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Calls for Transparency on Bad Physicians Grow Louder

   December 10, 2015

Whether physicians who are on probation should be required to disclose their probationary status to patients is a source of debate that's getting hotter in California, where a patient advocacy group is testing the boundaries of transparency.

Two leading patient safety organizations say they support an effort in California to force physicians to disclose their probationary status to patients.

That means California doctors may be a litmus test for a new debate about physician transparency. At issue is whether physicians who are on probation should be required to disclose their probationary status to patients.

The Medical Board of California (MBC) rejected a push from the Safe Patient Project, a patient and policy advocacy group backed by Consumer Union, for new physician disclosure requirements, but the MBC is appointing a task force to explore the current disciplinary system. "We are taking this seriously," says Cassandra Hockenson, MBC spokeswoman. "We could have said, 'we do outreach already, thank you.' But we are serious about patient safety. Our mission is consumer protection."

Tejal Gandhi, MD, MPH, CPPS

The task force will have four members, two from the public and two physicians. The members haven't been publicly named yet, but the group will be appointed by the time of MBC's January board meeting, according to Hockenson. "We had a task force for prescription drug abuse and use and we opened it up to stakeholders, so we will very likely open this up, as well," she says. "It's not going to be in a vacuum."

The disciplinary status of physicians and the details that led to sanctions are available online now through most state medical boards. But it isn't convenient and the burden shouldn't be on patients, says Tejal Gandhi, MD, MPH, CPPS, president and CEO of the National Patient Safety Foundation (NPSF). "Ethically, this is the kind of information patients have a right so see and [should not have to] go hunting for," Gandhi says.

NPSF just released a report on patient safety with eight recommendations that address culture, research, and metrics to improve patient safety. A separate NPSF report on transparency released earlier this year, explicitly called for clinicians to tell patients about their "experience, outcomes, and disciplinary history."

Gandhi says patient safety and transparency are intertwined. "I know there are challenges, but the fact that someone is on probation is something patients should know about," she says. "It's fundamental."

So far, major physicians' groups are mum. The American Medical Association did not comment on the issue. The American College of Physicians issued a statement that said, "We don't have a policy that speaks to this."

Gandhi, who was executive director of quality and safety at Brigham and Women's Hospital in Boston as well as chief quality and safety officer at Partners Healthcare, says one barrier for physicians agreeing to any kind of disclosure requirement is an agreed upon definition for probation.

"It has to be clear what probation means," she says. "There has to be the right way to explain it as well. Is there standard language? It's not the easiest conversation. The board should be providing some standard language and tools."

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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