The Association of Health Care Journalists, joined by the Society of Professional Journalists and Investigative Reporters and Editors, sent a letter to the Obama administration today protesting its decision to pull offline a public database of physician discipline and malpractice payments.
Read the letter sent by the journalism organizations to Mary K. Wakefield, administrator of the Health Resources and Services Administration.
Stories using the NPDB
The Kansas City Star
• Doctors with histories of alleged malpractice often go undisciplined
• Obama’s HHS shuts down public access to doctor malpractice data
Duluth (Minn.) News Tribune
• AHCJ article: Duluth News Tribune exposes malpractice allegations
• As Duluth hospital reaped millions, surgeon racked up complaints
• Multiple allegations against former St. Luke’s doctor
• Ailing patients speak out about former Duluth doctor
• Wisconsin restricts former Duluth doctor’s license
• In Texas, former Duluth surgeon may be sanction-free
• Federal database of malpractice cases doesn’t make public doctors’ names, or where they practice
Propublica
States Fail to Report Disciplined Caregivers to Federal Database
St. Louis Post-Dispatch
• Reporters encounter hospital’s lack of transparency
• Tip sheet from Bernhard & Kohler on researching health professionals.
• Award entry: Who Protects the Patients?
• Serious medical errors, little public information
• Caution urged with facedown restraints
• Doctor lost hospital privileges but kept clean record
• Girl, 16, dies during restraint at an already-troubled hospital
Milwaukee Journal-Sentinel
• Dangerous Doctors
• AHCJ article: Records show ‘dangerous doctors’ rarely face discipline
• Tip sheet from Gina Barton on state oversight of health professionals
Connecticut Health Investigative Team
• Disciplined Docs Practice Freely In State
West Hawaii Today
• Medical malpractice in Hawaii
• Diagnosis-related claims among top reasons for suit
Public Citizen
• Hospitals avoid reporting disciplined docs: The nonprofit group released a report showing that hospitals nationwide are taking advantage of loopholes to avoid reporting disciplined physicians to a national database. The Miami Herald‘s John Dorscher, the Detroit Free Press‘s Patricia Anstett and the Contra Costa Times‘ Sandy Kleffman reported local versions of the story that are no longer available online.
Earlier stories about access to NPDB:
• Data Mine reports on access to practitioner data: The Center for Public Integrity focuses on the National Practitioner Databank and the lack of public access to information in the database.
• Access to list of disciplined health workers in limbo: NPR’s Joseph Shapiro looked into the status of the Healthcare Integrity and Protection Data Bank.
• Public Citizen posted an open letter to HHS Secretary Kathleen Sebelius explaining why the database is important, and details the consequences of keeping it under wraps.
AHCJ, SPJ and IRE called for the government to immediately restore access to the Public Use File of the National Practitioner Data Bank. The government has made this file available online for years, and reporters have used it to call attention to lax oversight of physicians across the country.
Pursuant to the law, the public version of the database does not identify physicians by name or address, but it does provide other useful information about hospital sanctions, malpractice payouts and state disciplinary actions against every doctor in the country.
As an example, the database would allow a reporter or researcher to discover that certain, unnamed physicians have been sanctioned repeatedly by their hospitals but never were disciplined by their state’s medical board. It would also be possible to find doctors with lengthy trails of malpractice who continued to enjoy clear licenses.
The groups also expressed their deep disappointment that the U.S. Health Resources and Services Administration threatened a reporter from The Kansas City Star with financial penalties if he proceeded to write a story about a local neurosurgeon using information he gleaned from the public version of the database on the agency’s website. The newspaper published its story anyway on Sept. 4. The doctor’s attorney complained to the agency, prompting officials to remove the database from its website on Sept. 1.
The government said that it had to act now because reporters were able to link information in the data bank to specific doctors, and the law prohibits the public use file from identifying doctors. A HRSA spokesman said the data bank will be offline for at least six months and may never return unless the physician privacy concerns are adequately addressed.
AHCJ President Charles Ornstein said he was puzzled by HRSA’s sudden action because reporters have used the public version of the data bank for years to assist in their reporting and learn additional details about physicians they already had been researching.
“We are troubled that the Obama administration appears to have placed the interests of physicians ahead of the safety of patients,” Ornstein said. “Attempting to intimidate a reporter from using information on a government website is a serious abuse of power.”
Stories written by reporters using the public version of the National Practitioner Data Bank have drawn attention to troubled physicians and state inaction. Recent examples include the St. Louis Post Dispatch, the Duluth (Minn) News-Tribune and the Star. Other examples over the years have included The Hartford (Conn.) Courant and the Raleigh, N.C., News & Observer.
Some of these stories have resulted in new legislation and other steps that protect patients, by increasing transparency and sometimes toughening requirements on doctors.
The groups wrote that if HRSA determines the public version of the database violates the law in any way, it should seek swift legislative changes to remedy the problem and once again make the database available.
“In one stroke, the very administration that promised greater transparency not only excludes information of obvious public value to patients across this country but threatens legal action against a reporter for using public records,” said SPJ President Hagit Limor. “This is clearly outrageous.”
IRE President Manny Garcia said, “The removal of the Public Use File – whose very name means for public use – eliminates a valuable tool for journalists whose goal is to educate and protect the public. This database has allowed reporters to uncover flaws that have toughened legislation, and without a doubt, saved the lives of patients across the country.
“We are also stunned that a public servant has the hubris to threaten a health care reporter for doing his job. HRSA should be delighted that journalists are using public information to help saves lives, but in this instance the response is: get lost or get fined.”
Although I’ve never used the data bank, I applaud the three organizations on their stand. Actually, the issue here is a dramatization of a much broader, anti-media, anti-transparency trend than just removing the National Practitioner Data Bank.
After more than 50 years in journalism, I am deeply concerned about the media-hostile policies the Obama Administration is fostering. If you get the Columbia Journalism Review, you’ll see a good description in the current (Sept.-Oct.) issue. Also, just today FDA announced the appointment of a lawyer (Virginia Cox) to head their office overseeing the Press Office and all media contacts. Previously, the FDA Press Office was nominally independent with its own Associate Commissioner for Public Affairs; now it is officially subservient to the political Office of External Affairs.
All this adds up to a government-wide policy, independent of White House administration, that has almost imperceptibly taken overworking journalists’ formerly direct access to government sources. It began in the name of building security after the Oklahoma City bombing, and has quietly spread ever since, masquerading as improved service to media. Now a quasi-patronage system exists under which no journalist has secret government sources below Press Office level, and journalists strive to keep on the good side of their Press Office helpers, some of whom in my experience have been vindictive when their wishes as to editorial treatment are not followed.
The time has come in my opinion to take a stand against this government takeover of a free press’ access to government information that b y definition is public property (except where statute prohibits). I have a federal lawsuit pending at the firm of McKenna & Aldridge. All it is waiting for is a statement from a “willing speaker” in the government who is prepared to sign an affidavit (anonymously if need be) to the effect that “I am willing to speak with the news media but am afraid to do so with my supervisor’s or Press Office approval.”
Anyone who thinks he or she might be able to locate a government employee who will say this is urged to contact me.
Jim Dickinson, Editor, Dickinson’s FDA Webview, jim@fdaweb.com.
This is something I would expect from a Republican administration, to protect the business interests of medical professionals. Since medical professionals have trouble policing their own, I should think they would welcome making it possible for journalists to keep an eye on the bad apples among them.
— Pat McNees
I wrote a series of articles using the National Practitioner Data Bank that won me an award from the Hawaii Medical Association in 2008.
Here are two of them:
http://archive.westhawaiitoday.com/articles/2008/02/03/local/local03.txt
http://archive.westhawaiitoday.com/articles/2008/02/03/local/local05.txt
Please don’t take away this important public resource!
Nancy Cook Lauer
West Hawaii Today
If you are interested, here are several news accounts today of the letter AHCJ, IRE and SPJ sent to the administration.
NYTimes: http://prescriptions.blogs.nytimes.com/2011/09/15/obama-administration-yanks-doctor-disciplinary-files-off-the-web/
LATimes: http://www.latimes.com/news/politics/la-pn-physician-records-20110915,0,6100698.story?track=rss
Reuters: http://www.reuters.com/article/2011/09/16/us-usa-malpractice-database-idUSTRE78F03G20110916
St. Louis Post Dispatch: http://www.stltoday.com/lifestyles/health-med-fit/health/health-matters/article_7b01ba48-dfeb-11e0-93ef-0019bb30f31a.html
Thanks to our members for their support.
Charlie Ornstein
AHCJ Board President
It’s unheard of that the Obama administration, who campaigned on the idea of being open and transparent, would close the doors on a vital source of public information.
This is not a good policy choice. Please, restore the data bank.
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The AMA should be able to leave it to the judgement of health consumers when it comes to scrutinising the credentials of Doctors whose services they may wish to engage.
It is in the interests of transparency that de-identified information be available, even if a determined researcher or consumer wishes to seek out other publicly available information may be able to identify a particular doctor. With technological advances this is a fact of modern life and the risk of a person mosaicing or joining the dots is a phenomena that isn’t confined to medical practitioners.
I don’t find the AMA’s position very persuasive, and believe consumers should have greater access to this type of data in making decisions about their treatment.
The public is left to trust the watchdogs are adequately disciplining negligent and dangerous doctors. There is enough secrecy in the networks involved in health practices, including the relationships between pharmaceutical companies, health conglomerates and bureaucracies. Consumers can’t trust that Doctors that pose a risk will necessarily be prevented from practising medicine.
On another note, there is a tendency for more secrecy in some jurisdictions to protect the privacy and confidentiality of professionals who are disciplined for contraventions of medical regulations and ethics. The public don’t have open access to these proceedings before medical licensing boards and the process becomes shrouded in secrecy.
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