Internet disciplinary reports likely for N.Y. physicians

State legislators who once opposed putting any physician discipline data on the Internet now want to see medical malpractice judgments and settlements posted.

By Linda O. Prager, amednews staff. April 10, 2000.

A controversial plan to post detailed data on New York state's physicians on the Internet gained momentum following media reports about tragic errors and hidden malpractice histories of some of the state's prominent doctors.

Although they've successfully blocked dissemination of malpractice data in the past, medical society officials aren't optimistic they'll be able to do so this time around. And they warn many doctors will be reluctant to settle cases if data on those cases are included in what's posted for patients to see.

Key members of the state Senate and the governor now say they'll back a bill to give consumers Internet access to doctors' malpractice and disciplinary track records. For the past three years, the Senate has blocked similar legislation passed by the state Assembly.

"Now we're prepared to go even further," said Sen. Kemp Hannon, a Republican who chairs the state Senate's health panel. "We've decided to move forward, and we've gotten an indication from the governor for the first time that he's interested in putting malpractice information on the Internet."

The Senate majority leader also had indicated he plans to push a broad report card bill. Although not yet drafted, both he and Hannon indicated that bill would:

Give patients access to data on all liability payments made by specific doctors -- judgments as well as settlements..
Provide patients with a synopsis of the allegations in each case..
Allow doctors to post an explanation of each case..

Malpractice payment data would be one component of the report card. Data on doctors' education, certification status, community service, health plan participation, criminal convictions and disciplinary sanctions also would be included.

The bill as now proposed does indeed go further than the measure backed by the state Assembly. It also goes beyond systems already up and running in other states.

The Assembly measure calls only for posting summaries of doctors' liability histories, noting whether the frequency and severity of doctors' payments are high or low for their specialties. That's the tack taken by Massachusetts' online report card system, the nation's first. Systems online in Florida and Rhode Island do not include information on liability suits at all.

Hannon plans to amend a bill introduced in early March to include the broader range of malpractice data. That measure calls for doctor information to go online first, within a year of when the bill is passed. Data on hospitals and health plans would be phased in later.

Change of heart

The senator cited public outrage over the recent newspaper accounts of problematic doctors as well as better Internet technology as reasons the Senate leadership has finally decided to tackle this issue.

"As the Internet has developed, it's now possible to put forward complex information that can be complete, include appropriate caveats and lead people to further information," he said. "Frankly, two years ago that wasn't the case."

The Medical Society of the State of New York had voiced support for the more narrow bill, as long as the report cards weren't funded with money dedicated to the licensing board or through an increase in physicians' registration fees, noted Liz Dears Kent, counsel to the society's division of governmental affairs.

Even so, the society sees potential problems in posting hospital disciplinary data, arguing there's no standardization across hospitals in how sanctions are doled out.

But it's adamantly opposed to posting information on liability settlements. Settlements too often bear no relation to the question of competence, society officials said, but are merely a way to avoid the nuisance of going to trial.

In fact, the state's physician-owned liability insurer estimated that 75% of all cases settled involve no proof of any departure from acceptable medical practice.

Already, Kent noted, the state court system is mired in a backlog of cases. "You think you have a problem with a backlog now, just wait," she said. "Put settlement information online, and no one's going to settle."

Massachusetts' physician report card system continues to be cited by lawmakers in New York and elsewhere as they craft legislation. That system includes data on settlements paid as well as on court judgments, although no details of the cases are provided.

Kent balks at any comparison of the impact of report cards on New York state physicians vs. those in Massachusetts.

Kent contended that New York physicians encounter a much more litigious and impenetrable justice system than those elsewhere in the country. And that system would have to be radically reformed before settlement information could in any way be meaningful for consumers.

In addition, she noted, Massachusetts' medical board was under fire for inadequate oversight of physicians when it launched its profiling system. New York at that same time doubled physicians' registration fees to help ratchet up oversight.

"We sought to effectuate the cure by fully funding our misconduct system," Kent said. "So don't look to the Massachusetts profiling system to address the needs of the public or physician community here."