California's site provides basic information -- e.g., license number, address, medical school, years in practice -- about physicians. In addition, there are 98 "status codes" ranging from "Canceled" and "Deceased" to "Denied," "Probation," "Accusation" and "Accus w/drawn." No explanation is offered as to why the codes were applied; however, consumers can contact the medical board directly for this information.
Of greatest concern to most physicians is whether or not information about malpractice suits and settlements will be posted. Last year, the American Medical Association led the charge against proposals in the U.S. Congress that would have opened the National Practitioner Data Bank, maintained by the U.S. Department of Health and Human Services, to the public -- a move advocated by Public Citizen and some consumer groups and opposed by the health care industry.
The AMA testified before Congress that malpractice settlements often reflected business judgments rather than medical issues. They cited a study that showed that only one malpractice case in five involved questions of negligence, and they also argued that malpractice lawsuits are not a good indicator of quality. The legislation died and the sponsor is no longer in Congress.
Dale L. Austin, interim chief executive officer of the FSMB, told PT that his organization has no official position on opening the National Practitioner Data Bank to the public, but "we know some of the challenges of extracting the data. The way it was set up in the first place was to provide information on both public actions relative to quality of care, plus malpractice cases, plus hospital actions, and to share that information among hospitals and regulatory agencies. It would be difficult to retrofit that to make it available to the public."
But information about malpractice cases remains at the crux of many people's concerns about posting data on public Web sites. In Massachusetts, the legislature worked with the medical establishment to create a rule that would be fair to doctors while providing guidance for consumers.
"In 1996, toward the end of the legislative session, we were told that the legislature was going to pass a profiling bill," recalled Francis X. Rockett, M.D., president of the Massachusetts Medical Society, in an interview with PT. "So, we began to work with the people involved to introduce a bill that allowed this information to appear on the Web site, but it was very careful that it didn't record every time a physician was sued. It allows them to post information about suits, but only closed cases. There can be no statement as to how much money a suit was settled for, if there was a settlement. They can only say that the settlement was average, above average or below average."
In addition, a disclaimer accompanies the information noting the number and frequency of lawsuits against other physicians in this specialty.
"When this first was proposed, the rank and file members initially were very opposed to it," Rockett continued. "They called it an invasion of their privacy and complained that we were the only group of professionals having this done to them and that the state should do the same sort of thing for lawyers. I think the rancor and the fuming and fussing have subsided. We've found out that most people who use the site are looking for what insurance plans a physician [accepts]."