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Doctors Behaving Badly: Medical boards should drop the stone tools, join the digital age

Doctors Behaving Badly: Medical boards should drop the stone tools, join the digital age

Antidote has been on an alphabetical tour of state medical boards this year. As summer fades, I thought it would be a good time to pull over. To show where we've been, I created this Google map, and I will update it weekly.

View Doctors Behaving Badly in a larger map

First, why this road trip?

When Michelle Levander, the editor-in-chief of ReportingOnHealth and one of the smartest journalists you will ever meet, first talked to me in 2008 about my joining the site, I suggested a weekly item about doctors straying outside the lines of accepted medical behavior.

Bad doctor stories have always been a reader favorite, and I wanted to remind reporters and the public to constantly be vigilant about doctors' credentials and claims. Initially Antidote called the feature "Contraindications" to show that I took the subject seriously.

Too seriously.Nobody seemed to understand what "Contraindications" meant, and some of my (few) devoted readers asked me, "Why don't you write about bad doctors anymore?"

So I changed the title to "Doctors Behaving Badly," an homage to the British sitcom "Men Behaving Badly." A doctor friend of mine suggested I call it "Doctors Gone Wild."

By the end of 2009, I thought it would be good to stop picking random, oddball doctors for a while and turn my focus more onto the agencies ostensibly monitoring them.

Here's what I have found so far.

In most states, detailed information about a doctor's disciplinary, criminal or malpractice histories is either nonexistent or heavily redacted. The worst states, in alphabetical order, are: Alaska, Arkansas, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois and Kansas.

Even in the best case scenarios, despite massive advances in transparency, accessibility and accountability among government agencies, medical boards use antiquated and obtuse technology that confuses, frustrates and deceives consumers.

A cynic might think that their websites have been designed to shield doctors from public scrutiny. The boards, after all, are made up mostly of doctors, and the doctor's lobbies nationwide are among the best funded and most effective voices in state legislatures.

I think the problem lies in poor website design. A board starts with a simple site that allows people to see if a doctor has a valid license. Then that same board adds scanned documents from its disciplinary files, but instead of linking these two things together, it puts them in completely different parts of its site. When the board gets around to adding malpractice information or criminal histories, it layers those on top, too, instead of fully integrating them.

The effect is a stratified system of information that lets patients think their physicians have a clean history when, in fact, their records are simply too hard to find. States such as Alabama, Georgia and Indiana provide a lot of information but make it unnecessarily difficult to locate.

I am nearly half way through the country at this point. Right now, the Medical Board of California leads all other agencies in the way it provides information to the public in one easy-to-use and largely complete database. Like all medical boards, the board should provide consumers with longer histories, but the information that is provided is detailed and dummy-proof.

My reporting at The Orange County Register and the reporting of my fine colleagues there played a role in driving the state to improve its site, but the agency itself has made advances through the work of some great executives over the years, some visionary board members and one constant: Candis Cohen, the best agency PIO you will ever meet. Cohen can be tough on reporters and has called this reporter "shrill" more than once, but she is an honest broker. I have asked her to send me enough paper and electronic documents to fill a community college library, and she has never balked. This cannot be said for most other medical boards, state agencies, federal agencies or universities.

California's success is not attributable to size alone. Small states actually do a much better job than many larger ones. Idaho and Iowa make information relatively easy to find while Illinois, one of the country's most populous states provides next to nothing online.

As far as discipline goes, that requires a more detailed analysis, and perhaps I will put that together before year's end. For now, thanks for coming along for the ride with Antidote. I hope you enjoy our trips through Kentucky, Louisiana, Maine and beyond in the weeks to come.

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Doctors Behaving Badly: Rosencrantz and Guildenstern in Colorado, Part 1

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Doctors Behaving Badly: DC anesthesiologist was caught with painkillers meant for babies

Doctors Behaving Badly: Florida Doc Charged with Soliciting Underage Sex Online

Doctors Behaving Badly: Georgia ob/gyn made his office a singles bar

Doctors Behaving Badly: Hawaii psychiatrist hides from sex abuse troubles with "mahalo" from state

Doctors Behaving Badly: Idaho board bars doctor from tummy tucks, facelifts and other plastic surgery

Doctors Behaving Badly: Illinois obstetrician's malpractice case leaves one patient victorious, others stonewalled

Doctors Behaving Badly: Indiana doc plays the victim when finally caught overdosing patients

Doctors Behaving Badly: In Iowa, having an MD is a license to take meth

Doctors Behaving Badly: Kansas medical board hides misdeeds from public scrutiny

Comments

How plausible do you think it would be to write code to automatically generate the map? Are there easily discernible patterns in the reports that mark a really bad doctor? A manual approach is obviously limited by manpower, and without paying clients, I doubt there is significant manpower.

The code wouldn't be that hard if there were a clear location noted in every doctor profile. There are definitely discernible patterns. Here is one: overpresciptions. I actually have to dig through stacks of doctors who overprescribe just to find a doctor who has done something else wrong. Even with the guy I wrote about today, the focus was on the domestic violence but he also was accused of over-prescribing addictive drugs. Thanks for your comments.

Bill, Thanks for all your great reporting/blogging calling attention to this important issue. I hope it inspires other journalists to take on similar investigations in their communities. 

This is great that you've brought this to the publics attention; however the public still has no idea how to make sure they don't end up in the wrong hands of a doctor that has problems.  If I didn't work in a hospital (quality, medical staff, risk management) areas, I would have no way of knowing anything about which physician to select.  There is no way of finding out this information because most state medical boards do not post this information.  Physicians enter into consent orders because of issues but the public doesn't know that - they are left in the dark.  The National Practitioner Data Bank isn't available to the public but that doesn't always give you accurate information - just settled claims and most don't always mean a lot.

Thank you for this great post Bill! It’s unfortunate that so many doctors, people you would think to be trustworthy, are incredibly unethical.

Thanks for mentioning Harbor-UCLA Hospital; I have friends and family that have horror stories of that place.

Keep up the great work!

I believe you are hoping to elicit improvements from state medical boards that we never will get. See my study of the Ohio State Medical board at: http://patient-safety.com/osmb.htm

Thanks for sharing such an interesting post.

State medical board have a long history of protecting doctors rather than the public.  

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William, I'll give you a better story. Why don't you report about how Medical Boards lie about, and ruin innocent physicians? This happens regularly. You could then really be doing the public a service: exposing the flagrant and blatant abuse of government power, and the violation of civil rights.

Dear Anonymous, I am very interested in hearing your story. I write for 2 different investigative journals and want to be fair and balanced. I do not have a story yet in the works on this topic, but have started doing the research for one. If you wish, you can remain totally anonymous. Contact me at your leisure. Kathleen Cunningham Medical Investigator Certified Medical Legal Consultant Great Falls, MT 406.788.1135 kcmedicallegal [at] bresnan [dot] net Staff Writer, "The Legal Investigator" Contributing Writer, "Professional Investigator Magazine" Member, National Association of Legal Investigators

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