Our relationship with patients is a partnership—just as we gather information about our patients for their health care, patients should have access to information about us as well. But, the information provided to patients should be accurate, complete and support their ability to make informed decisions. Without these safeguards, patients will be encouraged to make ill-informed decisions about their physicians based on misleading and incomplete data.
A state-held responsibility
Currently, states are vested with the authority to evaluate the impact of medical liability settlements on physician competency. A recent proposal, from Consumer Reports, wants to place this responsibility in the hands of the federal government by allowing patients’ access to the flawed National Practitioner Data Bank which holds unanalyzed, raw data on physicians.
Patients should have access to reliable information about physicians, and state regulatory agencies—not the federal government–are best positioned to offer well-balanced information to help patients make informed decisions regarding physicians—for two reasons.
An inaccurate data bank
First, judicious and complete information that many states are working to give patients stands in stark contrast to information contained in the inherently flawed National Practitioner Data Bank. The Government Accountability Office (GAO) has said that its “detailed tests raise serious concerns about the integrity of National Practitioner Data Bank information.” The GAO found that the data bank is riddled with duplicate entries, inaccurate data and incomplete and inappropriate information.
This responsibility should rest with state regulatory agencies which already provide patients with reliable, well-balanced and complete information on physicians. State regulators are best suited to evaluate and determine how liability settlements reflect a physician’s competency. Failing to provide this important investigative safeguard distorts the true picture of the quality of health care we deliver.
Physicians take on risk to help their patients
Second, a vast majority of reports in the National Practitioner Data Bank are based on legal settlements that were never adjudicated by a court, never proven to involve negligence or never settled with the consent of a physician. Consequently, settlement information offers an incomplete and often misleading indicator of physician quality and competence.
Sometimes, a hospital or a physician determines that they will take less of a financial hit by settling as opposed to litigating a claim, even when no negligence has occurred.
The nation's best physicians who practice cutting-edge medicine take on the riskiest cases, yet the National Practitioner Data Bank information does not acknowledge their high-level of competence, but rather focuses only on the fact that they are involved in settlements.
Information on truly negligent practitioners absolutely should be disclosed to the public. However, the relationship of medical liability claims to physician skill is ambiguous. State governments have recognized this and require their regulatory agencies to provide an investigative review of medical liability records rather than simply disseminating unreliable legal data to patients. The information provided to our patients must be based on the true competency of a physician with much weight put on the risks they were willing to take for their patients.
As physician representatives, the AMA agrees with the conclusions of Congress, prominent commissions, institutes and other health care leaders who have found that opening the National Practitioner Data Bank would not help patients. We must ensure that our patients are accurately informed and to ensure this, the best approach is to enhance the state-based investigative and reporting systems already in place.
