The U.S. Health Resources and Services Administration resisted demands by three major journalism organizations for the immediate restoration of a Public Use File of the National Practitioner Data Bank, a tool that reporters have used to expose lapses in oversight of troubled physicians.
HRSA removed the Public Use File from the data bank website earlier this month because officials believe it was used to identify physicians inappropriately.
The National Practitioner Data Bank is a confidential system that compiles malpractice payouts, hospital discipline and regulatory sanctions against doctors and other health professionals. For years, HRSA has made a public version of it available without identifying information about the health providers.
In letters to the Association of Health Care Journalists, Investigative Reporters and Editors and the Society of Professional Journalists, HRSA Administrator Mary Wakefield said her agency regretted having to remove the Public Use File from its website and hopes to bring it back in some form “as quickly as is possible.” She did not provide a date.
“The statute that governs the NPDB clearly states that we are obligated to keep data about individual practitioners housed in the NPDB confidential,” Wakefield wrote. “We now know that the PUF in its current form can be manipulated to identify individual practitioners, and therefore were compelled to act.”
Wakefield said HRSA shared the groups’ interest in transparency and patient safety but was compelled to act in the way that it did.
Wakefield was responding to a Sept. 15 letter from the three groups, which called for the Public Use File to be returned online without delay.
AHCJ President Charles Ornstein took exception to Wakefield’s comments, noting that reporters have used the Public Use File responsibly for many years and that the agency only acted after a single complaint from one doctor’s lawyer. He said HRSA has been well aware of how reporters have used the database and even assisted them in their statistical analysis.
“It is not true that the Public Use File can be ‘manipulated’ to identify individuals,” Ornstein said. “Nothing in that data can be used to identify individuals if reporters or researchers don’t already know who the bad actors are. We remain troubled that it appears HRSA is more interested in protecting doctors accused of harming patients than protecting the patients themselves.”
Wakefield’s response came the same day the journalism groups – joined by the National Association of Science Writers, the Reporters Committee for Freedom of the Press, and the National Freedom of Information Coalition – wrote letters to members of Congress asking for their help in getting the old version of the Public Use File restored. The groups would like to see that file regularly updated.
Wakefield said HRSA is reconfiguring the Public Use File to prevent identification of a health care provider or patient, and that researchers and members of the media can request data in the interim on the agency’s website. She also said there would be a call at 1 p.m. Eastern on Oct. 13 to hear from the public about what they would like from the Public Use File.
But Ornstein said it remained unclear how useful the information would be if the agency removes unique identifiers for individuals, which had allowed reporters to see what type of follow-up action was taken against doctors who repeatedly made malpractice payouts or had been disciplined repeatedly by hospitals.
On Wednesday, AHCJ and its partner journalism groups released a report on how reporters and news organizations have used the Public Use File in the past to expose dangerous lapses in oversight by state medical boards. Several of those articles led to new laws and rules to increase transparency and implement patient protections.
“As result of our investigation – and the solid documentation provided by the NPDB, malpractice suits and patient records – Virginia passed a law giving its state medical board more authority to crack down on doctors … ,” wrote Liz Szabo, a USA Today reporter who used the data bank in 2002 while at the Virginian-Pilot. “Patients in Virginia are safer today due to our reporting, and due to the data provided by the NPDB.”
Wakefield noted in her letter that the amount of information in the databank has increased dramatically in the past 18 months. Journalism leaders say what she failed to state was that a huge number of reports came in only after journalists (including Ornstein) showed that state agencies were not reporting discipline to the data bank and that HRSA was not following up on glaring inconsistencies and irregularities.
Wakefield did not address a request by the journalism groups to seek legislation permitting the continued disclosure of the Public Use File in the same form as before it was pulled Sept. 1.
She also did not apologize, as requested, to Kansas City Star reporter Alan Bavley, who was threatened with sanctions if he wrote a story based on information from the data bank. She said Bavley will not be pursued but was reminded that the Public Use File was for “statistical analysis only.”
Ornstein said the issue is larger than Bavley. “The threat to Alan is not a moot point just because HRSA didn’t fine him. Such threats by the federal government could have a chilling effect based on a news’ organization’s ability – and willingness – to stand up to government fines and local lawsuits.”
“There needs to be an apology and a promise that reporters won’t be threatened by the federal government when they plan to report public information,” Ornstein added.
IRE has made available free on its website a copy of the Public Use File, downloaded last month, along with documentation and instructions.