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David Mittleman
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Practitioner Data Bank: a Method to Keep Patients Safer, But Is It Working?

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For almost 20 years something known as the Practitioner Data Bank has existed—and for good reason. Per federal law, hospitals and medical boards are required to report doctors they discipline for medical incompetence, unprofessional conduct, or substandard care. However, according to the nonprofit consumer group, Public Citizen, many hospitals don’t appear to be following the law.

The Practitioner Data Bank is important for several reason: it allows hospitals to and medical organizations to see a doctor’s disciplinary record prior to hiring the person—a move that can help protect patients from doctors with a bad history. Furthermore, the bank also allows state medical boards to conduct investigations into physicians that they feel are potential liabilities to their patients.

According to the Public Citizen researchers, 49% of hospitals in the United States haven’t reported a single doctor to the Data Bank from its initiation in 1990 until the end of 2007. Furthermore, the report also indicates the the data that has been collected is still dangerously weak:

In response to the OIG report, HRSA convened a national conference in October 1996 of many stakeholders such as the American Hospital Association, American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations ("Joint Commission"), Center for Medicare and Medicaid Services, Public Citizen and OIG. The consensus report from the conference found that the number of reports in the NPDB is unreasonably low, compared with what would be expected if hospitals pursued peer review effectively.

Collectively, the OIG report, the 1996 national conference, and a 2002 HRSA funded study of hospital compliance made a total of 10 different recommendations to remedy this serious problem. However, as of December 31, 2008, only one of the recommendations has been fully implemented.

Public Citizen also makes some important suggestions on how these problems could be remedied. For example, the researchers suggest new Medicare rules that would force hospitals to comply with the Data Bank requirements and $25,000 for each failure to do so. Overall, the report shows how important hospital accountability and legislator enforcement is to patient safety.

Read the full report at http://www.citizen.org/documents/1873.pdf