HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Friday, March 18, 2011

Adverse Hospital Action But No State Discipline?

The common law implications for institutions failing to disclose adverse results associated with individual physicians were recently discussed here. But what are the downstream results when institutions do take action against physicians with clinical privileges? The answer provided in the Public Citizen report, State Medical Boards Fail to Discipline Doctors With Hospital Actions Against Them, available here, is all too frequently, not much! 

The report analyses 10 years of data in the National Practitioner Data Bank, here. It found that 5,887, or 55%, of physicians who had their clinical privileges revoked or restricted had experienced no state licensing actions. Over 2000 of this cohort had one or more of the most serious violations, such as incompetence or "immediate threat to safety."

It is hard to fault Public Citizen's conclusion:

Hospital disciplinary reports are peer review actions that are one of the most important sources of information for medical board oversight. Subsequent state medical board action against a physician’s license provides a greater assurance than a hospital disciplinary action alone that the practitioners medical practice would be monitored or limited and that other state medical boards and future employers will have a more complete account of a practitioner’s practice history.

Our analysis of physicians with clinical privilege reports but no state licensure action raises serious questions about whether state medical boards are responding adequately to hospital disciplinary reports and whether, as required by federal law, state medical boards are receiving such reports.


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There is a major flaw in assuming that a hospital's decision to revoke a physician's privileges or to enforce a disciplinary action necessarily means that a physician is actually bad. This is not even the most likely scenario by any stretch of imagination. The current laws actually do not have a provision, whatsoever, that an accused physician be provided with a constitutional "due process", believe it or not. In other words, if some gang up, and they control the entire process against an undersirable physician (for whatever reason) there is no recourse for the physician since she/he may not be given the right to an "impartial" authority (equal to an impartial jury). So, I just wanted to alert the readers that the current process lumps together rogue doctors with excellent ones who got "shammed" by their peers. A peer review reform is needed to protect the patients from the rogue doctors who stay in power without being subjected to any reviews, and protect the good doctors who are now pushed under the bus by malicious-acting peers. Patients are victims of a process that does not effectively differentiate the definitely good from the definitely bad. Loopholes get exploited all the time.

Posted by: Shammed Doc | Mar 18, 2011 9:36:42 PM

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