We believe that the patient’s wellbeing should be at the center of every health care decision.
The For The Patients campaign provides guidance on how to put patient safety first.
The Issue
Not Enough Discipline for Bad Doctors
A recent analysis found that of over 8,000 doctors with five or more malpractice payouts since 1990, only 25% have ever been disciplined by their state’s medical board.
This low rate suggests that state medical boards often fail to hold bad doctors accountable for patient harm. See our analysis of the trends in state disciplinary actions across the U.S.
In August of 2020, Public Citizen wrote state medical boards demanding they institute a zero-tolerance policy against sexual abuse of patients by doctors, investigate every complaint, and push for improved state laws.
Meanwhile, several states have mandated caps on damages for medical malpractice that often prevent patients from getting anything close to adequate restitution.
The Players
Congress
Congress established The National Practitioners Database (NPDB) in 1986 ‘to improve health care quality, protect the public and reduce health care fraud’. Since September 1990, state licensing boards, hospitals, and other health care entities, including professional societies, have been required to report certain adverse licensing and disciplinary actions taken against individual doctors.
- All reports are not publicly accessible so patients who try to get information about their health care providers can’t get access to the database to find out the truth about their doctors.
- Hospitals are required by law to check the NPDB every two years and every time they hire a doctor.
- Half of all hospitals have not made any reports at all to the NPDB in the last 20 years.
A big part of the problem is the loopholes and lack of incentives to actually use the data base. For example, even doctors themselves can’t get information from the NPDB.
Despite all of these issues, Congress has not taken decisive action on patient harm in more than three decades.
Congress has not mandated a federal bill of patient rights.
State Medical Boards
State Medical Boards (SMBs) are responsible for licensing, disciplining and regulating physicians. The system of licensing medical practitioners was designed to protect the public from physicians who are inadequately trained or incompetent or whose conduct is illegal or abusive towards patients.
- State medical practice acts mandate that medical boards take disciplinary action against licensees who have endangered or injured patients, yet the rates of action taken are low nationwide.
- State medical boards also should be regularly querying and submitting disciplinary licensing action reports to the NPDB, but they rarely take serious disciplinary action against bad doctors in the first place.
- At the state level, medical board members are typically physicians, rather than public members, who generally support minimizing transparency and protecting their colleagues.
Special Interests
The American Medical Association, which currently represents only 30 percent of physicians in this country, plays an outsized role in dictating policy regarding patient safety due to the $20 million annually they invest in lobbying, as well as sizable and bipartisan political contributions.
The AMA is the strongest advocate of keeping the NPDB closed to the public.
Racial Disparities
The system is failing patients of color at greater rates. For example, there is evidence that hospital staff are more likely to report patient safety events for white patients than they are for patients of color.
Research by The National Academy of Medicine and other sources report that with all other variables accounted for, racial and ethnic minorities are more likely to receive lower quality of care in the U.S. Black patients are less likely to even receive the type of care as their white counterparts.
Act Now
We believe that the patient’s well being should be at the center
of every health care decision. For The Patients
campaign provides guidance on how to put patient safety first.