Tag Archives: disciplined doctors

Lawsuit reveals failures in hospital hiring practices

St. Petersburg Times reporter Curtis Krueger’s story about a successful whistleblower suit against a Florida hospital provides a powerful storyline about how disciplined health care workers continue to get hired. Here, he skips the government agencies and state databases and looks at communication between the hospitals themselves.

After all, don’t hospitals consult references and do background checks when hiring new doctors and nurses? In the corporate world of major hospitals, the answer is apparently “yes, but it doesn’t seem to do any good.”

… in general, (Beth Hardy, a spokeswoman for Morton Plant Mease Hospitals) said, if a hospital calls seeking information about a former employee, the company will simply confirm the worker’s dates of employment and last position held. She said that is “a standard and accepted policy across a lot of large organizations.”

The whistleblower suit itself, which resulted in a $450,000 award, involved a nursing supervisor who was fired soon after she criticized nurse Bernard M. Moran for falsifying records, a practice which got him fired at a previous job. Moran now works at another area hospital, one which says it checks the disciplinary records of all new hires.

The story only came to light because of the lawsuit. To understand just how many blind eyes were turned toward Moran’s behavior during this series of events, just take a look at Krueger’s story.

(Hat tip to Health News Florida)

CMS failed to report disciplined providers

ProPublica’s Marian Wang reports that the Centers for Medicare & Medicaid Services “essentially undermined” HHS efforts to create a national database of disciplined health care providers by failing to report disciplinary actions. The news comes from a report by the HHS Office of Inspector General (23-page PDF).

According to Wang, the investigation “found that CMS, which oversees health care programs serving about 45 million Medicare beneficiaries and 59 million Medicaid beneficiaries, took disciplinary action against numerous bad medical providers but did not report those actions to the Healthcare Integrity and Protection Data Bank.” As anyone who’s been following ProPublica’s award-winning “When Caregivers Harm” series knows, the database is chronically deficient, and – despite federal requirements – CMS isn’t helping.

CMS is required by law to report the following types of disciplinary action to the database: revocations and suspensions of laboratory certifications; terminations of providers from participation in Medicare; civil monetary penalties against all types of providers, managed care plans, and prescription drug plans.

Some of the data that should’ve been reported includes 148 sanctions imposed against laboratories in 2007 and 30 sanctions taken against managed care and prescription drug plans between January 2006 and July 31, 2009. From 2004 to 2008, the agency banned 45 nursing homes from participating in Medicare, and those actions were not reported until fall 2009, long after the required reporting timeframe, the inspector general’s office said.

According to officials, it was all just a big misunderstanding.

Disciplined doc gets top rank in Google

In SF Weekly, Ashley Harrell investigated the disconnect between a local plastic surgeon’s record of “gross negligence” which left one patient in a fatal coma and several others with burns, and the legions of glowing reviews of her practice posted all over the internet.usha-rajagopal

The reviews, she found, were connected to the astroturfing efforts of a PR agency the doctor had hired. The group also earned the doctor a top spot in Google’s PageRank algorithm at the same time that she was serving a three-year probation set by the state medical board.

Harrell’s story, Doctoring the Web, examines ways that some doctors are trying to game online ratings systems, as well as the current weakness of enforcement, both federal and local, in the arena.

Heisel’s ‘Doctors Behaving Badly’ goes viral

As anybody who follows the Reporting on Health blog knows, William Heisel’s virtual roadshow of physician background research has been gaining ridiculous amounts of steam lately. His Doctors Behaving Badly brand has taken on a life of its own, propelled by a Google Map he put together to place his findings into geographic context.

View Doctors Behaving Badly in a larger map

That geographic context has become the focus of his investigation, as Heisel has turned what was once a quirky little recurring item into a systematic, state-by-state way into how the public can check up on disciplined (or otherwise problematic) doctors. He’s almost reached the halfway point, and he’s reached some interesting conclusions. My favorite is that he doesn’t think states that have terrible sites with which to check up on doctors are being malicious, they’re just bad at making websites.

I think the problem lies in poor website design. A board starts with a simple site that allows people to see if a doctor has a valid license. Then that same board adds scanned documents from its disciplinary files, but instead of linking these two things together, it puts them in completely different parts of its site. When the board gets around to adding malpractice information or criminal histories, it layers those on top, too, instead of fully integrating them.

The effect is a stratified system of information that lets patients think their physicians have a clean history when, in fact, their records are simply too hard to find.

Heisel recently appeared on Fox News to explain what he’d found thus far.

On the whole, Heisel’s effort helps illuminate the power of my favorite online reporting tool: The progressively investigated database.

How bad docs keep clean records

The St. Louis Post-Dispatch‘s Jeremy Kohler and Blythe Bernhard used the example of one litigious St. Louis psychiatrist to demonstrate how doctors can work the system to keep their records clean and professional prospects bright despite work histories that are sometimes anything but. The strong anecdote provides engaging context for a well-analyzed report on the reporting of physician errors under the current system.

Critics say hospitals are underreporting and that puts patients in harm’s way. As long ago as 1996, a government agency concluded that the number of hospital reports was “unreasonably low.” It has gotten even lower. In 2008, the number of reports was three-fourths of the 1996 total, according to the newspaper’s analysis.