowing there were multiple suits against a particular physician would be relevant and appropriate.

If you google 'medical board disciplinary actions' there are multiple links that show how to access physician's disciplinary actions in each state. It literally takes 30 seconds for a patient to figure out how to find their physician's record with the state medical board if they actually want to, and over 40 of those states you can find the info online.

That actually did work, eventually, but for my state (Texas), it was far from a simple 30-second process. I had previously googled 'physician review' and got only those useless Yelp-type sites. I suspect most patients who attempt any sort of due diligence do that instead of "medical board disciplinary actions" and get only similarly-useless information.

What I'm really talking about is a way for patients to protect themselves from the Christopher Duntsches of the world without, as @aProgDirector alludes to, unfairly crucifying a generally competent provider. By the time the Duntsch information was publicly available, dozens of patients had been harmed, some irreparably. (http://healthcare.dmagazine.com/201...topher-duntsch-the-jailed-plano-neurosurgeon/)

I'd like to see the medical profession do a little more to protect the public and police itself before the government decides it needs to step in and "help". Some sort of credible 'official' site sponsored by medical board, medicare, government, or health insurance company would be very welcome.

 

[16candles]

Medical school and residency - sure. Though how much good that would do helping a patient make an informed decision is debatable. Home address? There's just no good reason to publish that...

I'd like to see the medical profession do a little more to protect the public and police itself before the government decides it needs to step in and "help". Some sort of credible 'official' site sponsored by medical board, medicare, government, or health insurance company would be very welcome.

Definitely needed. A good reference for state medical boards is here.

 

[Cinclus]

The 4-5 popular physician review sites I've seen do NOT show this information, though I suppose there's some that may. You're right that 'nuisance' and 'frivolous' suit information could be unfairly prejudicial, but knowing there were multiple suits against a particular physician would be relevant and appropriate.

I just went to Healthgrades, a very popular physician review website, and it is on the first page that comes up when you pull up a particular physician. I circled the relevant links in my screenshot.

 

[DokterMom]

I just went to Healthgrades, a very popular physician review website, and it is on the first page that comes up when you pull up a particular physician. I circled the relevant links in my screenshot.

What now that's interesting... I had some serious doubts about my son's former pediatrician, so sought information about him online several times over the past years. He's been my 'search guinea pig'. His Healthgrades profile shown no suits and no sanctions. However his 'medical board disciplinary actions' Google search shows both a malpractice lawsuit and DWI conviction, both during the time frame when he was treating my child.

 

[W19]

In FL, the medical board basically displays your life in your license: med school attended, place you did your residency/fellowship, board certification, hospital privilege(s), financial responsibility (i.e malpractice coverage), disciplinary action(s) (or proceedings and actions as they call it), languages spoken at your practice, optional information etc...

There is one doc I know that they put on his license that there should always be a chaperone in the room when he is seeing female patients...

 

[Mad Jack]

Next thing you know people will come into the ER and threaten to give me a bad Yelp review if I don't write them off work with some Percocet.

Well, given that patient pain management scores factor into reviews at many hospitals, that's basically what's happening already in many places.

 

[16candles]

Well, given that patient pain management scores factor into reviews at many hospitals, that's basically what's happening already in many places.

HCAHPS scores are being used for all US hospitals that rely on CMS Value-Based Purchasing for reimbursement (so, basically, all of them). And yes, pain management is one of the dimensions patients are scoring hospitals on, so this is a big deal. Just ask your nonprofit hospital CEO or CFO.

 

[Stagg737]

That actually did work, eventually, but for my state (Texas), it was far from a simple 30-second process. I had previously googled 'physician review' and got only those useless Yelp-type sites. I suspect most patients who attempt any sort of due diligence do that instead of "medical board disciplinary actions" and get only similarly-useless information.

What I'm really talking about is a way for patients to protect themselves from the Christopher Duntsches of the world without, as @aProgDirector alludes to, unfairly crucifying a generally competent provider. By the time the Duntsch information was publicly available, dozens of patients had been harmed, some irreparably. (http://healthcare.dmagazine.com/201...topher-duntsch-the-jailed-plano-neurosurgeon/)

I'd like to see the medical profession do a little more to protect the public and police itself before the government decides it needs to step in and "help". Some sort of credible 'official' site sponsored by medical board, medicare, government, or health insurance company would be very welcome.

I googled "medical disciplinary board texas" and found the website that lets you look up any physician as the first hit and this was about 4 links down:
https://www.tsbep.texas.gov/board-licensees-with-disciplinary-sanctions

Also, I said it takes 30 seconds to figure out how to find the info, not to actually get it. I agree that the public should be able to see, relatively easily, if their physician has had disciplinary actions brought against them and for what reason. However, I think seeing lawsuits brought against them is realistically useless and potentially dangerous info against docs because of the number of them which are frivolous or basically scams.

 

[VA Hopeful Dr]

What click is that? I'm asking about a way for ordinary patients to be able to find this information --

Seriously? Google "<your state> medical board". Most have a big link for Licensee lookup or something similar. Super easy.

 

[Rekt]

Seriously? Google "<your state> medical board". Most have a big link for Licensee lookup or something similar. Super easy.

Some even have a PDF right on the same page regarding any board actions and you can just read it.

 

[Brahnold Bloodaxe]

I think it's pretty darn shameful that lawsuits and complaints that never end up going anywhere due to their complete frivolity still end up on physicians' official public records for everyone to see. Not only is this completely unfair, but it leaves us open to extortion or at the least to petty vengeance. I can arbitrarily lodge a complaint or file a suit against any physician if I were so inclined, and it would forever be part of that doc's public record regardless of whether there was one iota of substance behind my action. Yeah I get it the world isn't far and there is no easy way to force third party services like Healthgrades or Yelp to be conscientious, but I'd have expected better from the actual Medical Boards.

 

[VA Hopeful Dr]

I think it's pretty darn shameful that lawsuits and complaints that never end up going anywhere due to their complete frivolity still end up on physicians' official public records for everyone to see. Not only is this completely unfair, but it leaves us open to extortion or at the least to petty vengeance. I can arbitrarily lodge a complaint or file a suit against any physician if I were so inclined, and it would forever be part of that doc's public record regardless of whether there was one iota of substance behind my action. Yeah I get it the world isn't far and there is no easy way to force third party services like Healthgrades or Yelp to be conscientious, but I'd have expected better from the actual Medical Boards.

Uhh, that's not at all how this works. A complaint to the medical board that doesn't result in any action (only investigation) does not show up on any public records. Same thing for lawsuits that don't get settled or that you lose. If you win or get dropped, it doesn't go on the NPDB.

 

[Brahnold Bloodaxe]

^^Thanks for clarifying that.

 

[oncology2020]

Disciplinary actions by the state board and court cases are already public information. We do not need to be policed anymore than we already are, physicians are held to higher standards than our own politicians. Setting up a review based system of physicians that would be visible to everyone would be a terrible idea--you can save a patients life who comes in with septic shock but they will remain disatisfied by their physician for serving them a tuna sandwich instead of the roast beef sandwich that they had requested--yes this actually happened. This is also why tying reimbursement with patient satisfaction results was one of the dumbest ideas ever..

The only instance where user reviews for a physician should matter would be for elective or cosmetic procedures where you are choosing to undergo a procedure and paying someone for their service out of pocket.

 

[criticalelement]

danger,, grave danger... is there any other kind?

 

[gracie369]

I'd like to see the medical profession do a little more to protect the public and police itself before the government decides it needs to step in and "help". Some sort of credible 'official' site sponsored by medical board, medicare, government, or health insurance company would be very welcome.

This is the reason why I explain things to patients like they have the education of a sixth grader. Our licenses are already controlled by the state government. We need more federal government and health insurance control like we need another hole in our heads. Stop looking to the federal government to solve all of your problems. It's not the answer. I'm not even sure to tell you where to begin. Maybe you would be much happier in communist China.

 

[DokterMom]

This is the reason why I explain things to patients like they have the education of a sixth grader. Our licenses are already controlled by the state government. We need more federal government and health insurance control like we need another hole in our heads. Stop looking to the federal government to solve all of your problems. It's not the answer. I'm not even sure to tell you where to begin. Maybe you would be much happier in communist China.

Please read a bit more carefully. I am not looking for the government to step in at all. OR suggesting that it should. Just suggesting that if some organization within the medical field does not meet the perceived need for consumer safeguards, the government might feel compelled to step in and "solve" the problem. (Note that "solve" is in quotation marks.)

The publication I cited is a widely-read consumer-protection magazine that offers unbiased reviews of products, financial services, and the like geared toward an informed audience, not a fear-mongering tabloid. They've been in business for decades, and consistently advocate science over popular pseudo-scientific crap. They do their research --

What I am saying is that the general public feels that reliable information about bad doctors (substance addicted, incompetent, sexually abusive, felonious -- the kind of truly scary thing you read about in the papers) is not readily available to them. While there do appear to be ways for the public to access this information (thanks to all who pointed out the state medical board sites, productive search terms, etc.), the public perception is still out there that unsafe doctors continue to practice nearly unfettered, and that as a profession, doctors tend to 'circle the wagons' and shield their own. The public perception exists that there are insufficient safeguards in place to alert and protect the public from physicians who have (post-licensing) shown themselves to be incompetent or otherwise dangerous.

That public perception is a real problem that can be addressed by the medical profession or by someone else. I'd prefer the medical profession be the one to deal with it, as they are far better able to police their own -- to detect patterns of carelessness and incompetence, and to distinguish the frivolous lawsuits from the legitimate claims.

 

[VA Hopeful Dr]

What I am saying is that the general public feels that reliable information about bad doctors (substance addicted, incompetent, sexually abusive, felonious -- the kind of truly scary thing you read about in the papers) is not readily available to them. While there do appear to be ways for the public to access this information (thanks to all who pointed out the state medical board sites, productive search terms, etc.), the public perception is still out there that unsafe doctors continue to practice nearly unfettered, and that as a profession, doctors tend to 'circle the wagons' and shield their own. The public perception exists that there are insufficient safeguards in place to alert and protect the public from physicians who have (post-licensing) shown themselves to be incompetent or otherwise dangerous.

You're correct about the public perception, and it is troubling. However, and forgive me for sounding trite, but wait until you actually are a doctor and you'll think about this differently.

We all come across other physicians that we see doing things that are unwise if not outright dangerous. The problem is, reporting another physician is fraught with complications. First, if they find out you ratted them out you're just asking for them to retaliate. As I think most here have learned by now, doctors tend to be a narcissistic lot and narcissists don't take kindly to getting in trouble. Second, we all make mistakes from time to time. Unless you are perfect, the inclination is to give others the benefit of the doubt since it could be just an honest mistake and its not worth potentially ruining someone's career when a few years from now it could be you in the same situation. Third, and this isn't unique to medicine, often times the worst doctors have the best personalities and so have powerful friends.

Trouble is, I don't really know what to do about this that doesn't have great potential to make things worse. My general advice that I give is to ask your PCP (or doctor friends/family) if Dr. So-and-so is good. Word does get around about crappy docs, at least to other doctors, so we can steer people away from those that are less than great. As an aside, this is the danger to working for a large health system. If you don't refer to other employed docs, you will get called on it. Trouble is, what if the employed docs aren't as good?

 

[DokterMom]

You're correct about the public perception, and it is troubling. However, and forgive me for sounding trite, but wait until you actually are a doctor and you'll think about this differently.

We all come across other physicians that we see doing things that are unwise if not outright dangerous. The problem is, reporting another physician is fraught with complications. First, if they find out you ratted them out you're just asking for them to retaliate. As I think most here have learned by now, doctors tend to be a narcissistic lot and narcissists don't take kindly to getting in trouble. Second, we all make mistakes from time to time. Unless you are perfect, the inclination is to give others the benefit of the doubt since it could be just an honest mistake and its not worth potentially ruining someone's career when a few years from now it could be you in the same situation. Third, and this isn't unique to medicine, often times the worst doctors have the best personalities and so have powerful friends.

Trouble is, I don't really know what to do about this that doesn't have great potential to make things worse. My general advice that I give is to ask your PCP (or doctor friends/family) if Dr. So-and-so is good. Word does get around about crappy docs, at least to other doctors, so we can steer people away from those that are less than great. As an aside, this is the danger to working for a large health system. If you don't refer to other employed docs, you will get called on it. Trouble is, what if the employed docs aren't as good?

Thanks for the insightful and responsive post --
And you're so right about narcissists and how they detest being embarrassed. Hell hath no fury like a narcissist scorned.

 

[VA Hopeful Dr]

Thanks for the insightful and responsive post --
And you're so right about narcissists and how they detest being embarrassed. Hell hath no fury like a narcissist scorned.

Its both sad and infuriating, but the longer I'm in medicine the more I dislike doctors. And its one of those things where most are fine people doing their best, but just enough are the absolute worst kind of dingus that it colors everything.

 

[Psai]

Its both sad and infuriating, but the longer I'm in medicine the more I dislike doctors. And its one of those things where most are fine people doing their best, but just enough are the absolute worst kind of dingus that it colors everything.