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Turning a blind eye: Hospitals fail to discipline doctors

In 1986, lawmakers figured they had come up with a way to keep track of bad doctors. That is, making sure a doctor who gets fired from one hospital for wrongdoing or incompetence doesn’t just pop up on the staff of another hospital. What they proposed was a national database. Hospitals would be required to submit the names of any doctors who had their admitting privileges revoked or suspended for 31 days or more. This way, a hospital could easily check a doctor’s background before hiring him or her.

Back then, government and industry officials estimated that U.S. hospitals would report anywhere from 5,000 to 10,000 doctors a year.

Since 1990, when the National Practitioner Data Bank went online, hospitals have reported, on average, 650 doctors a year. Nearly 50 percent of all hospitals did not submit a single name to the database in its first 17 years. What does it mean? Are the doctors at these hospitals so skilled as to go almost 20 years without ever making a serious mistake, as well as being morally and ethically beyond reproach?

Not likely. What’s more likely, as Public Citizen outlines in a report released today, is that the there is a serious lack of discipline in this nation’s hospitals and a large number of hospitals that are finding ways not to report their doctors to the national database.

“It is impossible to justify the fact that thousands of hospitals, which collectively have granted admitting privileges to hundreds of thousands of doctors, have not reported a single discipline case in 17 years,” said Dr. Sidney Wolfe, Public Citizen’s acting president and director of its Health Research Group. “Our report shows there is an urgent need for the Obama administration to step in and hold hospital administrators accountable as well as ensure that hospital medical staffs hold their own physicians accountable for patient safety.”

Along with issuing the report, Public Citizen sent a letter to the secretary of Health and Human Services, urging her to act on recommendations in the report, which include creating fines for hospitals that don’t report doctors and making compliance with the database requirements part of the Medicare certification process.