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Reporting Recipe: How to Investigate Health Professionals

We've launched two 50-state guides to researching the license and disciplinary records of doctors, nurses and other healthcare professionals.

(David Sleight and Hannah Birch, ProPublica)

Today we're launching two guides to help researchers, journalists and citizens check the license and disciplinary records of medical professionals in every state. One is for doctors, the other for nurses.

State boards are responsible for investigating alleged wrongdoing, incompetence and mistakes made by doctors and nurses. When they find problems, boards can revoke a license—stopping a doctor or nurse from practicing—or impose lesser discipline. But all too often, the details of their findings remain inaccessible to the public.

There is no free and open national database that allows the public to scrutinize the qualifications of doctors and nurses. The Federation of State Medical Boards, a trade group for state medical boards, has a lookup tool for doctors, but it costs nearly $10 per search. "The fee helps defray a portion of the significant costs involved with gathering, verifying and maintaining licensure, disciplinary and medical specialty information," said Drew Carlson, the federation's director of communications, in an email. The National Council of State Boards of Nursing, a trade group for state nursing boards, has a national search tool to verify nurses' licenses, but not all states participate — and often the documents explaining any misconduct are unavailable.

Every state licensing board in the U.S. provides the public with basic license verification for medical professionals registered in their states, including whether or not practitioners have been disciplined. Most publish the legal documents online, giving the public a detailed description of any violations and the subsequent enforcement actions.

For example, Arizona's medical and nursing boards publicly list every enforcement action, along with documents that reveal the details of the wrongdoing.

However, 16 medical and nursing boards lag behind, withholding key details about misdeeds and mistakes, including the legal documents.

Dr. Sidney M. Wolfe, the founder and former director of the Health Research Group at the consumer watchdog organization Public Citizen, says that state boards should be more transparent with disciplinary information.

"The ability for people to get information on their doctors and nurses in this country depends on what state you live in," said Wolfe, whose organization published a yearly index ranking state medical boards by the number of disciplinary actions per physician. "That kind of information is too important to be left to the whims of the state."

The states that do not post the records online require patients to pay fees or file public records requests to find out the details about their doctors' and nurses' histories.

For many patients, that hurdle is too high. And in the U.S., where medical negligence is the third-leading cause of death, finding out this information could make a life-changing difference.

Medical and nursing boards reached by ProPublica cited two reasons for withholding disciplinary details from their websites: money and privacy.

Wyoming's State Board of Nursing posts all public records of nurses' wrongdoing, but the state medical board does not.

"Our data system is antiquated and we're going through a long-term transition," said Kevin Bohnenblust, executive director of the Wyoming Board of Medicine. The medical board lists a one-sentence summary of disciplinary actions, but provides no further detail. "Because we're so small, we are doing it in bite-size pieces. We've wanted to get it right rather than have a broken product."

Some medical and nursing boards rely on fees from public requests for disciplinary documents to cover their budgets.

"That is our way of obtaining monies," said Frances Carrillo, a special projects officer at the Mississippi State Board of Medical Licensure. "We don't take money from state coffers—we take money from fees and fines and licensure fees. This is our way of covering our budget to operate."

Other boards say that although medical and nursing disciplinary records are public records, they should not necessarily be publicized.

"We don't publicize that information for every nurse. It is public record but we just don't put it out there probably because of privacy issues," said Angela Rice, an administrative coordinator at the Louisiana Board of Nursing.

For our complete, state-by-state guide to public records of medical licensing board documents, and for more information on investigating doctors and nurses, check out our guides: How To Investigate Nurses and How To Investigate Doctors.

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