But Jean Marie Rocha, vice president of clinical affairs for the Hospital Association of Rhode Island, said that the "biggest incentive for hospitals and physicians is to know they're providing the best care for hospitals and patients." Instead of fining hospitals, Rocha said, reporting to the data bank should "be done on a voluntary rate."
Rhode Island hospitals reported more to the data bank than any other state, according to the report, with about 19 percent of its hospitals in that state failing to ever have filed reports.
The process of hospital peer review has been called "one of the pillars of quality assurance in the United States" by the Journal of the American Medical Association, according to the Public Citizen report.
But hospitals across the country have devised new ways to avoid reporting, according to a medical board member who requested anonymity in e-mails to Public Citizen earlier this year. That person said hospitals dodge the rules by having physicians take a "leave of absence" or changing their bylaws.
"About half the hospitals in the country have never reported one doctor out of the couple hundred thousand doctors that are on the staffs of those hospitals," Public Citizen's Wolfe said. "It's just not believable. The only answer is the hospitals aren't doing their job disciplining doctors."
The allure of profit also means hospitals may fail to report things they should, the report says.
A 2002, an FBI raid on California's Redding Medical Center found two physicians had conducted unnecessary cardiac procedures on more than 600 patients since 1995. Because of the revenue generated by the surgeries, the physician was able to "block hospital peer review," according to the FBI affidavit.
Reporting varies by state, according to Public Citizen. More than 70 percent of hospitals in North and South Dakota, for instance, never reported information for the database, compared to Rhode Island's 19 percent that did not.
The Public Citizen report indicates there are several ways to rebuild hospital peer review in the United States, making it more beneficial and accountable for patients.
In addition to fining hospitals, the group would like to give the federal Centers for Medicare and Medicaid Services the authority to sanction hospitals and physicians who do not complete peer reviews.