PrimeTime: Researching Your Doctor

Nov. 16, 2000 -- How much do you know about the doctor you choose from your health plan?

A six-month PrimeTime Thursday investigation found that between Cigna and Aetna, more than 150 doctors on their 1999 provider lists for the New York City, Washington, D.C. and Los Angeles areas had been disciplined by state medical authorities in the last 10 years for a wide range of offenses. More than 70 had been disciplined for medical negligence or incompetence, including two surgeons who had operated on the wrong knee. Others were cited for substance abuse, sexual misconduct, fraud, poor record-keeping and over-prescribing drugs.

“There’s no question that doctors who have repeatedly been found to practice poor medicine are put on these lists, and it’s just a matter of which patient it’s going to be that’s going to be the next victim,” says Dr. Sidney Wolfe of Public Citizen’s Health Research Group, which publishes a yearly book called Questionable Doctors.

But Susan Pisano of the American Association of Health Plans, a trade group representing managed care, says, “Health plans go through a very rigorous credentialing process with physicians.” Health care companies, she says, check the National Practitioner Data Bank, which is not open to consumers, for any disciplinary action against a doctor and monitor performance and sanctions on an ongoing basis.

Unless a doctor’s license has been suspended or patients are at risk of imminent harm, she says, then a peer-review board evaluates doctors on a case-by-case basis, taking into account, for example, the passage of time or a doctor’s possible rehabilitation.

Patients, she adds, are better off choosing a doctor from a health plan’s list because picking a doctor out of the Yellow Pages is not nearly as secure as choosing one that has been pre-screened by a managed care company.

Still, she says, “we would agree that more information needs to be made available” because it’s a good idea for patients to do their own research before choosing a doctor.

So how can you find out if your doctor has been sued for malpractice or disciplined by a state medical board or federal agency?

The American Medical Association (AMA) Physician Select service claims to provide “comprehensive information” on virtually every licensed physician in the United States — but it offers nothing on their doctors’ disciplinary history. You can, however, gather basic demographic and professional information about a doctor.

The Official Osteopathic Physician Profile Report includes doctors’ training, license and DEA status, as well as state and federal sanction alerts.

State Medical Boards

To uncover disciplinary information about your doctor, your best bet is to contact your state’s medical board. What is made available to the public varies from state to state, but, says Pisano, there is a growing emphasis across the country on the rights of individual patients.

“The trend has been toward providing more information for consumers about physicians’ malpractice and discipline records,” she says, particularly via the Web.

The Alabama State Board of Medical Examiners and Medical Licensure Commission lists public actions taken against doctors over the past three months. To research past actions, they invite you to pull up newsletters by date, which, of course, is no help if you’re trying to find out whether a particular doctor has been disciplined at all. For that, you can make a request in writing to the disciplining agency.

The Arizona Board of Medical Examiners (BOMEX) site allows you to verify credentials and look at disciplinary action taken against doctors over the past two years.

The Medical Board of California allows you to verify if a doctor is certified and provides a license number, address and schooling. No information is offered online about disciplinary action taken, but you can call 916-263-2525. There is a separate site for the Osteopathic Medical Board.

The Colorado State Board of Medical Examiners offers a summary of disciplinary actions by month and year, but covers only the past twelve months. For information on a particular physician, you must submit a written request.

The District of Columbia’s Department of Health requires that you send a check or money order for $50 to find out about a doctor’s disciplinary history.

The State of Iowa Board of Medical Examiners lets you verify by phone whether a physician or acupuncturist is licensed. The Web site will tell you more than you ever wanted to know about how a physician is licensed and what the disciplinary process for licensees’ entails —but nothing about particular physicians who have violated state law or board rules.

The Kansas Stated Board of Healing Arts offers an alphabetized database of doctors (everything from physicians to occupational therapists to athletic trainers) who have been disciplined over the past five years.

The State of Maine Board of Licensure lists “adverse actions” alphabetically and chronologically as far back as 1981.

In Maryland, the Board of Physician Quality Assurance (BPQA) offers a profile for active licensed physicians, including disciplinary actions taken by the BPQA or another state board as provided to the National Practitioner Data Bank. You can also call 800-492-6836.

The Massachusetts Board of Registration in Medicine helps you find out about a doctor’s education, training, awards, publications, insurance plans accepted, as well as malpractice and disciplinary histories.

The Minnesota Board of Medical Practice lists three doctors who were disciplined in September 2000. But if the doctor you’re trying to find out about isn’t one of those three, you can contact the board at 612-617-2130. The Board’s Health Professional Database can, however, help you find a doctor’s town and license number.

The New Jersey State Board of Medical Examiners lists all New Jersey physicians along with their license status and disciplinary history, or you can call 609-826-7100.

In New York, the Professional Misconduct and Physician Discipline Web site provides a listing of all physicians, physician assistants and specialist assistants who have been disciplined since 1992. To find out about disciplinary actions prior to 1992, call 800-663-6114.

The North Carolina Medical Board lets you search bi-monthly reports on disciplinary action and look at all actions taken by the board for offenses such as failing to renew a license or attempting to produce an abortion contrary to law.

The North Dakota State Board of Medical Examiners allows you to research licensure and disciplinary information by a physician or physician assistant’s name.

The State of Ohio Medical Board has an online service for checking a licensee’s status, including formal actions taken. You can also search medical actions taken by month for the past two years online or call 614-466-3934.

The Oklahoma Board of Medical Examiners covers everything from dieticians to apprentice athletic trainers to perfusionists (one who injects fluid into an artery in order to reach the tissue). You can search disciplinary action status by name, county and specialty. The Oklahoma Board of Osteopathic Examiners lists disciplinary actions taken against doctors of osteopathy by doctor taken over the last five years.

The Oregon Board of Medical Examiners charges $10.00 per doctor’s name to find out extensive background information or you can call 503-229-5027 to find basic information on up to three doctors.

The Rhode Island Board of Medical Licensure and Discipline offers a list of state-licensed physicians who have had disciplinary action taken against them. These names are also disseminated to all hospitals, healthcare facilities and HMOs.

The Texas State Board of Medical Examiners has an online verification system. If you can’t figure out how to use it (which may very well be the case), you can call 800-248-4062.

The Vermont Board of Medical Practice lets you search any board action by doctor’s name.

In Washington, the Medical Quality Assurance Commission allows you to check the disciplinary status as well as the number of complaints against any licensed, registered or certified health care provider by calling 360-236-4800.

For states not listed above, try State Medical Board Web sites or State Board Directory.

— Additional reporting by Michael Mendelsohn