The federal databank hospitals and insurers use to credential physicians is poorly managed and may include inaccurate and incomplete information about physicians' conduct, according to a report released last week by a congressional watchdog agency.
The General Accounting Office report was good news for physicians and dentists, who have long wanted the 10-year-old databank shut down.
The National Practitioner Data Bank tracks malpractice settlements and disciplinary actions taken against them. Congress created the databank as part of a quid pro quo with the medical lobby in exchange for granting federal antitrust immunity to physicians and other practitioners who participate in peer review in good faith.
"Today's GAO report confirms the (American Medical Association's) view that the databank is seriously flawed," said Thomas Reardon, the AMA's immediate past president, in a written statement.
"In short, the databank is unreliable," said Warren McPherson, M.D., chairman of the Physician Insurers Association of America, a trade group of more than 50 healthcare professional liability insurance companies primarily owned by doctors, dentists and hospitals.
The GAO report also throws cold water on the efforts of some lawmakers and consumer advocates, who have pushed for public access to the confidential information in the databank. Under the law, only hospitals and insurers can query the databank.
The GAO reviewed data submitted to the databank during September 1999. The agency found that of 252 reports of state licensing actions, about 30% were submitted late. Actions must be reported within 30 days of the initial malpractice claim payment. In addition, 11% contained inaccurate or misleading information concerning the severity or number of times practitioners had been disciplined.
The GAO also blasted HHS' Health Resources and Services Administration, which operates the databank, for its inability to combat underreporting to the databank--the issue that most threatens the reliability of the system to be a comprehensive source of information on questionable physicians.
Ironically, the underreporting is caused by hospitals themselves. The American Hospital Association has acknowledged that some hospitals alter the way they discipline physicians to avoid reporting to the databank on their staffs.
Carla Luggiero, the AHA's senior associate director for federal relations, said HRSA's unclear reporting guidelines contribute to underreporting and inaccuracies.
The GAO recommended 10 ways that HHS could improve the databank.
In a Nov. 9 letter responding to the GAO's study, HHS Inspector June Gibbs Brown rejected seven of those recommendations, including taking immediate action to incorporate into the databank disciplinary actions against nurses and other healthcare practitioners. Brown, whose letter was attached to the GAO report, said her office needed time to review the 1987 federal law on which the GAO based its recommendation to include in the databank reports against nurses.
