Massachusetts is making plans to publish a broad range of detail on the state's 30,000 licensed physicians, profiling everything from scholarly achievements to scrapes with the law.
Much of the detail already is accessible to determined consumers who want to comb court records and licensing-board summaries and spend time on the phone hunting down physician backgrounds.
But under legislation sent to Gov. William Weld last week, the state will be ready, starting in September, to take orders for all that information and more (See chart) in one easy call.
The physician-profiling program, to be administered by the state Board of Registration in Medicine, is the culmination of a 10-year crescendo of consumer agitation in Massachusetts for full disclosure of punitive actions taken against doctors.
That pressure two years ago led the Massachusetts Medical Society to draft its own physician-profiling bill to gain some control over what was disclosed and to influence the collection of data to increase accuracy, said Joseph Heyman, M.D., the society's president.
"The public wants it all," Heyman said. "Sometimes it's hard to fight the inevitable."
The idea behind taking the lead was in part to head off other efforts that would have indiscriminately demanded a range of raw data without regard to usefulness, he said.
Physicians also were concerned that information on such actions as malpractice judgments could be misinterpreted without a context supplied by the medical profession.
The final product approved by the Legislature gives physicians and providers a say about the methods and formats used to compile the profiles.
It also broadens the scope to include distinctions such as authorship of medical articles, responsibility for educating medical students and professional or community service awards.
Other state licensing boards provide periodic reports on disciplinary actions and publish toll-free numbers for consumers seeking physician licensing and disciplinary records, said James Winn, executive vice president of the Federation of State Medical Boards.
But Massachusetts is the first state to propose blending such a broad range of physician information into one comprehensive file through a single source, Winn said. "What they're doing is commendable*.*.*.*to bring together a lot of information that consumers would like to have."
Not all the society's 16,000 members are behind the effort, according to Barbara Rockett, M.D., a vocal critic who served as medical society president in the mid-1980s.
She said the state medical board's files have a history of inaccuracy, and physicians are worried that the board will be unable to cope with the bigger job of keeping accurate records on a continuing basis.
But even fully accurate data won't give a complete picture of physician performance for patients seeking to make an intelligent choice, Rockett said.
For example, a physician who commendably takes on high-risk surgery on indigent patients might be maligned for having more malpractice actions, which she said comes with the territory because patients and their families increasingly sue the surgeon if the outcome isn't perfect.
Surgeons also are pressured by malpractice insurers to settle claims rather than fight them, she added.
Rockett said the medical board should step up its pursuit of physicians practicing bad medicine and either rehabilitate them or take away their licenses, rather than starting a major new program to publicize the records of all physicians.
But Heyman said the new law requires the medical board to place each record in the context of the physician's specialty to help consumers judge by medical-industry norms.
For example, malpractice experience of individual physicians will be compared with the average number of lawsuits lodged against a particular type of specialist, divided into three categories based on the amount of settlement. If most of the settlements are in the lowest category, it may indicate a high number of "nuisance" lawsuits rather than cases involving significant medical errors, Heyman said.
The medical registration board sent out two mailings earlier this year to physicians baring their current records and asking for corrections, said David Ramsay, the board's medical director.
But mailing snafus and tight deadlines for returning the corrected printouts angered physicians, triggering 3,000 calls to the board's education unit. A third mailing this month will show physicians their final profile and give them one more chance to proof it, Ramsay said.
A plan to make the profiles available free on the Internet and at cost on CD-ROM to hospitals, libraries and consumer groups was postponed until at least next May in the final legislation.
That was in response to appeals from some Jewish doctors concerned that their heritage would be widely publicized through information included in their profiles, and that they might be vulnerable to attack from anti-Jewish extremists looking for targets.
Ironically, the information they objected to involved the most positive elements of the profile, such as community service, awards and achievements. The final bill made reporting of those elements optional.