Dangerous Doctors Allowed to Keep Practicing

By Peter Eisler and Barbara Hansen
USA Today
Originally published August 20, 2013

Here is an excerpt:

Despite years of criticism, the nation's state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct that puts patients at risk, a USA TODAY investigation shows. Many of the doctors have been barred by hospitals or other medical facilities; hundreds have paid millions of dollars to resolve malpractice claims. Yet their medical licenses — and their ability to inflict harm — remain intact.

The problem isn't universal. Some state boards have responded to complaints and become more transparent and aggressive in policing bad doctors.

But state and federal records still paint a grim picture of a physician oversight system that often is slow to act, quick to excuse problems, and struggling to manage workloads in an era of tight state budgets.

USA TODAY reviewed records from multiple sources, including the public file of the National Practitioner Data Bank, a federal repository set up to help medical boards track physicians' license records, malpractice payments, and disciplinary actions imposed by hospitals, HMOs and other institutions that manage doctors. By law, reports must be filed with the Data Bank when any of the nation's 878,000 licensed doctors face "adverse actions" — and the reports are intended to be monitored closely by medical boards.

The entire narrative and video story is here.

Will Patient Safety Initiatives Harm Physicians?

By Brian S. Kern, Esquire
Medscape Today News
Originally published on March 12, 2012

Peer review, the patient safety method designed to identify ineffective, unethical, or impaired physicians, can help improve the delivery of medical care, provide risk-management lessons, and lead to improved policies and procedures. At the same time, some doctors and hospital administrators have expressed concern that peer review produces fodder for civil or criminal lawsuits against physicians and healthcare institutions.

The body of law on patient safety initiatives and their level of confidentiality has evolved considerably. Historically, case law, recognizing the importance of peer-review procedures -- and the need to keep them confidential -- has protected self-critical analysis and other forms of internal investigation.

For example, in Christy v. Salem (2004), a New Jersey appellate court addressed whether a hospital's peer-review committee report was discoverable in a medical malpractice case. In declining to "adopt the privilege of self-critical analysis as a full privilege," the court chose to rely on a "case-by-case balancing approach" and essentially held that facts contained within a report are subject to legal discovery, but "evaluative and deliberative materials" are not.

Shortly thereafter, the Garden State adopted the New Jersey Patient Safety Act (NJ PSA), which in large part codified Christy v. Salem. The measure was tested early when, during the discovery phase of a medical malpractice trial against an obstetrician, a plaintiff's attorney sought hospital reports related to patient safety. The defense objected, asserting that the information was privileged and thus legally protected against disclosure.

The entire story is here.