Removal of Online Malpractice Data Sparks Outcry

September 17, 2011

September 17, 2011 — Journalists and consumer groups are calling on a federal agency to reverse its decision to remove a public data file on payments in medical malpractice cases and clinician disciplinary actions from the National Practitioner Data Bank (NPDB) Web site.

The Health Resources and Services Administration (HRSA), which operates the NPDB, removed the file from the Web site on September 1 after news organizations such as the Kansas City Star managed to use it to identify physicians frequently accused of malpractice who went undisciplined by state medical boards. The NPDB data does not include physician names or addresses, but journalists have traced the data to individuals by piecing it together with other data sources.

"Federal law mandates that information about individual physicians remains confidential," HRSA spokesperson Martin Kramer told Medscape Medical News. "We have a responsibility to make sure federal law is being followed."

Individual researchers can still access the malpractice data by contacting the NPDB, and HRSA may post it online again after the agency figures out how to prevent clinicians, patients, and healthcare organizations from being outed. That deliberation will take at least 6 months, according to HRSA.

In the meantime, a group called Investigative Reporters & Editors has posted a copy of the file — downloaded from the NPDB Web site in August — on its own Web site.

The IRE along with the Society of Professional Journalists and the Association of Health Care Journalists sent a letter to HRSA Administrator Mary Wakefield on September 15 asking her to repost the so-called Public Use Data File on the NPDB Web site.

"The Public Use (Data) File...provided invaluable information about the functioning of state medical boards and hospital disciplinary systems," the letter stated. "Reporters for years have used the data to identify flaws in their states' regulatory systems that have led to patient harm. As a result of these stories, states have enacted new legislation and medical boards have taken steps to investigate problem doctors."

The journalism associations also said they disapproved of an intimidating letter that HRSA sent to Kansas City Star reporter Alan Bavley about a story that he was researching with the help of NPDB information about a much-sued neurosurgeon. That news story was published on September 3.

AMA Applauds Removal of Online Malpractice Data

Other groups that have demanded the reposting of the malpractice data include Consumer Union, the publisher of Consumer Reports; and the watchdog group Public Citizen. The groups wrote in separate letters to HRSA that its decision to take the information off the NPDB Web site runs counter to a push for more transparency within the Department of Health and Human Services and other government agencies.

One group that applauded HRSA's action is the American Medical Association (AMA), which considers the NPDB an unreliable source of information about the overall qualifications of physicians.

"The AMA has long opposed public access to the National Practitioner Data Bank and welcomes the decision to stop posting its public data file online to prevent breaches of physician confidentiality in the future," AMA President Peter Carmel said in a written statement. "Duplicate entries, inaccurate data, and inappropriate information in the NPDB provide, at best, an incomplete and haphazard indicator of a physician's competence or quality."

Congress created the NPDB in 1986 to give hospitals, insurers, state medical boards, and other government entities a way to check up on physicians, dentists, and other licensed healthcare professionals. The Public Use Data File contains information reported to the NPDB on such matters as:

  • Payments in medical malpractice cases (settlements as well as jury awards)

  • Adverse actions on licensure, clinical privileges, and membership in professional societies

  • Adverse actions taken by the Drug Enforcement Administration

  • Exclusion from Medicare and Medicaid

  • Criminal convictions

In the past, the online file had been updated quarterly, but Public Citizen complained in its letter to HRSA that, earlier this year, updates "have not been posted in a timely fashion."

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