Medical Errors

Doctor Discipline

Washinton Post - Series of April 10-12, 2005 on Medical Errors/Doctor Discipline
Arthur Caplan, Ph.D. -University of Pennsylvania Center for Bioethic - Medicine has not yet bit the bullet. It is still protecting the guild.
4/10/2005: Doctors with substance abuse problems are allowed to keep practicing, often despite relapses, and medical boards rarely revoke licenses.
• 4/11/2005: A physician in Maryland or Virginia is twice as likely to be punished as a doctor in the District, where the medical board's record of serious disciplinary action has been among the lowest in the country.
• 4/12/2005: Doctors who are disciplined often restart their careers by moving to a another state, despite a federal system meant to prevent physicians from hiding troubled pasts. Related Documents • John F. Pholeric Jr.. Kenneth D. Hansen. Joseph Shaw Jones. Lewis M. Satloff

Do house officers learn from their mistakes?
JAMA 265(16):2089-94 (1991 Apr 24) Wu AW, Folkman S, McPhee SJ, Lo B
Residents will not tell teaching physicians of 46% of their errors for fear of the consquences to their careers. 31 % of these errors resulted in deaths in this article from the San Francisco VA hospital.

A Free Ride for Bad Doctors
New York Times Editorial - Op Ed 3/4/2002 By Sidney M. Wolfe, M.D.; Public Citizen - Health Research Group .
Only a small percentage of doctors account for most of the money paid out in malpractice cases. Yet, only a small fraction of these doctors are disciplined by state medical boards.

Massachusetts: Pharmacists Rarely Disciplined by Board
The Boston Globe, April 16, 2002 - 10% of pharmacy errors resulted in discipline

3 Doctors Are Warned by Board
The Boston Globe January 27, 2002

National Practioner Databank: (See Federal Law )
Intro to DataBank-Hartford Courant: April 30, 2000 .State Ranking.Links to State Regulators.
questionbledoctors.org. 13 states have online versions of their lists of disciplines doctors.
White Coats / Dark Secrets . 1 .2. 3 .4 . 5 . 6 . 7 . 8 .

Disciplining of physicians under review; Maryland legislators to begin hearings on reforming system; 'Dramatic changes' needed; Baltimore Sun; December 2, 2001 Sunday
Baltimore physician who has never faced disciplinary action or a restriction of his practice despite 18 malpractice suits during the past two decades -- half of which led to payments that total more than $2 million.

Inept Physicians Are Rarely Listed as Law Requires
The New York Times, May 29, 2001, Section A; Page 1
A federal program to protect patients from incompetent doctors is failing because health maintenance organizations and hospitals rarely report those doctors to the government as they are required to do, federal investigators say.

US government warns practitioner database underused
The Lancet; June 9, 2001, Pg. 1855
US managed care organisations (MCOs) are violating federal law by routinely failing to report poorly performing doctors to the National Practitioner Data Bank (NPDB), according to a study by the US Department of Health and Human Services (DHHS) Office of Inspector General. See http://oig.hhs.gov/oei/reports/a521.pdf

2 Doctors Suspended After Surgery on Wrong Side of Man's Brain
The New York Times , February 26, 2001; Section B; Page 5

OPERATING BEHIND CLOSED DOORS - The Virginian-Pilot June 23, 2002 Sunday Final Edition, Pg. A1
The Virginian-Pilot first reported in July 2001 news of a state investigation of Dr. Robert G. Brewer, a surgeon whose medical license later was revoked. Over the past 11 months, medical reporter Liz Szabo has interviewed dozens of patients and their families about problems with Brewer's work. Her review of nearly 2,000 pages of medical charts and court records reveals that serious problems with Brewer's surgeries had surfaced as early as 1990, yet Brewer continued operating on patients??? for 11 years. Today, The Pilot presents a special eight-page report on harm caused by one doctor and failings in the system that allowed him to continue working. Full text online - Requires registration.

Medicine's Code of Silence
Los Angeles Times; August 24, 1995, Part A; Page 1
An eight year old boy died when his anesthesiologist fell asleep suring his operation.
The Hospital was top-ranked by professional groups and consumers.
The doctors colleagues had informed the Hospital on at least six occasions in the past that the same anestheiologist appeared to be sleeping during operations, and handled the anesthesiologist's problems internally rather than notify state regulators.

The three-year project will seek more information about how errors occur and about how patients, doctors, hospital officials and others can make the system safer.

Paths to reducing medical injury: professional liability and discipline vs. patient safety -- and the need for a third way. Journal of Law, Medicine & Ethics September 22, 2001; Pg. 369

Harvard Prof Urges Hospitals to Spot, Curb Bad Doctors
The Boston Herald March 30, 2001
"Every hospital has doctors whose performance is a concern," said Dr. Lucian L. Leape, professor at the
Harvard School of Public Health. "We do have problem doctors. Everybody has witnessed it. But everybody insists it is someone else's problem. It's a major issue and hospitals have to take the primary responsibility."

Ideas & Trends: Do No Harm , Breaking Down Medicine's Culture of Silence
December 5, 1999, Section 4; Page 1; Column 1

How Many Medical errors? .
What kind of errors?, Wrong Side Surgery, Not Following Guidelines, Reducing Errors,
Doctor Discipline