List date(s) this work was published or aired.
Sept. 4, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
Being sued successfully over and over again won’t necessarily get a doctor disciplined in Kansas or Missouri, even when patients’ lives are lost. “Bad Medicine” detailed the history of a Kansas City area neurosurgeon who has a long history of malpractice cases involving paralysis, disfigurement and deaths yet maintains a spotless Kansas medical license. The story includes statistics gleaned from a federal database to show that this doctor’s case isn’t a fluke: he is one of 21 doctors in Kansas and Missouri who had 10 or more malpractice payments made on their behalf but had never been disciplined. While licensing boards in 17 states make information about doctors’ malpractice histories available to the public, the Kansas and Missouri boards do not.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I used court files of malpractice suits, including depositions, hospital records and other discovery documents. I also used data from the National Practitioner Data Bank public use file. No FOI requests were needed. I had no difficulties obtaining electronic data.
Explain types of human sources used.
Family members of a medical malpractice victim, attorneys, medical experts, officials and spokespersons of medical licensing boards.
Results:
Gauging from reader response, the story heightened public awareness of the limited amount of information available on the histories of physicians. However, my reporting led to a chain of unintended consequences that are still being felt. While seeking comment from the neurosurgeon I was writing about, I laid out to his attorney what sources of information I would be citing, including lawsuits and material from the NPDB. That prompted the doctor to complain to the agency about a security breach. (While the full Data Bank reports are confidential, I had access only to the public use file and was using it in a way reporters had been doing for years.) About a week before my story was scheduled to run, I received a letter from the director of the NPDB, Cynthia Grubbs, advising me that she was aware that I was working on a story involving the Data Bank and warning me of civil fines of up to $11,000 for unauthorized disclosure of confidential information from the Data Bank. I notified Grubbs that I was using the public use file. The Kansas City Star went ahead with the story as I had written it and published it on its scheduled run date Sept. 4. Days before the story appeared in print, I discovered that the Data Bank had taken the public use file off its website. I learned later that my reporting was the reason. What followed was an uprising by journalists, academics, patient safety advocates and U.S. Sen. Charles Grassley which led to a reinstatement of the public use file. However, the public now can download the data only after agreeing to restrictions that make some of the reporting I did impossible. My most recent story illustrates how the restrictions work to maintain the anonymity of even the most questionable doctors.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
Follow-up stories reported on how the Department of Health and Human Services took the database offline after the neurosurgeon complained that its confidentiality had been breached; the protests by journalism groups, academics and patient safety advocates of the removal of the database; and the restoration of the database by HHS with onerous restrictions on its use. The most recent story used the database according to the new terms set by HHS to present examples of doctors across the country who have extreme histories of malpractice or disciplinary actions. The story makes it clear to readers that the new restrictions make it impossible for reporters or any other members of the public to use the data to find out who these doctors are. No one has questioned the accuracy of any of the stories, and no corrections or clarifications have run.
Advice to other journalists planning a similar story or project.
Even with the restrictions placed on journalists who download updated versions, the Data Bank can still be useful providing the statistical underpinnings to stories about the regulation and malpractice histories of physicians and other health care providers. However, it is large and cumbersome. I would suggest that anyone who is not highly adept at manipulating and interpreting databases seek help with it.