The NPDB Shut Down: Even Worse Than Texas Malpractice Law?

The national consumer group Public Citizen has a dynamite new study out today called "A Failed Experiment; Health Care in Texas Has Worsened in Key Respects Since State Instituted Liability Caps in 2003."  Like the Texas Watch report released a short time ago, here is some of what Public Citizen found:

• Per-enrollee Medicare spending in Texas has risen 13 percent faster than the national average;
• Medicare spending specifically for outpatient services in Texas has risen 30.7 percent faster than the national average;
• Medicare diagnostic testing expenditures in Texas have risen 25.6 percent faster than the national average;
• Premiums for private health insurance in Texas have risen faster (51.7 percent) than the national average (50 percent);
• The percentage of Texans who lack health insurance has risen to 24.6 percent, solidifying the state’s dubious distinction of having the highest uninsured rate in the country;
• The per capita increase in the number of doctors practicing in Texas has slowed to less than half its rate in the years leading up to the caps;
• The per capita number of primary care physicians practicing in Texas has remained flat, compared to a sharp increase in the years leading up to the caps; and
• The prevalence of physicians in non-metropolitan areas has declined.

Now, this would be important news on its own given how Texas is often touted as the new “gold standard” by the insurance and medical lobbies.  That would be if you define “gold” as decimating patients’ legal rights and making sure everyday people with real injuries due to real negligence no longer have access to the courts.  And ensuring that patient safety takes a huge nosedive. 

But there’s another critical news angle here that may shock you even more. Public Citizen’s important research in the health care field, such as today’s report on Texas, often relies heavily on data from the National Practitioner Data Bank (NPDB). (See also, e.g., here.)  This is a databank containing the malpractice and disciplinary records of physicians – but the identities of the actual bad doctors are protected from any public disclosure. 

Now, it’s bad enough that the NPDB data is mostly secret.  Only institutions like hospitals have access to most of it.  The many calls to open it up have so far gone nowhere. (See here, here). 

But a small amount of information is available publicly, so at least researchers can obtain important information about the state of patient safety in this country.

However last month, the Obama administration took the extraordinary step of shutting down the public part of the database, claiming that a journalist was able to use the database to find out too much about a  doctor with 16 malpractice claims.  Oh no, thanks to the investigative work of a journalist, the public was able to learn about the terrible malpractice record of this doctor!  Time to shut the whole thing down!  Huh?

This sparked outrage from every sector you can imagine.  The New York Times prescription blog wrote last week:

Senator Charles E. Grassley on Friday joined with dozens of academic researchers, consumer groups and journalism organizations who have protested an Obama administration decision to pull off the Web a database of doctor malpractice and disciplinary cases.

In a strongly worded letter, the Iowa Republican, who has led investigations of fraud and waste in government health programs, said the now-removed file “serves as the backbone in providing transparency for bad-acting health care professionals.” Senator Grassley asked the Health Resources and Services Administration of the Department of Health and Human Services to provide an in-depth briefing, answer questions and release internal documents by Oct. 21. …

Twenty-three academic researchers also protested the decision in a letter dated Sept. 22. By removing the file at the request of a physician with 16 malpractice claims, the researchers wrote, the government “took a large step in the direction of the ‘bad old days’ when secrecy prevailed and providers’ interests took precedence over patients’ safety and well-being.”

 So read up on the Public Citizen report while you can.  Let’s hope it’s not the last.

Comments

[Andrea]

It is outrageous that the data bank was shut down. Yet another example of wrongdoers being permitted to cover and hide their activities.

[Christopher Mellino]

Hello there, I enjoyed reading your summation of the NPDB and absolutely agree with the conclusions found in the report you linked to. Thanks for sharing. I think your readers would enjoy this similarly anecdotal lesson in the error of medical malpractice caps.

http://www.christophermellino.com/2011/09/medical-malpractice-caps-are-unfair-and-inequitable-for-affected-individuals/