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Consumer Group Wants Full Access to National Practitioner Data Base

John Commins, for HealthLeaders Media, November 16, 2011

Glen R. Stream, MD, president of the American Academy of Family Physicians, is ambivalent about access to the database.

"In general our academy is very patient-focused in our advocacy for how our healthcare system should be structured. Having informed patients making informed decisions about their physicians and other providers is important," Stream told HealthLeaders Media. "One of the concerns physicians have is that if you create a data repository for an original purpose and try to extend it for other purposes, then it may or may not meet that other need." Stream says the database was originally designed for the credentialing process for hospitals, health insurers, medical groups, and state licensing agencies. "To repurpose that information to be the transparent view for patients, I don't know how accessible things are."

"The same issues apply when we talk about patient access to their health information," Stream says. "We very much support that. Yet the structure and vocabulary and the meaning of some of that information is difficult for someone without a medical background."

 

The battle over public access to the database has see-sawed in recent weeks. In September, HHS removed the database from public view after it received complaints from a doctor whose malpractice history was detailed in a newspaper article. Then, last week, HHS restored the database to public scrutiny but included provisions that shield physicians' identities.

Stream says the lay public often doesn't have the experience or expertise to comprehend much of what is contained in the database. Taking an example from his own practice in Spokane, WA, Stream says a patient read about a physician in the Washington state database and raised concerns that the physician's medical license would soon expire. "The patient thought that was meaningful, when in fact your medical license is not unlike your driver's license. You need to renew it," Stream says. "She read into it that this person's ability to practice medicine was going to expire in the next few months."

Stream says that any physician database must include explanations for the public. "It needs to be created with a user-friendly interface and with some sort of key or dictionary or vocabulary guidance for how to interpret the data. To my knowledge, the National Practitioner Data Base does not contain that."


John Commins is a senior editor with HealthLeaders Media.

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1 comments on "Consumer Group Wants Full Access to Data on Problem Docs"


Roger Downey (11/18/2011 at 3:33 PM)
I am only familiar with the Arizona Medical Board. It posts the disciplinary actions it takes against physicians in the physician profiles available on the Board's Web site. The date of the discipline is the hyperlink to the legal documents detailing the facts of the case and the state law that was violated. You can also see when the physician was first licensed in Arizona and when the license renewal date is. Also in the profile is the physician's education and training history and the area of interest or specialty. So, Arizona already provides much of the information that people would find in the NPDB regarding disciplinary action. Some issues are confidential and must remain that way. For instance, if a physician contacts the Board and self-reports a problem with substance abuse, the Board treats this as a confidential, non-disciplinary action to help the physician recover. Physicians with this problem are often sent to a treatment center for assessment and rehabilitation. But this only works for the first offense. If the physician relapses, the Board takes public, disciplinary action against the doctor. But you can understand why the self-report needs to stay confidential. Who would self-report if his action was on the Internet or accessible by the public the next day? By the way, an Arizona physician with a substance abuse problem may only return to practice on the recommendation of the treatment facility and with Board approval. Some medical boards keep much of the disciplinary actions against doctors confidential, usually because of the lobbying efforts by county and state medical societies. If the consumer advocates want real reform, they need to work at the state medical board and state legislature level to make this information available on the Internet.