Reporting on Health Practitioners

The mandatory reporting of health practitioners' professional competence and conduct is an important step forward in the promotion of patients' rights. The passage of the Health Care Quality Improvement Act of 1986 (title IV of Public Law 99-660) established the National Practitioner Data Bank to collect and release information on health professionals. Dissatisfied with the limitations of the Data Bank, some states have enacted legislation to ensure that malpractice information and disciplinary actions are reported. The state of Michigan recently passed its own series of bills related to health professional licensure and discipline. Health professionals and consumers differ in their reactions to these state and national efforts.

Passage of the Health Care Improvement Act (HCQIA) was partly in reaction to the growing number of malpractice claims and medical lawsuits, a number that continues to call for legislative reform. Testifying at a Congressional public hearing, one consumer rights advocate quoted a Harvard medical study on the increasing incidence of malpractice, "One hospital patient dies every 6 minutes in this country from malpractice, and that translates to 100,000 deaths and 300,000 serious injuries . . . " (U.S. Congress, 1994, p. 65). The dollar amounts of medical malpractice awards also continues an upward trend; the median malpractice award of $356,000 in 1994 jumped to $500,00 in 1995 (U.S. Congress, 1996, p. 231). Prior to the passage of the HCQIA, he

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ations have proven deficient in self-policing their members and protecting consumers: " . . . the state boards have done an abysmal job because they're underfunded and too closely tied to the state medical societies" (Montague, 1994, p. 55). Advocates for health professionals fear that public access to the Data Bank might lead to increased efforts of self-protection from disclosure. For example, if physicians choose to fight lawsuits instead of settle them, the legal system could become overburdened. Some physicians have successfully sidestepped mandatory reporting by waiving their fees or providing refunds, because technically, money does not exchange hands in such settlements. Advocates suggest that health professionals further protect themselves by self-querying the Data Base: "There are plenty of horror stories about problems with NPDB reports . . . Until recently, many reports went into the Data Bank without the physician's having any input at all" (Schaumburg, 1994, p. 42). Dissatisfaction with the National Data Bank has caused some states to legislate their own health information systems. A series of bills related to health professional licensure and discipline became effective in Michigan on April 1, 1994. The

Category: Medical - R