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How Complaints From a Single Doctor Caused the Gov’t to Take Down a Public Database

Documents give a behind-the-scenes look at why a government agency restricted public access to a medical-malpractice database.

An agency within the U.S. Department of Health and Human Services that maintains a discipline and medical-malpractice database reopened it for public access yesterday, two months after the agency had first taken the database offline.

The National Practitioner Data Bank contains information used by hospitals, insurers, and licensing boards to track doctors' records, check prospective hires, and make other decisions. A publicly available version of the database -- which removed confidential identifiers such as doctors' names and addresses -- had long been used by reporters and others interested in patient safety. In the years it was online, journalists could reference the database and, with additional reporting, could at times identify doctors with uniquely long histories of being sued or disciplined for medical malpractice.

Then, two months ago, the government cut off public access -- a decision that was sharply criticized by a number of journalism organizations and consumer groups

What was behind that decision? Apparently, one Kansas doctor with a trail of malpractice suits.

A public records request by Sen. Charles Grassley and the New York Times turned up documents about the decision that shows that the agency closed the database days after the doctor, Robert Tenny, complained to the government. Thanks to the database, he told the Health Resources and Services Administration, or HRSA, he was about to get unwanted attention in his local paper.  

We culled through the documents and pulled out some interesting snippets that give a glimpse into the backstory behind why the public database was temporarily shut down and why -- even now -- the restored database has some new restrictions.  

A brief timeline:

Aug. 16 - A local newspaper reporter requested a comment from Dr. Tenny, a neurosurgeon, through Tenny's attorney. The reporter, Alan Bavley of the Kansas City Star, was working on a story about doctors who went undisciplined despite histories of malpractice allegations. He had used the public database coupled with publicly available court records to do his reporting.

 

Aug. 24 - The doctor sent a fax to Cynthia Grubbs at HRSA. Tenny asked for help, alarmed that the reporter had identified him and was poised to report on his malpractice settlements. The fax looked like this:

 

Aug. 26 - The HRSA wrote to the reporter, warning that he could face at least $11,000 in fines for each violation of confidentiality. The doctor was copied on the letter.

 

Sept. 1 - The agency cut off public access to the database.

Sept. 4 - An article ran on the front page of the Kansas City Star, telling the story of a woman who died in 2007 after undergoing a brain surgery with Dr. Tenny. It noted that Tenny had been sued at least 16 times for medical malpractice but had never been disciplined by the state’s licensing boards. (Update: Worth noting that according to the report, Dr. Tenny settled at least six of the 16 lawsuits; the others were either dismissed or the outcomes either weren't clear. "In at least one case, the verdict was in Tenny's favor," the Star reported.) 

On the same day, the doctor wrote to HRSA again, this time with a copy of the article, and expressed a desire that this “will change the way public data is presented.”

 

Sept. 5, 7, 11, 14, 15, and 20 - Dr. Tenny wrote five more letters to HRSA, complaining that the newspaper was making “a concerted effort” to end his career and that the article “significantly questioned the security of your data.” He also speculated that the reporter had gotten improper access to information from the full data bank either from a local medical center or from a disgruntled former Data Bank employee.

Sept. 22 - The Kansas City Star wrote a story about how groups were urging that the database be reopened. Dr. Tenny wrote to HRSA again: “Stay strong and keep up the good work!” (The American Medical Association, around this time, also wrote a letter supporting the agency's decision to remove the file.)

 

Sept. 26 - HRSA responded to Dr. Tenny's six letters, telling him that the publicly accessible database had been removed, and that the agency had contacted hospitals to remind them of confidentiality requirements and sanctions for breaches of confidentiality.

 

Nov. 9 - HRSA restored public access to the database, but as many reports have noted, it comes with a major caveat. According to the website, users of the new database are no longer allowed to combine information gleaned from the public database with any other publicly available information in a way that would identify doctors. In other words, the government is now trying to tell the public -- including the press -- what it’s allowed to do with publicly available information. (The agency told the Kansas City Star that it has a duty "to make certain that information about individual practitioners remains confidential.")

Sen. Grassley and others have pledged to keep fighting the agency’s interpretation of the law, questioning whether the database is ultimately meant to protect the public or to protect physicians.

“The interpretation of the law ought to be for public benefit,” Grassley said. “A single physician complained that a reporter identified him through shoe leather reporting, not the public data file. One complaint shouldn’t dictate public access to federally collected data for 300 million people.”

We've called Dr. Tenny's office for comment but have not received a response.

This is a stunning story. And I say that as someone who is being sued by a hospital over a domain name I am using on a web page that reports details of medical-malpractice lawsuits here in Albany, NY.

I started first a blog in 2004 and later a web page after I became aware that the local papers hadn’t reported a single lawsuit alleging medical negligence against local hospitals in five years.

Now one of the hospitals is claiming that I am harming its reputation and is demanding an injunction and money damages. This week I counter-sued over documents that I believe were withheld by the hospital after my wife died unexpectedly there in 2003.

The disputed web page is at: http://www.northeasthealthclaims.com
The blog, with details of the lawsuit, is at:

http://www.answersforlisa.blogspot.com

Richarfd Rosenthal

Nov. 10, 2011, 5:10 p.m.

This is only the tip of the iceberg of government indulgence of medical errors and healthcare acquired infections that kill 200,000 people a year. The government has the power to stop this simply by withdrawing medicare-medicaid accreditation from the hospitals and other healthcare faciities that are the biggest offenders. Medicare and Medicaid provide healthcare facilities with 70% of their income. Fear of losing this would quickly reverberate and have a remedial affect far beyond the tortoise like & weak measures contained in the Obama healthcare law. Healthcare facilities know how to greatly reduce these killer errors and infections at very little cost but have been dilatory in doing so.

At the core of the problem is the special status of the joint Commission which accredits 80% of the country’s hospitals for medicare and Medicaid payments. the Department of Health & Human Services has deemed the JC this authority to accredit and reaccredit healthcare facilities for these payments. Medicare & Medicaid payments. This is a ghastly conflict of interest, hiding in plain sight, for the Joint Commission is actually paid by the hospitals etc for the accreditation and reaccreditation inspections it performs. This is a conflict of interest even more deadly than the C of I between the securities raters and securities marketers that gave us the financial calamity of 2008.

My extended enquiries, following my own brushed with death from two hospital acquired infections in 2009 indicated that in the previous 10 years, while some 2 million Americans were killed by hospital infections and errors, and 36 million sickened or injured and $35 billion in Medicare funds was paid out because of them not one hospital or healthcare facility was deaccredited by the Joint Commission. As a result continued to receive medicare and medicaid payments.

I will gladly provide my research to any reputable, seriously interested journalist.

I don’t understand the issue with the availability of records of malpractice suits. Every state maintains publically available physician profiles detailing law suits, settlements and disciplinary action. Physicians’ identities are not hidden therein.

Janice (Fritzie) Borgwardt

Nov. 10, 2011, 7:45 p.m.

The public has a right to know. This is a great example of ...“what’s the point of charging taxpayers for keeping a data base at all?” Private attorneys have the power to silence free speech in the public interesT Who think’s that’s a decocracy, or even a republic?

It never ceases to amaze me how so so many of these doctors are faaaaaar more concerned about running a HIGHLY profitable business than patient care and healing. 

As a former employee of an investment firm, I can’t tell you what a large percentage of our high net worth clients were doctors who would constantly call during the day putting on new trades or always trying to eek out a way to make more money.

Toni Brayer, MD, FACP

Nov. 10, 2011, 8:55 p.m.

The National Practitioners Data Bank was created after the shocking case of handsome physician, Dr. Michael Swango.  He was able to go from state to state (and even to Africa) and practice medicine and at the same time was a serial killer of up to 60 patients.  Because there was no mandated reporting, he was able to move to another hospital after he was suspected and even convicted…and continue to practice and kill. (read Blind Eye, James B. Stewart).  Prior to 1990 there was no clearinghouse or effective sharing of information for physicians convicted of crimes or malpractice.

The NPDB was created to protect the public.

My daughter has had type 1 diabetes for over 20 years. I have seen hospitals neglect her blood sugar over and over.

NEVER LEAVE A TYPE ! DIABETIC ALONE IN A HOSPITAL.

I felt the need to yell. It is that bad, mismanagement is more likely than proper management. This is especially true for young diabetics.

Doctors and Pharmaceuticals have always been the scum of the earth.  Hopefully Americans will wake up and realize this, defund them, then kick them as hard as possible…  My family hung them at Neuremburg, our drugged up country should have never come to this…

Barry Schmittou

Nov. 10, 2011, 10:59 p.m.

“who have went undisciplined?” It should read “who have gone undisciplined.”

Gary Baltimore

Nov. 11, 2011, 5:57 a.m.

I am sad with this kind of story. I cannot imagine that a doctor can perform well when he/she facing lawsuit which anyone can cost the career. Has anyone think on behalf of a doctor? In real life, there is no 100% assurance that a disease can be cured, nor any procedure performed is without risk. The percentage in calculating the risk is just numerical. There are so many factors that can affect the outcome, especially patients’ condition. If something happen after the procedures, it can be due to other conditions which not neccessary related to the procedure. How pathetic the public just want to win over doctor by using lawsuit and complaints to lower their reputation. Is this the correct way towards someone who give service to your life?

One thing that isn’t mentioned here is that the NPDB reports may be highly inaccurate.  So from that fact alone, they shouldn’t be made public.  I’m a dentist who was unfairly disciplined by the Maine dental board (as were many others) and lost my license, my practice and was forced out of the state.  I harmed no one, committed no fraud, broke no statutes.  What happened was that one of the seven board members had reneged on an agreement over office space, leaving me without a facility.  So the board attacked me, disregarding my truthful statements about what had transpired and claiming I’d abandoned a patient and other bogus charges.  The fact is that it’s virtually impossible to get due process when the board is biased.  Then they reported me to the NPDB.  Although I disputed it, the report stays on your record, so I have an undeserved black mark on my reputation.

I believe the public should be protected and other comments have mentioned the deaths from medical mistakes, etc.  Yet often those involved are not disciplined.  But this data bank is also broken and can’t be depended on for accuracy.

I’m getting sick and tired of this recent trend in government to “guilty until proven innocent.”  The Internet has somehow created a world where the first inclination to any accusation is to shut things down and create blacklists, which violates…oh, every damned law in the country.

We see it here, where one doctor complains, so we cut access to the database.  The public, I guess, shouldn’t know about malpractice.

We saw it in California, where the BART administrators cut cellphone access to the entire system because of a vague threat.  That would have prevented people from reporting a problem or calling for help, had there been an actual emergency.

Wednesday, the “Stop Online Privacy Act” goes to committee, which will command ISPs, name servers, search engines, advertising brokers, and payment processors to eliminate the existence of any website that is accused (not proven, just accused) of copyright infringement!  If it passes, say goodbye to whistleblowers, since by definition, they’re making private information public.  Say goodbye to political newcomers and investigative journalism like ProPublica, who probably use SOMETHING illegally, somewhere on the site (and there’s no penalty for false accusation, so the truth is hardly a defense).

Red light cameras “decide” that you’ve broken the law, with no evidence or recourse.

The TSA functions on the very premise that each of us is probably a terrorist, so our right to privacy or even our right to modesty is at their whim.

And don’t forget all the contracts people blindly sign with employers and service providers (with the alternative being disconnected or unemployed) that deny them the right to sue to prevent or recover from harm.

We’re treated like criminals as big businessmen violate human rights for excessive profit, which they use to bribe Congressmen.  That’s OK, apparently.

‘doctors who have went undisciplined’, sorry I am unable to read the rest of the story. Please stop ruining the language.

Barry Schmittou

Nov. 11, 2011, 12:55 p.m.

I did not write the post five comments above using my name that says :

“who have went undisciplined? It should read who have gone undisciplined.”

I did not write that post.

Barry Schmittou

Nov. 11, 2011, 1:05 p.m.

Judges quotes below prove deadly fraud committed by independent physician consultants who write fictitious reports. Obama and Bush’s Directors did nothing to stop them.

Dr. Gary Greenhood (who was paid by MetLife) wrote reports where he ignored :

(a) A foot Ms. Joanne Vick broke in five places.

(b) MRI’s showing Multiple Sclerosis, brain lesions and much more in the case of Ms. Jacquelyn Addis.

Exact case quotes are one paragraph below :

(1) U.S. District Judge Robert Cleland wrote Ms. Joanne Vick broke her foot in 5 Places after she developed diabetic kytoacedosis following childbirth.

Here are exact quotes written by Judge Cleland :

“Noticeably missing from Dr. Greenhood’s report is any mention of Dr. Al-Kassab’s November, 2001 office notes, Dr. Churchill’s November 13, 2001 office notes, and Dr. Churchill’s March 14, 2002 office notes. This is particularly significant in that Dr. Greenhood’s August 2, 2004 report specifically noted that “[t]here is no indication of seizures or falls.” Dr. Churchill’s March 14, 2002 report, however, indicates that as a result of her right sided weakness, Plaintiff broke her left foot in January 2002—in five places, no less.”

“Moreover, both Dr. Greenhood’s and Dr. Gosline’s reports contained numerous errors and inherent inconsistencies, which should have been noted by the plan administrator and resulted in less weight being given to them. (E.D. Michigan, Southern Division. No. 03-CV-73124-DT)”

(2) Quotes written by U.S. District Judge Timothy Savage in the case of JACQUELINE ADDIS v. THE LIMITED LONG-TERM DISABILITY PROGRAM :

“MetLife relied almost exclusively upon the report of Dr. Gary Greenhood, an internist hired by MetLife, who did not examine Addis and did only a records review. Dr. Greenhood selectively viewed Addis’s medical records. MetLife then selectively adopted parts of Dr. Greenhood’s report to support denial of the claim.”

“Although the denial letter listed reports of several physicians, it relied exclusively on Dr. Greenhood, and gave little consideration to Addis’s treating neurologist, Dr. Tatarian. There is no discussion of the reports or findings of any of the other physicians who are listed.”

“Dr. Greenhood selectively extracted portions of Dr. Tatarian’s treatment notes to support his conclusions, which are contrary to those of Dr. Tatarian. At the same time, he ignores parts that bolster Addis’s complaints and support her doctor’s diagnosis and prognosis.”

“He also ignores the MRI reports evidencing MS, November 2, 2000, and December 9, 2003. To the contrary, Dr. Tatarian documents a variety of spinal problems; and, MRIs consistently showed the presence of lesions and plaque on the brain. Dr. Greenhood ignores Dr. Tatarian’s report of a positive Babinski sign, which is indicative of nerve damage consistent with Addis’s complaints of stumbling and falling.”

“Both MetLife and Dr. Greenhood ignored the Multiple Sclerosis Medical Source Statement of Functional Abilities and Limitations completed by Dr. Ana Lavdas. Dr. Lavdas reported her patient’s prognosis was poor and she had significant functional limitations. Among the symptoms were pain in the lower extremities, fatigue, weakness and shaking in lower and upper extremities, poor coordination, bladder and bowel problems, blurred vision, and other physical problems. She noted that Addis had “significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movement or gait and station.” Dr. Lavdas concluded that her patient was “unable to work,” and could not sustain a job.”

“Significantly, there is no discussion of the records of Doctors Lavdas, McDonald, Gray, Files and McCarel, which he lists as having been submitted to him. Dr. Greenhood simply ignores them.”

“MetLife assigned reconsideration of Addis’s claim to Tammi Phillips, who was not a physician and whose qualifications are unknown.” “Her assessment ignores Dr. Tatarian’s unequivocal diagnosis that Addis was suffering from “relapsing, remitting MS with possible repeat exacerbation.”

Civil Action No. 05-357 U.S. District Court Eastern District Of Pennsylvania March 30, 2006

Dr. Greenhood also ignored my eye cancer symptoms; there is so much evidence I will not post it here.

You can see quotes from numerous Judges that show the same patterns of fraud by pasting :

deadlyorganizedcrimes.blogspot.com and see the big picture at obamadrugmurdersconnection.blogspot.com

(Obama’s Directors’ wrote me letters saying it’s their top priority to stop these violations, but they have done nothing. Bush did nothing, but personal surgeries and my father’s death prevented me from documenting as much. I still have falls and accidents ( two in the last ten eleven days) but I feel I must continue fighting corruption that is destroying so many lives)

“Barry” impersonator & Jimbo,

Thanks for flagging the copy error. No language-ruining intended.

It had actually been caught in editing and I’d changed it before the post went up, but somehow those changes either weren’t saved or didn’t take. Fixed.

Best,
Marian

Barry Schmittou

Nov. 11, 2011, 2:56 p.m.

Ms. Wang,

I pointed out that I did not make the error comment because I hope that I would have said ‘please note” or something like that to be polite while pointing out an error.

I hope ProPublica is able to prevent people from posting in others names. I have to enter my email address when I post and I have never shared that email on ProPublica.

I have been told that my efforts seeking justice have helped some very sick and severely injured people, I have filed much of the evidence in Federal Court, and since I use my full real name it could hurt the credibility of the evidence I present if someone uses my name to make posts that are not from me.

16 litigations to Dr. Tenny’s record-a question for Mr. Bavley: what kind if medical liability insurance is the good doc able to obtain? Is it mostly covered by The Kansas Health Care Stabilization Fund?(http://www.hcsf.org) Or very very high priced private Insurance? Or both?

After reading the HCSF Oversight Committee Nov.1, 2011 report page 8, Miller v. Johnson may have contrubuted to the preceived need to shutdown the NPDB public records. Also pending:

http://www.ksbha.org/public.html
Dr. Tenny has two scheduled public meetings.

2/6/12 10:30am, preconference hearing by teleconference to ber held @ the Office of Administrative Hearings, 1020Kansas Ave. Topeka, Ks.

4/9/12 8:30am through 4/13/12 to be held @KSBHA 800sw Jackson Lower Level, Suite A, Topeka, Ks.To set asside five daysfor hearing is unusual.

We should all have a blog that posts bad doctors on it and someday get a website that blows the whistle on worthless doctors. They let them get away with murder!

Tenny isn’t really the problem. The NPDB overreacted to his letters and is now trying to dictate public policy that breaches free speech. Doctors are sued all the time; especially those in high risk fields. All the NPDB can and should do is remind the public that a lawsuit isn’t a verdict. It has no right to tell a reporter or the public in general not to use other resources to ID the doctors. That’s overstepping, especially for a publicly funded program. That said, once a doctor loses his or her license, that’s it. It takes a lot for a doctor to lose a medical license and that information should defintely be widely available.

The comment by N. Baro states…”..once a doctor loses his or her license, that’s it.  It takes a lot for a doctor to lose a medical license and that information should definitely be widely available.”  Sorry, but that’s a myth.  I’m a dentist and lost my license only because the seven member board was biased in favor of a member who had severely harmed my business.  I never harmed anyone, never had a malpractice suit, etc.  I’ve had my career and life impacted unfairly.  Many of the people who are commenting here aren’t in health care professions, haven’t spend years and lots of money getting trained, then to build a business and don’t know what’s really going on.  The public also loses access to good practitioners.  But I agree that a lawsuit being brought against a practitioner isn’t a verdict and doesn’t really mean they provided substandard care.  The US has a culture with a suing mentality and often the person suing is looking to “cash in”.

Don’t be whining docs and dentists. Too many big people do the same to hide things. The very fact ur whining about it is a red flag and you should be investigated. I don’t see any real names here.
However, I worked with a woman in a library in Okc City who had been a nurse who married a norman doctor. Her son from first marriage was a teenager who died in a car accident and the doctor was highly suspected of causing his death, after the fact that he was sleeping with many of his female patients came out and the divorce began and was fighting to keep their little daughter who would more than likely be sexually abused by him as well. As these things came out in public and to Okla. state medical board, they turned their eyes away and pretended not to see. Not even a slap on a perverts wrists. Which is ANOTHER red flag for an investigation! He should have been busted and throw out of the profession FOREVER, yet the perverts in offices were helping him! That’s why Okc, is satan’s belt buckle!

O; and btw; a few years ago, our DA’s wife was a big doctor who was finally caught by her addiction to loratab pain pills but according to our perverted medical board, it was ok. Let the bitch go. Now the case has arisen and the crappy way they treat our little people should be done the same to the big! If they don’t do what they are supposed to do their arrogance and superiority is showing they work for satan and are likely to trigger a civil war along with their buddies in city, state, and federal back-stabbers!

After the fact-I went through the motions of researching the doc that has been sued then 16 & now 17 times. I live in Kansas I and my family are potential patients in the very hospital from which Dr. T. was removed. I have a right to know more. As a patient we pay for good and bad care. (That is unless it is a ‘never event”.)

I know how the Kansas Medical Society functions. I read much of the outcomes of the KSBHA hearings. I want to know about the docs and hospitals that my family might have to use. I want to understand the medical culture that exists in my state.

When the KSBHA investigates a licensee it can take up to and through three years to research sometimes the supporting documentation. There is always a possible due process hearing. There is always a possible appeal even to the Kansas Supreme Court level. There sometimes is a criminal investigation going on simultaneous to the license hearing.

I know that Dr. T. attorney almost exclusively represents Dr.s who have “possible sanctions” and then comes before the Kansas State Board Of Healing Arts. I have been at the KSBHA meetings to observe how the Board functions. I see who sits with me sometimes using their wireless laptops to communicate with others. I know how much happens in closed session. I know how much is redacted from the Hearing Sanctions.

FYI: wsg
Not every state publishes doctors malpractice history. Kansas does not have one complete data base but with little digging one can find out a lots of facts. Thank God for good investigtive reporting.

I also believe that if the NPDB was completly open for everyone to read-the bad actor docs would be in another line of work.

Let me preface this by disclosing I am a physician.

Transparency is vitally important to improving patient care.  Atul Gawande’s books, including Complications, Better, and the Checklist Manifesto are just one physician’s ideas of how we can achieve better outcomes for our patients.  These books are all excellent reads.

However, the unabashed doctor-bashing on this comment board is inappropriate.  Most doctors give up a significant portion of their life and potential earning years to train to serve our patients.  Personally, I attended four years of college, four years of medical school, participated in four years of residency and am currently pursuing a year-long fellowship.  Thirteen years of education.  Also, I am currently over a quarter million dollars in debt - simply from medical school cost.  My debt to income ratio is 5:1.

Perfection, efficiency and ideal outcomes are continually expected of physicians, though we an often working with protoplasm that is less than perfect.  Production pressure (especially in my chosen field of Anesthesiology), demands almost super-human ability to obtain a full and complete patient history, be compassionate, sympathetic and explain the full risks and benefits of necessary procedures - all in less than five minutes, with complete documentation, lest I get sued. 

The environment physicians work in is intense and often unforgiving.  We cannot cure all, but are expected to.  Before you bash a doctor, consider our working conditions.  Consider some of the sacrifices made in pursuit of this calling.  Also, think to yourself - would you ever have the same malice and indifference in your comments, say towards nursing or other allied health care workers?

Just think about it.  Thanks.

Oh, plzzzzz….yesterday. What arrogance and whining for the group in America who think they are gods! Doctors started going down in MY book when I found out about the doctors hate towards a ‘healer’ who almost ruined their business by healing their patients without Pharmaceutical medicine! Homeopathy medicine should be the greatest healers in America not to take doctor’s paid for poisons! Geez. It was total hell for me to almost die and have to let a doctor into my brain! I loathe going to a doctor just as bad as any man! And most men try desperately to avoid going to one!

Wesley Sandel

Nov. 13, 2011, 7:36 p.m.

All of this screams “we need public health in the US”

A lot of the clinics in my town won’t take new Medicare patients. Why? I checked my Medicare statement and discovered that my GP was billing and getting paid over $130 for 15 minute appointment and then he was billing me a $20 co-pay on top of that - and he claimed it wasn’t enough.

So many physicians are “businessmen” and “entrepreneurs” first and physicians second. I certainly don’t trust businessmen to give me a fair shake, in fact, I start transactions with them with the assumption that if they can cheat me they will. So if my doctor is a businessman my confidence in him just went through the floor.

A good start to solving the problem would be to build more medical schools and arrange it so futures doctors can get through them without a mountain of debt.

Medicine should be about healing, not making a ton of fu*king money.

Sunday, Kansas City Currents KCUR public radio reported on Propublica’s coverage of Bavley and the NPDB PU issue. Her quote made it appear Secretary Kathleen Sebelius is in support of the questionable and onerous rule attached to the PU Data.

If the NPDB had been focused on full and useful participation of the mandated reporters to the Data Bank it would have been unnecessry for Mr Bavely to apply his craft.

Assure the public the Data Bank functions as it was intended by Congress and stop shooting the messenger. Remove the questionable cavet it looks like egg on your face.

“Perfection, efficiency and ideal outcomes are continually expected of physicians, though we an often working with protoplasm that is less than perfect.”

LL, this isn’t an argument I want to get into, but the problem is that you’ve described all of our jobs.  The difference?  We get fired without any review or recourse on deadlines that are built around corporate earnings reports rather than lives.  So while we all understand what you’re saying, it’s not going to buy much sympathy.

The other problem is that, any time a story like this comes up, doctors come out of the woodwork (in any forum) to decry transparency and accuse us all of being evil, litigious beasts who shouldn’t worry about whether the right limb was amputated or if anybody bothered to check for known drug allergies.  Look at Krista’s comments for an example.

(As to the need for a superhuman memory, this isn’t the proper forum, but computers are cheap, and I believe that HIPAA-compliant EMR systems will allow you access as long as it’s secured.  I know it sounds flip, but there is an entire industry of frustrated IT-types solving exactly that problem, after all.  My year at Eclipsys a lifetime ago didn’t give me nearly enough knowledge of the field to help, but I’ve heard good things about OpenEMR, for example, though I don’t know how easily it’d integrate into your infrastructure.  If the local bosses aren’t interested, point out how much time you waste an the number of cases mishandled and convert it into dollars for them.)

I’ll happily grant you that the problems aren’t the doctors in general, of course, just like I don’t blame the engineer who gets canned because he can’t make the EV battery defy the laws of physics in time for the quarterly earnings report.

However, the system is built unnecessarily around doctors when most problems could be resolved by someone with much less specialization, and the doctors at the center are in artificially short supply to (seemingly) optimize someone’s earnings.  I assume that the AMA is at fault, but the doctors support the AMA and accept the system and the AMA couldn’t care less what I think, whereas enough doctors could probably change things.

I get it.  The work is rewarding, but the job isn’t.  Believe me, I get it.  But if you don’t act to change it at the top, how and who does it help to defend doctors who have a pile of malpractice suits (that, frankly, they probably deserve if it’s more than one…)?

I have seen an outrageous amount of fraud by doctors and clinics billing medicare for medical treatments that were either not necessary never peformed.

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