Club Med
Greenberg, David
Club Med How the medical franity keeps the government from exposing the skeletons in doctor's closets by David Greenberg I n 1978, Connie Fay Blackstone, a married Ohio woman in her...
...Thirteen thousand new ones roll in every week...
...Noticeably, the AMA failed to throw its weight behind the effort...
...Another doctor got licensed in Wyoming while under investigaiion in Michigan...
...In other words, the woman’s lawyer charged, Blank would settle only if his name wasn’t on documents that might wind up in the Data Bank...
...Both Inlander and Sidney Wolfe, the head of Public Citizen’s Health Research Group, say Wyden has promised to introduce public access legislation soon...
...Still, the bank in its diluted form is better than no bank at all...
...But making the Data Bank accessible to us all is one obvious way to start sorting out the Kruzes from the Welbys...
...So when he applied for a temporary license in Missouri, Nierras lied, denying that he'd ever been convicted of a crime...
...According to Lynn Trible, a spokeswoman at HHS, the bank recorded almost 9,000 malpractice payments and “adverse action reports” in the first five months of operation...
...Those hopes were quickly dashed...
...Of course, monsters like Kruze are rare...
...Indeed, it’s time to stop screwing around with what could be a life-saving public resource...
...After finally awarding the contract to the Unisys Corporation, HHS next had to haggle with OMB over guidelines for running the Data Bank...
...The AMA hopes to doctor Data Bank information in other ways as well...
...State licensing boards, medical societies, nursing homes, and health maintenance organizations may also use the bank...
...But Nierras was a little too solicitous...
...Administered by the Department of Health and Human Services (HHS), the National Practitioner Data Bank contains the names of all licensed doctors and dentists in the U.S...
...We did talk to some congressmen to make sure the money was there, but there was no all-out push when it came to getting funds,” says Todd of the AMA...
...When that second license was revoked after some trouble there, he took up x-actice in New York City...
...Software glitches...
...He now serves as a supervisor of psychiatrists at Warren State Hospital...
...Seventy-seven members of Congress, including Speaker Tom Foley and Republican Whip Newt Gingrich, received gifts of $10,000 or more...
...Then came a lengthy bidding process, as HHS looked for another organization to man the system...
...A few years before Roe v. Wade, Barbara Seitz, a dancer in Cleveland, wanted an illegal abortion...
...The AMA, which once planned to run the bank itself, pulled out...
...I think that mechanical stuff is a lot of hooey,” says Inlander...
...Wyden originally wanted it to be open,” says Charles Inlander, president of the Allentown, Pennsylvania-based People’s Medical Society...
...Whenever a doctor has his license suspended or revoked, loses or settles out of court in a malpractice suit, or is otherwise disciplined by a hospital or state board, that information enters the repository...
...Most of the blame for the public shut-out lies with the American Medical Association (AMA), which has spearheaded a relentless assault on the Data Bank...
...asks Todd...
...After his release, Kmoved to Hawaii, where Kaiser Permanente, D-ldCre &T aoreyanf-T1F New Republic...
...obstetrician Kenneth Blank and the Columbia Hospital for Women suggests, doctors are already finding Data Bank loopholes they can leap through...
...So there was a tradeoff...
...But 3etween the Kruzes and the Marcus Welbys, ,here’s a surprising amount of room for statelopping quacks, each of whom theoretically ias up to 50 chances to get his act together...
...So she went to see Vilis Kruze, a local doctor, who administered various drugs and implanted an IUD coil for $100...
...Wyden knew the only way to get it passed was to keep out the public access provision...
...Besides the matter of funding, several other kinks had to be worked out before the bank was up and running...
...In response to concerns like Wyden’s, Congress passed the 1986 Health Care Quality Improvement Act, which strengthened peer review and set up the Data Bank...
...In yet another Zase, a Louisiana doctor was accused of sexusl molestation by several patients...
...Public Citizen’s Lynn Soffer, who serves on the Data Bank’s executive committee, predicts that it will take several years before the bank has any clout...
...Rather than processing requests within a few days, it is taking a whole month to answer them...
...This information will not be understood by the consumer.’’ That fear completely ignores the real issue: the effect on the patient...
...only then did Wyoming bar him as well...
...Although he was eventually Forced to surrender his Michigan license, Wyoming made no such demands...
...In the course of his investigations, he stumbled across the state-hopping problem...
...The idea was to make accessible violations otherwise sealed up within the medical community’s brotherhood of silence...
...Seitz committed suicide and Kruze was jailed, eventually serving time in the Lima State Hospital for the Criminally Insane...
...Before the case went to trial, the doctor’s lawyer offered the following deal: He’d settle for $485,000-but only if the doctor’s name was dropped from the suit (leaving the hospital the sole defendant...
...Indeed, any attempt by Joe Public to use the bank will draw him a stiff $10,000 fine...
...She turned to Dr...
...After the woman’s lawyer went public, the offending clause was deleted...
...There, he was murdered by the xother of a woman who overdosed on drugs hat Kruze gave her...
...Wyden was particularly struck by a dodge used in his home district, which bordered Washington state...
...I don’t know why...
...Nienas- earlier accused of sexually harassing his former receptionist-was convicted in 1980 of attempted sexual battery...
...After this episode, k z e moved to Zalifornia...
...If a physician has his credentials suspended for failing to complete some chartwork, that goes on his record,” says James Todd, senior deputy executive vice president of the AMA and a member of the Data Bank’s executive committee...
...Starting to wonder if you should check up on your doctor’s background...
...His peers knew about it, even a representative of the local medical board knew about it, but no one reported it...
...In its own records of doctors’ performances, predictably, the AMA does not list malpractice suits...
...Malpractice assurance Once Congress passed the legislation creating the Data Bank, many thought it would be functioning within a matter of months...
...vithout investigating his past, hired him as a iediatrician...
...Frustrated, the mother intended to report Blank to the Data Bank herself...
...Just last year at a Virginia hospital, for example, an alcoholic surgeon was regularly drinking on the job...
...The state issued the license, but the medical board eventually caught on and canceled it...
...Nice idea, but good luck...
...He surrendered his license upon entering prison...
...The AMA has been pushing to impose a $30,000 threshold for reporting malpractice settlements and judgments...
...Until they come up with a way to wipe out the disease, the AMA and its congressional co-conspirators should at least make it possible for the rest of us to battle the symptoms...
...Because Unisys initially understaffed the project, there is a huge backlog now...
...If nothing has happened to a physician in five years, then why should that mark continue to be there...
...Meanwhile, hospitals have made 285,000 queries about employees and candidates...
...It sounds like a total disaster...
...Then he fondled and pinched the woman's breast...
...Wyden himself will say only that he wants to see the Data Bank running cleanly under its current regulations before modifying it...
...and to empty the bank of all information except license revocations every five years...
...But before Blank’s lawyer would mail the settlement check, he asked her to sign one last agreement-which specifically forbade her from reporting her doctor to the bank...
...If you see that your physician got disciplined for turning in his Medicare forms late, you’re still going to go to him,” says Inlander...
...Leo Nierras, a psychiatrist, for help...
...And while he’s right in saying that no written draft of the bill ever included such a provision, public access was certainly part of the initial concept...
...According to the journal Medical Economics, some 25 to 30 physicians were doing it each month...
...Right now, patients must still rely on hospitals to monitor their physicians for them...
...If everyone’s driver’s license can be on file so that any cop in any part of the country can go to his car and call it up, then they can do this, too...
...Kruze misdiagnosed the llness, which turned out to be meningitis...
...But four and a half years later, you still can’t use the federally funded Data Bank to find out if your doctor has skeletons in his closet-unless you’re a member of the brotherhood yourself...
...In 1989, a Maryland woman charged that Blank’s negligence during the birth of her son damaged his brain and eventually killed him...
...We had mixed emotions about it from day one...
...At its December meeting, it recommended that the government allow physicians to attach personal explanations to the official accounts of their misdeeds...
...Nierras then practiced psychiatry in the Philippines for two years before returning to the States, where he got lucky again with the licensing board in Pennsylvania...
...In the early eighties, concerned that peer-review panels were too weak, Wyden explored the idea of imposing some federal check upon the medical profession...
...But the AMA was the number-two PAC...
...He wants time, he says, to work out the software glitches...
...the ielayed diagnosis permanently brain-damaged he boy...
...Besides, the average citizen can distinguish between grave and minor offenses...
...Soon thereIfter, a patient under his care died...
...Not too mixed: The AMA lobbied key appropriations committee members to withhold Data Bank funds...
...Given the resistance of the AMA, Congress doubted the organization would let even the government see any doctors’ records...
...As one architect of the Data Bank legislation put it, the mighty AMA “opposed this thing every step of the way...
...Peter Budetti, a professor of health law and policy at George Washington University and former counsel to the Health and Environment Subcommittee, explains why the legislators cut a deal...
...During a session with Blackstone, the doctor exposed himself to her and told her, as he masturbated, that he could be both her doctor and her lover...
...Wyden denies that the Data Bank legislation originally called for public access...
...The result was a bloody, botched abortion...
...Under that $30,000 figure, all claims will be dismissed as “nuisance suits” and ignored...
...We get letters every week from citizens who ask why they can’t have access to that information,” says Cowell...
...Hospitals then query the bank, both to keep tabs on their regular staff (they must do so every two years) and to find out the histories of prospective employees...
...And when the AMA talks, congressmen listen: The AMA is America’s second most generous PAC...
...Finally, his colleagues privately forced the man to get treatment...
...Released after serving three months, Nierras hoped to practice medicine elsewhere, but with sexual battery on his record, his chances looked slim...
...Of course, just having the freedom to turn a doctor in doesn’t mean the Data Bank will listen...
...There is a great benefit in the legislation right now because it puts the heat on medical providers,” says Wyden...
...3ne California surgeon, whose license was revoked when his gross negligence led to a pa:ient’s death, managed to get credentialed in Michigan...
...Small settlements, it says, should not discredit those doctors...
...The reason the AMA chose a span of five years, Todd says, was “arbitrary...
...It creat=d the National Practitioner Data Bank, a computerized storehouse of transgressions by all the nation’s doctors...
...Both sides are frustrated...
...But advocacy groups such as the People’s Medical Society and Ralph Nader’s Public Citizen contend that public access is the sine qua non of a useful Data Bank...
...There wouldn’t have been anything in the Data Bank if it were public,” he says...
...to leave out certain cases in which doctors have their hospital privileges suspended...
...Congress appropriated no money until the fall of 1988,” says Daniel Cowell, director of quality assurance at HHS...
...They could go across the border into Washington to practice, and they wouldn’t even have to move,” he says...
...But real clout won’t come from time alone...
...Todd at the AMA gripes that the backlog has delayed some physicians in acquiring their credentials at new hospitals...
...A pound of prevention Of course, delayed credentials aren’t the only reason that the AMA is now busy trying to soften the Data Bank’s rules...
...The AMA claims the average patient won’t know how to interpret a black mark beside a doctor’s name, so any notation will forever brand a physician as incompetent...
...If hospitals don’t check the Data Bank and there’s a problem-if they credential a physician with a serious record of violations-in a lawsuit, they’re in deep trouble...
...In return for the AMA’s cooperation, public access was quashed...
...In 1990, the organization contributed money to the campaigns of 478 senators and representatives...
...One of the few who got nothing from the AMA last year was Ron Wyden, an Oregon Democrat who serves on the House Health and Environment Subcommittee and is a longtime advocate of medical reform...
...Lauren Lubow, case control officer of the Ohio State Medical Board, says that when she called Data Bank staff members to tell them about certain incompetent doctors she’d learned of, they said they weren’t interested...
...A young couple came to him to reat their four-month-old son, who’d come lown with a fever...
...Part of the delay was caused by the budget crunch: As federal spending straits tightened, the Data Bank, with few advocates in Congress, was squeezed...
...Overcoming the medical profession’s impulse to protect its own will require deeper reform than any computer system could possibly achieve...
...And there remains no check whatsoever on doctors in private practice...
...Club Med How the medical franity keeps the government from exposing the skeletons in doctor's closets by David Greenberg I n 1978, Connie Fay Blackstone, a married Ohio woman in her mid-twenties, found herself severely depressed after the death of her mother...
...Meanwhile, as a recent lawsuit against D.C...
...It argues that a money-hungry patient can sue a perfectly competent doctor, and the doctor, rather than slug it out in court, will settle for a small sum...
...In a concession to the association, Congress included in the 1986 legislation a provision calling for a review of the bank after no more than two years to weigh various changes in the system...
...A month behind is really significant,” says Ingrid van Tuinen, a staff researcher at Public Citizen...
...When investigators looked into his past, they learned he’d been denied full privileges at the Illinois hospital where he used to work because of similar complaints...
...If you see he’s settled 28 lawsuits in a period of two years, you’re going to want to find out more...
...It had been my naive assumption that when Congress passes a law, the money goes along with it...
...In 1986, Congress tried to stop shady doctors from wiping the slate clean every time they changed their addresses...
...The man’s patients, it seems, had no need to know...
...This enormous volume has surprised everyone involved...
...It will come when Congress opens the Data Bank up to the average consumer...
...After all, patients maimed by incompetent doctors will suffer far more than doctors who lose business because of spotty records...
...At long last, the Data Bank opened last September 1. Requests and information immediately poured in...
...Still, the Data Bank won’t shine a light into every grimy corner of the medical profession...
...CBS's "60 Minutes" tells a similar story...
Vol. 23 • May 1991 • No. 5
