Dangerous Doctors
Milwaukee Journal Sentinel
Directory of state medical boards
Directory of state insurance departments
National Practitioner Data Bank Public Use Files from the National Institute for Computer-Assisted Reporting – While the database excludes the names of health practitioners, journalists have used it, in conjunction with other databases and documents, to pinpoint dangerous doctors. Journalists can look at trends and patterns in malpractice cases and state actions against offending practitioners.
Defaulted doctors: Did a doctor fail to pay back his/her student loans?
Court rules in favor of a consumer group that sued the Health and Human Services Department to allow disclosure of specific data about doctors from the Medicare claims database. HHS has appealed the decision.
Public Citizen ranking of the rate of state medical boards’ serious disciplinary actions, 2005-07
By Gina Barton
Milwaukee Journal Sentinel
I was covering federal court when I came across a huge malpractice verdict against a nurse midwife who had botched a delivery, resulting in severe disabilities for the baby. The nurse had worked at a federally funded clinic, and the government had conceded liability, a rarity in medical malpractice cases. The case went to trial on only the issue of damages. I wanted to include something in the coverage about the status of the nurse’s state license. When I checked, I was surprised to learn that the state board had taken no action against her.
I pitched a bigger project to my editors, comparing medical malpractice verdicts with actions by the state’s Department of Regulation and Licensing. Ultimately, analyzing all medical practitioners proved unmanageable, so the focus shifted to doctors, who are the targets of malpractice cases more often than nurses.
I first asked the state court administrator for a spreadsheet of malpractice cases. Unfortunately, their system is for case management, so there is not a field that shows which party prevailed. I wanted to focus on cases in which the doctors had been proven liable. The only way to determine that would have been to individually query the thousands of cases they sent me through Wisconsin’s online court records system and then read the docket notes. That wasn’t going to work. Instead, I decided to work backwards.
We obtained a database spanning the years 2002 to 2006 from the state licensing department that listed all “formal actions” the Medical Examining Board had taken against doctors. But all formal actions are not disciplinary, so we used that database to generate a spreadsheet of disciplinary actions.
I also asked for a list of physicians who were investigated but not disciplined, and access to the investigative files for those cases. The records custodian said I could have the list, but I couldn’t see the files because of patient privacy concerns. He was sympathetic as I expressed my frustrations. Finally, he said if he knew what I was trying to do, maybe he could help me narrow my request. I gambled and told him I was trying to compare disciplinary actions with civil judgments.
He told me he could send a second database, which listed referrals to the state from the National Practitioner Data Bank and from the Wisconsin Commissioner of Insurance, indicating that an insurance payment had been made on a doctor's behalf. In some of those cases, the board took disciplinary action. In some cases, it did not. The list of doctors who appeared on that list multiple times was manageable. However, the names of the patients who had complained were redacted.
I ran the doctors’ names through our state’s online court records system, and then had to match up the nature of the problem and the date from the board complaints with the lawsuits in order to figure out the patients’ names. Once I found them, the patients were happy to talk about their complaints against the doctors.
Wisconsin also has an entity called the Medical Mediation Panels. Patients must file a complaint there before they can file a lawsuit. We were able to get case histories on specific doctors from them. These histories date back to the 1970s and include cases that were settled in mediation, eliminating the need for a lawsuit to be filed.
I found doctors who paid out in numerous malpractice cases, including a neurosurgeon who has had serious legal problems for 20 years, but wasn’t reprimanded by the state board until 2007. He became the focus of the first day’s story.
I also found doctors with criminal records – including one who had pleaded guilty in 1992 to sexually assaulting two patients but didn’t lose his license until 10 years later. He became the focus of the second day’s story.
In the end, we reported on a system of medical regulation that favors doctors over patients. The board is slow to look into complaints, keeps many of its investigations secret and rarely imposes serious discipline, even in cases in which patients die. From 2002 to 2006, the state received about 2,400 complaints about physicians – 213 resulted in some kind of discipline. Just 24 doctors lost their licenses. The board often does not become aware of doctors' potential problems for years. Investigations can drag on for months or even years.
A legislator who is also a physician plans to sponsor a bill next session that would authorize the medical board to conduct criminal background checks on prospective licensees and periodic checks once someone has a license. Now, such checks aren’t done by the licensing board at all, either before someone gets a medical license or afterward.
A tip from someone who read the two-day series led to a third story, which found that area physicians are almost never criminally charged or convicted for incorrectly prescribing OxyContin and other potentially dangerous drugs. The Medical Examining Board has allowed several doctors to keep their licenses despite repeated investigations of inappropriately prescribed drugs with grave consequences to patients. The story also showed that traditional methods used to investigate drug crimes are ineffective when it comes to prescription drugs – even when doctors can be linked to fatal overdoses.
Gina Barton is an investigative reporter with the Milwaukee Journal Sentinel's Watchdog Team.
