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."