Court Decision Opens Competency Files on Doctors

Ever wondered how good the doctors are that you go to? A new federal court ruling will open never-before-available files about doctors. This will allow patients, business owners and insurors to see how well docs perform. The group Consumers' Checkbook had sued to see the U.S. Department of Health and Human Services' records on 700,000 doctors. Now those files will be public.

Most of us have been funneled to a doctor by our insurance company, at some point in our lives. The freedom to choose a doctor is often not an option, if you are in a "managed care plan," or if you're a Medicaid or Medicare patient. Basically you go to the doctors on a list in your area.

Ever wondered whether you're getting care from a competent practitioner with no record of botched operations or dishonesty? I know I have wondered if the doctors on my health insurance "list of preferred providers" are really any good.

Well, now a federal court decision will open the way for consumer access to data about many thousands of physicians in all 50 states. In a decision last week, U.S. District Judge Emmet Sullivan ruled in favor of a consumer group that sued the Health and Human Services Department. They were asking the court to allow disclosure of specific data about doctors from the Medicare claims database.

Health and Human Services has until Sept. 21 to turn over the data. With information on nearly 700,000 doctors, the Medicare database is indeed vast. Those files could reveal how many times a year a surgeon performs a specific operation, giving you an idea of experience levels. Or, you might glean information from the database about how your own doctor makes decisions about preventive health care or the number of tests to use for a given illness -- and much more.

Robert Krughoff, president of Consumers' Checkbook -- the nonprofit group that sued for the information -- says the group's website will compile and post the data for all to see online, at no charge.

The Department of Health and Human Services has not decided whether to appeal the ruling. An appeal could be politically difficult for President Bush and HHS secretary Mike Leavitt. Both campaigned in the past for greater "openness" in healthcare.

Congressional support for opening up the Medicare database is growing, in part from business groups that want a look at the files. But American doctors at the American Medical Association say they're worried that Medicare files don't accurately portray the numbers. For instance, Medicare files might show a higher-than-average number of patient deaths for a particular doctor's office. But that could be because the physician accepts the oldest or sickest patients, and the files won't necessarily explain that fact.

Originally, the lawsuit only sought access to four states and Washington D.C. However, Consumers' Checkbook has filed a Freedom of Information Act request for the same information from the remaining states.

In the mid 1990s, I and a couple of other newspaper reporters attempted to get the files on Alabama doctors. The state medical examiners and the state AMA fought us every inch of the way. They refused to give us files, or they said files were lost or "checked out."

You see, doctors who lost their licenses in other states were granted licenses to practice in 'Bama with a wink and a nod. Because there is a severe shortage of docs in poor rural counties, desperate hospital administrators often hire anyone just to get a doc into the ER at night or get one to deliver babies.

Eventually, we got the records as well as data from patients who had been harmed by the "bad docs" Alabama was letting in. We found some physicians who had lost their licenses multiple times and who were seriously addicted to Demerol and other drugs; we found one who sexually molested patients, several with inadequate education and still more who botched procedures because they were practicing way outside their training.

Personally, I don't want an eye doctor taking out my gall bladder, but that's just me. Anyway, after the series ran for a week in the paper (we named names, honey, and we kicked some butt), the Legislature passed a new law placing a consumer on the medical licensure committee that had previously been a secret docs-only group.

When the data from HHS becomes available, I think we really owe it to ourselves to take a long, close look at the names on there.

And here's a round of applause to the Consumer's Checkbook group and Judge Sullivan. You may have saved some lives.

Gita M. Smith is a journalist living in Alabama. Her blog may be seen at www.Myspace.com/gitahandley.

Copyright © 2007 Gita M. Smith