Aug. 8, 2000

Public Citizen Releases New Edition of Questionable Doctors

Majority of 20,125 Disciplined Doctors Not Required to Stop Practicing Even Temporarily

WASHINGTON, D.C. -- Public Citizen today released a new edition of 20,125 Questionable Doctors, an invaluable consumer guide containing information about physicians who have been disciplined by state medical boards and other agencies for incompetence, misprescribing drugs, sexual misconduct, criminal convictions, ethical lapses and other offenses.

Available in regional volumes or as a four-volume national set, 20,125 Questionable Doctors is the only publicly available national listing of sanctioned physicians. A similar federal database, called the National Practitioner Data Bank, is kept secret by act of Congress.

"Choosing a doctor is arguably one of the most critical choices consumers make," said Dr. Sidney M. Wolfe, director of Public Citizen?s Health Research Group, which conducted the research. "We believe the public should be armed with as much information as possible when doing so. Unfortunately, consumers can find out more about a car they plan to purchase than a doctor they plan to visit."

The new version of Questionable Doctors includes an analysis concluding that the nation?s system for protecting the public from medical incompetence is far from adequate, and that medical boards are too forgiving of doctors who have erred. It contains a state ranking to help citizens determine which states are doing the best job of regulating the medical profession.

The majority of doctors who were disciplined for the five most serious offenses -- sexual abuse or sexual misconduct; substandard care, incompetence or negligence; criminal conviction; misprescribing or overprescribing of drugs; or substance abuse -- were not required to stop practicing even temporarily. Therefore, it is likely that they are still practicing and that their patients are unaware of their offenses. For instance, 3,215 doctors were disciplined for substandard care, incompetence or negligence, but only about a third had to stop practicing, even temporarily. Similarly, only about two-fifths of the 2,963 doctors with criminal convictions had to stop practicing, even temporarily, while only about a third of 1,715 doctors disciplined for substance abuse were required to stop practicing, even temporarily.

"In the majority of cases, the seriousness of these offenses was not matched by the severity of the sanctions ordered by medical boards," Dr. Wolfe said.

Almost all of the disciplinary actions -- 90.6 percent -- taken against the 20,125 doctors were for serious offenses (including substandard care, criminal conviction, substance abuse, sex-related offenses, misprescribing of drugs, providing false information to the state board, loss of hospital privileges or insurance fraud). Despite the gravity of these offenses, only 48 percent of the disciplinary actions were serious: revocation, suspension or surrender of license, or probation/restriction of license.

20,125 Questionable Doctors lists doctors disciplined from 1990 through December 1999 and is organized by state. Information came from all 50 state medical boards, the District of Columbia, the U.S. Department of Health and Human Services, the Drug Enforcement Administration, and the Food and Drug Administration. The 20,125 doctors had a total of 38,589 disciplinary actions taken against them. The new edition of Questionable Doctors contains information about 6,185 doctors who were not listed in the 1998 edition. Previously listed physicians who have not been sanctioned again during the past decade were removed.

Using the information from the state and federal agencies, Public Citizen created a database containing the doctor?s name, degree, license number, date of birth, location, the disciplinary state or agency, the date of the disciplinary action, the nature of the discipline and available information about the case. Public Citizen asked all the state medical boards to provide information about court actions that may have overruled or changed previous disciplinary actions. Any disciplinary actions that were overturned by courts or for which litigation ended in the doctor?s favor were deleted from the database.

Although some earlier editions of Questionable Doctors included disciplinary actions against dentists, chiropractors and podiatrists when state boards provided the information, these doctors were eliminated from the database because information about them from states was so inconsistent.

Public Citizen has long sought greater consumer access to information about doctors, and there have been recent improvements in making that information available. Most state medical boards, for instance, now provide some physician information on the Internet, but the information about the disciplinary actions varies greatly, is often inadequate and can be difficult for people to access.

Information about doctor discipline, including state sanctions, hospital disciplinary actions and medical malpractice awards, is now contained in the National Practitioner Data Bank, but that data is kept secret from the public.

"It is time for Congress to respond to the needs of citizens and open the National Practitioner Data Bank to the public," Wolfe said. "There are no excuses for allowing this data to be viewed by HMOs and insurance companies but not by the people who must put their lives in the hands of these practitioners."

The rate of serious disciplinary actions by state medical boards in 1999 was only 3.5 serious actions per 1,000 doctors. This shows that an extremely small fraction of the nation?s doctors face any serious state sanctions each year despite the fact that at least 80,000 patients are killed and 234,000 are injured as a result of negligence in hospitals, most cases involving doctors.

"A key problem is that too many state medical boards believe their first responsibility is to protect the doctor from the public, rather than the other way around," Wolfe said.

Public Citizen recommends that states promptly make public all their disciplinary actions, strengthen their medical practice statutes, restructure their medical boards to sever any links with state medical societies, and better staff and fund their medical boards. Also, states should establish programs to weed out bad doctors and encourage complaints. Congress should consider legislation requiring doctors who accept Medicare patients to be periodically recertified for competency.

Copies of the full four-volume 20,125 Questionable Doctors are available to consumers for $407.50; regional editions are $23.50 (prices include shipping and handling). To order, consumers should send a check or money order made out to Public Citizen, Dept. QDPR, 1600 20th St. N.W., Washington D.C. 20009, or call 1-877-747-1616. To order on the Internet, go to www.questionabledoctors.org. Please specify the state for all regional orders.