Doctors resigned to public Web profiles

With Washington and Georgia the latest states to post physician profiles online, those living with the systems offer mixed reviews.

By Damon Adams, amednews staff. May 5, 2003.

Beginning in June, felony convictions and some malpractice settlements and awards against Georgia doctors will be posted on the Internet.

The Medical Assn. of Georgia fought for a compromise to keep misdemeanor convictions and lower malpractice settlements off the Web. But some doctors aren't thrilled about felonies and higher settlements being put online by Georgia's Composite State Board of Medical Examiners.

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"We're getting a number of calls from physicians who have concerns. Physicians are wondering why the medical profession is being singled out," said David Cook, the association's executive director.

Physicians and medical societies object when a state proposes listing physician profiles and disciplinary actions on the Internet for consumer access. Doctors worry that medical board postings of malpractice information and disciplinary actions will scare away patients, supply attorneys with data for lawsuits and give the impression they are bad physicians.

Georgia and Washington are the latest states to stir these fears by putting physician profiles online. But for the most part, physicians in other states seem resigned to having their profiles on the Web. Problems of mass misinformation and patient departures didn't materialize, they said.

"Has it hurt doctors? Nah. As far as I can tell, there's been no besmirching. Most of us have not seen any effect," said Joseph Heyman, MD, a gynecologist in Amesbury, Mass., and an AMA trustee.

About two years ago in Virginia, some medical societies fought the Virginia Board of Medicine's plan to list unfounded complaints against doctors. With disclaimers added to the board's Web site, the uproar has quieted. "They've all sort of just settled in that it's there," said Roberta Sorensen, executive director of the Medical Society of Northern Virginia.

Fueled by reports of medical errors and a push for patient safety, many states have a searchable database for license information and disciplinary actions on state-supported Web sites.

New York posts hospital restrictions, criminal convictions and malpractice information. Virginia and others list disclaimers with malpractice information, saying paid claims vary by specialty and studies show little correlation between a doctor's lawsuit history and competence.

Massachusetts takes the lead

In 1996, Massachusetts was the first state to make its profile database available to consumers. The Massachusetts Medical Society initially opposed efforts to mandate physician profiles and got the governor to veto one bill. In hopes of controlling the fate of physician information, the society supported a different profile bill, which passed in 1996.

Many states modeled legislation after the Massachusetts profiles, which include a doctor's address, medical education, board certification, disciplinary actions, number of malpractice payments and criminal convictions.

None of the horrific predictions expressed by doctors came true, said Nancy Achin Audesse, executive director of the Massachusetts Board of Registration in Medicine. "Did it cause doctors to flee the state? The answer is no," she said. "This is supposed to be a consumer education tool. No doctor should be afraid of good patient information."

But Barbara Rockett, MD, a surgeon in Newton, Mass., doesn't like the profiles. She said doctors in high-risk specialties may be judged wrongly on malpractice payments and younger doctors may appear to have cleaner records. "It's worthless. [Patients] don't rely on the profiles," said Dr. Rockett, former president of the Massachusetts Medical Society.

Disclosure of malpractice settlements was a sticky issue in California last year when legislators considered changing physician profiles to disclose settlements of more than $150,000, but the California Medical Assn. pushed for a compromise.

The new law calls for posting three or more settlements per doctor (four for high-risk specialties) in a 10-year period starting Jan. 1, 2003. Doctors with two or fewer settlements (three or fewer for high-risk specialties) would not have that information posted.

"We were successful in striking some sort of balance," said Robert Hertzka, MD, an anesthesiologist in San Diego and CMA president-elect. "[Profiles] are a mixed bag. For doctors, it's one more thing to worry about. For patients, if done properly, it's a plus."

On April 15, Washington began posting doctor license status and disciplinary actions. State officials and physicians are waiting to see what impact, if any, the new information will have on the public and profession.

"Certainly, we're not opposed to people knowing about a doctor, but we also want to make sure the information is accurate," said Maureen A. Callaghan, MD, a neurologist in Olympia, Wash., and president of the Washington State Medical Assn. "Sometimes, it's about the level of detail -- what is or isn't revealed."