Wednesday, January 05, 2005

The Cop on the Beat...
From the New York Times today: Panel Seeks Better Disciplining of Doctors
Experts retained by the Bush administration said on Tuesday that more effective disciplining of incompetent doctors could significantly alleviate the problem of medical malpractice litigation.

As President Bush prepared to head to Illinois on Wednesday to campaign for limits on malpractice lawsuits, the experts said that states should first identify those doctors most likely to make mistakes that injure patients and lead to lawsuits.

As has been pointed out before a few bad apples are ruining the whole bunch:
Randall R. Bovbjerg, a researcher at the Urban Institute, said, "If you take the worst performers out of practice, that will have an impact" on malpractice litigation. "Most doctors have few or no claims filed against them," he added. "But within any specialty, a few doctors have a high proportion of the claims."
Medical boards have been more aggressive over time,doing a difficult job:
The boards usually have small budgets and small numbers of employees to cope with thousands of complaints each year, he said. Moreover, he said, revoking an incompetent doctor's license can take months or years and cost a great deal, especially if the case goes to a full hearing before a board of examiners.

State medical boards took 5,230 disciplinary actions against doctors in 2003, according to the Federation of State Medical Boards, the national umbrella group for the state agencies. The total was up 7 percent from 2002 and up 41 percent from 1993.
Medical boards have extensive due process provisions, because if you lose a license in one state it is virtually impossible to keep, much less obtain, a license. Massachutsetts is cited as an example to follow:
Without waiting for a complaint to be filed, the Massachusetts Board of Registration in Medicine conducts a clinical review of any doctor who has made three or more malpractice payments to patients as a result of jury verdicts or settlements.

Nancy Achin Audesse, executive director of the board, said: "Three is a magic number. Doctors who have to make three or more payments are also more likely to be named in consumer complaints and to be subject to discipline by hospitals and the medical board."

In Massachusetts in the last 10 years, Ms. Audesse said, "one-fourth of 1 percent of all the doctors - 98 of the 37,369 doctors - accounted for more than 13 percent of all the malpractice payments, $134 million of the $1 billion in total payments."
In Georgia if you have a judgment or settlement of over $100,000 the Board of Medical Examiners gets involved, regardless of previous claim history.
Perhaps state boards could devote more time and effort to quality assurance and less time on junk like this.
The boards need to step forward because of the obstacles placed in the way of medical staff intervention concerning quality of care.
Now in what may be described as the alter-ego of the infamous DoctorsKnow a site which "unmasks" the evil among us:Questionable Doctors has data about the number of "Serious Doctor Disciplinary Actions" by state medical boards.
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