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Reporting law ignored, group says

By Carol Gentry
5/28/2009 Health News Florida

Nearly half of the state's hospitals have never reported a single incident of physician discipline to the National Practitioner Data Bank, which opened 18 years ago to protect patients from questionable doctors, a consumer group reported Wednesday. 

Earlier this year, the same group -- the health research branch of the Washington, D.C.-based Public Citizen -- cited Florida's Board of Medicine for its weak handling of physician discipline, saying it was one of the most reluctant in the nation to mete out significant punishment for misdeeds. But in the current report on hospitals' failure to carry out federal law, Florida has plenty of company.  

While compliance with the federal reporting law varies from state to state -- 70 percent of hospitals in Louisiana have never reported, compared with only 25 percent in Connecticut -- the national average is just short of 50 percent, according to the study.  In Florida, the report shows, 105 of 227 hospitals registered with the Data Bank, or 46 percent, have filed a report.  

Public Citizen said the report,"Hospitals Drop the Ball on Physician Oversight," is based on information as of December 2007 from the Inspector General of Health and Human Services, as well as other sources of data.
The law requires that a report be filed to the Data Bank when a hospital (or committee of doctors at the hospital) revokes or restricts a physician's hospital privileges for more than 30 days, whether the reason is conduct or competence.  The federal government estimated before setting up the Data Bank that it would receive about 5,000 reports a year, but the average has been about 650.

Public Citizen rejected the notion that the non-filing hospitals have unusually good medical staffs, to the point that no doctor in almost two decades merited restrictions. The group examined actions reported to the Data Bank by state medical boards and found numerous cases in which physicians who were disciplined by boards for events that occurred in hospitals had not ever been reported to the Data Bank by the hospital.

In some cases, the group said, hospitals' peer-review process was itself too lax, so that there weren't reports to be filed. In other cases, the report said, loopholes were created so that doctors could be disciplined without triggering the reporting requirement -- by limiting the action to less than 31 days, for example, or by giving doctors a leave of absence in lieu of suspension.

The government has stressed the importance of hospitals reporting problems with doctors to the Data Bank because other hospitals and health plans check there before granting privileges. State boards check there before granting a medical license. The point of setting up the Data Bank was to prevent problem doctors from moving from  hospital to hospital and state to state.

 In 1996, the shortage of reports to the Data Bank prompted a federal agency to hold a conference on the issue. But the majority of recommendations that emerged have not been implemented, according to the authors of the report, Public Citizen's Acting President Sidney M. Wolfe, MD, and researcher Alan Levine. On Wednesday, with the release of the report, they asked HHS Secretary Kathleen Sebelius for a meeting on the issue. 

--Carol Gentry can be reached by e-mail or at 727-410-3266.