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FOI Columns
Return to The FOI Center
March-April, 2001
Physicians and greater access
By Charles Davis
The freedom of information movement has turned its attention to physician data in recent months, attracted by a series of newspaper reports on medical errors. And unlike so many of our frustrating crusades, the campaign for access to information about doctors is wholly successful, driven by journalism that has aroused reformers.
In January, a sweeping New York state law requiring public access to a broad range of provider information took effect — the direct result of the 2000 investigation of the New York Daily News into the state's haphazard regulation of bad doctors. Other states are exploring a variety of methods for facilitating public access to physician data. And Congress is making noise about mandating disclosure of the massive National Practitioner Data Bank, despite a General Accounting Office report blasting the database's sloppy management.
For health reporters, these must be heady days. For years, reporters on the medical beat have faced a stone wall of resistance by physicians, HMOs, state medical boards and medical schools, who long ago banded together into a hyper-effective lobbying machine determined to keep the medical community safe from the prying eyes of journalists and the public.
Much has changed in the past year, however, thanks to the work of the Daily News, which found, among other things, that the state Health Department knew the identities of hundreds of New York doctors who have been sued repeatedly for malpractice, but rarely launched investigations of their care.
After months of follow-ups detailing a system rife with apathy and inattention, the newspaper's work found its way into the halls of the state legislature, which provided access to physician data long hidden from citizens. New York's law establishes a patient safety center within the state health department and makes available via the Internet and a toll-free number a spate of healthcare information. Now available to New York citizens: hospital report cards; health plan data; and physician profiles detailing education, criminal convictions, disciplinary actions, privileging affiliations and suspensions, malpractice history, contracted health plans, publications, partners and more. It's an investigative reporter's gold mine, but more importantly, it arms the public with the information they need to do some reporting on their own about their doctors.
Commerce Committee Chairman Thomas J. Bliley, R-Va., wanted to do the same thing on the federal level, opening up the federal data bank so patients could search a Web site to learn about their doctors' records. Bliley faced a much tougher fight on Capitol Hill, however. Bliley introduced legislation late last year that died in committee, and retired after the 2000 session. The American Medical Association — which once fought every effort to disclose doctor records but now publicly supports some type of public access — cites a General Accounting Office Report that revealed major flaws in the federal data bank.
The AMA's shift toward some level of public access is a major step forward, and demonstrates the power of the many stories around the nation detailing medical malpractice and lax oversight of those doctors who repeatedly violate their oath.
Investigative journalism is driving this shift toward access, which is moving inexorably toward greater access to records about physicians than ever before.
Already, numerous states, state licensing boards and even some local hospitals are compiling and making available to the public balanced and complete information about physicians. This is in sharp contrast to the National Practitioner Data Bank, which is largely devoted to malpractice litigation information, a particularly poor indicator of a physician's qualifications.
Advances in computer technology, coupled with growing public and professional interest in information about physicians' qualifications, are rapidly changing the environment in which such information is gathered and disseminated. The next battleground likely will involve malpractice payment records, usually the result of court action.
Doctors are especially sensitive to malpractice suits because physicians who take risky cases often end up with more lawsuits on their record even though they have done nothing wrong. Many physicians claim this lack of context merits continued closure of such records, but the recent work of the Daily News, The Hartford Courant and the Associated Press used public records to identify doctors with large numbers of malpractice payments or disciplinary actions. In each series, editors and reporters worked to keep information about medical malpractice in context, and doing so did nothing to minimize the findings.
Journalists and others committed to open government should capitalize on the newfound interest among policy makers in access to physician data. For evidence of what can be done, look at New York, where citizens and journalists can now monitor the health of their health care providers in ways unimaginable even a year ago.
Charles Davis is executive director of the Freedom of Information Center, an assistant professor at the Missouri School of Journalism and a member of IRE’s FOI Committee.
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