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February 25, 2014

You can examine your doctor's record, but don't expect to learn everything

— Recently a reader wrote me to ask how patients can perform background checks on their doctors, to make sure that they're in good standing. He had a reason for asking: A few years ago, he said, he'd agreed to have a spinal fusion performed by an apparently well-regarded surgeon. The operation left him worse off than when he started, and he later discovered that there were numerous malpractice lawsuits pending against the surgeon.

The reader was outraged and confused. He had been given the surgeon's name by another doctor. He'd even looked up the surgeon's profile online, and what he found there looked like a clean record.

Unfortunately, there's no foolproof way to vet your doctor, says physician Michael Carome, director of the health research group at Public Citizen, a consumer advocacy organization based in Washington. But there are some basic steps you can take to look into a doctor's credentials and record.

Start at your state's medical board. Most state medical boards' Web sites allow you to search for individual physician licenses. Boards vary in the amount of data they disclose on these sites, Carome says, but many will list information about disciplinary actions taken against a physician and payments made for medical malpractice lawsuits. If your state doesn't post that information, you may be able to contact the medical board and request it, Carome says.

Realize, though, that such records will show only settlements that have been made, not pending lawsuits or investigations that aren't complete, and states vary in how aggressive they are in taking action against problem doctors, Carome says. "Too often, medical boards give problem physicians a slap on the wrist - like a letter of reprimand, probation or a suspended license that is then immediately reinstated - so that they can continue practicing." What may appear like a minor infraction in the doctor's record could represent something serious, so don't be afraid to ask questions, Carome says.

State medical boards generally provide their information free of charge, but you can also order a report on an individual doctor through Docinfo (www.docinfo.org), a service of the Federation of State Medical Boards (FSMB). For $9.95 per search, you can look up a physician's medical school and year of graduation, licensure history, board specialties, location, alternate names and disciplinary actions taken against him or her.

"Every disciplinary action reported by state medical boards to the FSMB is uploaded," says Lisa Robin, chief advocacy officer of the federation.

It's not easy for doctors to run away from disciplinary measures. "Under federal law, suspended licenses must be reported to the National Practitioner Data Bank," Carome says. These records aren't publicly available, but hospitals and state medical boards have access to them. If, say, a physician who had his license suspended in California moves to Ohio and applies for a license, the State Medical Board of Ohio is able to check that physician's record in the national data bank before making a decision, Carome says.

Although patients can't access the national database, they can look up information about physicians on sites such as Healthgrades.com, a for-profit venture that's free for patients. (The company makes its money from advertising bought by drugmakers, medical device manufacturers and hospitals and doctors who pay extra to highlight their products and services, says Evan Marks, Healthgrades' executive vice president for informatics and strategy.)

The site provides doctor reviews collected from patients as well as information from the Centers for Medicare and Medicaid Services and state medical boards, Marks says. Like other sources, Healthgrades collects information only about lawsuits that have been settled, so a doctor with pending lawsuits may still appear to have a spotless record.

If you're concerned that your doctor may be unduly influenced by pharmaceutical companies, you can use the "Dollars for Doctors" page maintained by the ProPublica journalism project to find out if he or she has received drug company money and, if so, how much. You can also see how doctors' prescribing habits compare with their peers' at ProPublica's Prescriber Checkup page, projects.propublica.org/checkup. The site shows how often a physician prescribes drugs that present special risks compared with the average doctor, as well as rates of name-brand drug prescriptions and the average number and cost of prescriptions their patients are given.

An Internet search may turn up patient complaints or lawsuits that are still pending, but keep a skeptical eye about such reports, says Daniel Spogen, a physician at the University of Nevada School of Medicine and a member of the board of directors of the American Academy of Family Physicians. Sometimes a doctor does everything right but the patient fares poorly anyway, through no fault of the physician, and the patient or his family sues. The average physician is sued for malpractice once every seven or eight years, but not every lawsuit has just cause, Spogen says.

As for the reader with the back surgery gone wrong, he now searches the Web for lawsuits or complaints against doctors he might choose to visit, and he looks for their names in court records before seeing them. His methods may seem extreme, but he's willing to spend the extra time to ensure that he has turned over every stone.

 

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