1. Provide the title of your story or series and the names of the journalists involved.
"Doctors Behaving Badly" by William Heisel, Additional credit: Jenn Harris, Barbara Feder Ostrov
2. List date(s) this work was published or aired.
This series was published between January 2010 and December 2010.
3. Provide a brief synopsis of the story or stories, including any significant findings.
In January 2010, we undertook a state-by-state analysis of how doctors are disciplined and how the public is informed. With the help of intern Jenn Harris, William Heisel found that medical boards from coast to coast are inconsistent, inefficient and ill equipped to monitor the hundreds of thousands of doctors licensed under their watch. There are some standouts, but, overall, they do not adequately protect patients and inform the public. The 51 doctors profiled were responsible for injuring or killing 290 patients. These include overdosing patients, blinding them and making the wrong diagnoses. The majority of these doctors are still in practice and most have had licenses in more than one state.
There were three disturbing trends: First, states seem to think that doctors who have a tendency to molest their patients will only do so if they are above or below an arbitrary age limit. Second, multiple states have made a habit of funneling doctors with histories of fraud, negligence and abuse into areas where patients are already vulnerable, namely poor communities, addiction treatment centers and prisons. Third, state agencies, federal agencies and hospitals do not act in a concerted way to protect patients. Perhaps the best feature of the series and the one that has generated the greatest public response has been an interactive Google map that we created to show people exactly where the doctors practice. This, we believe, is the first map of its kind. Because physician oversight is so fragmented, it is nearly impossible for patients to go to one spot and check to see if their doctor has been in trouble.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
We reviewed records from more than 100 physicians in every state and the District of Columbia. We used online databases provided by state medical boards, records available online from the U.S. Drug Enforcement
Agency, records available online from the U.S. Department of Justice, the Drug Industry Document Archive and state and federal court databases. Heisel and Harris submitted Freedom of Information Act requests to 19 state medical boards and other agencies. This slowed down the reporting considerably. In all, Heisel examined 128 disciplinary actions ranging from assurances of compliance to full-on license revocations. (It should be noted that he did this outside of the hours of his day job, either at night or on weekends.)
5. Explain types of human sources used.
Heisel interviewed state lawmakers, patients, union representatives, doctors, lawyers, patient advocates and other health writers. He made appeals to several boards for interviews with board executives or members but was rebuffed.
6. Results (if any).
The story generated a huge response from the public and from patient advocate groups, such as Consumers Union and Public Citizen. The map has drawn more than 220,000 page views, and Heisel has been deluged with inquiries from patients and physicians about how to find out more about physicians, especially those who have hopped from state to state.
7. 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.
There have been no corrections and no one has challenged the accuracy of any of the stories.
8. Advice to other journalists planning a similar story or project.
Heisel took on this project as part of the overall mission of his blog, Antidote, and the greater Reporting On Health venture to provide specific tools and guidance for health writers. Journalists need to spend a more time researching the backgrounds of their doctors when they profile them or quote them as experts. We covered multiple doctors who had been quoted or profiled by outlets who never mentioned their disciplinary history or who never followed up after the doctor had been disciplined. The vast majority of the doctors we covered had never received any media attention. To adequately background a doctor is tough, but you should begin by checking every state where the doctor may have practiced. Check court actions both state and federal. Check with the Drug Enforcement Administration. Check the specialty boards where the doctor should have received his or her certification. Even the worst medical boards will tell you if a doctor is licensed, so there is no reason a doctor without a license should be quoted in a story, yet we have seen that happen. Reporters also need to put more pressure on state boards to provide information to the media and the rest of the public. It is clear that many of these boards receive very few requests from the media and so are not used to providing detailed information. If they were more in the habit of providing more thorough information, everyone would benefit. Lastly, every state-focused media outlet could do their readers a service by finding doctors who have been licensed in multiple states and writing about how different states handled their discipline and how they provided information to the public. It is only by pointing out specific inconsistencies and flaws in the system that any changes will be made to improve public safety.