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Physicians battle to keep records secret

If you were going under the knife, would you want to know whether your doctor has been sued by previous patients? What if your doctor paid malpractice judgments to several of them? Would you want to know that, too?

I did. After years of covering medical malpractice in North Carolina, I'm not your typical patient. The typical patient assumes a doctor capable of doing harm to them because of psychological problems, drug and alcohol addiction, or a pattern of carelessness or plain incompetence wouldn't be allowed to practice in North Carolina.

Regular readers of this column know better. The North Carolina Medical Board, a state body that is supposed to regulate medical professionals, has a long history of slapping the hands of doctors who maim, kill or sexually abuse their patients and returning them quickly to practice. These doctors are a tiny percentage of the thousands who practice here, but it can be extremely difficult to determine who they are.

So before I had surgery recently, I spent a lot of time quizzing nurses, doctors and anesthesiologists who work in operating rooms about who does the best C-sections in town. I also quizzed malpractice attorneys and spent hours combing through lawsuits at the courthouse.

Oddly enough, they all seemed to be in agreement on which docs were the best and which ones to avoid. Another helpful sign is when the doctors, nurses and lawyers you ask all seem to send their family members to the same physicians and use them themselves. That's because there's a real difference in the quality of medical care you get from one doctor to the next.

If this is common knowledge in the medical community, why are patients kept in the dark? Why can you get more information about your plumber than you can your doctor? Why do patients have to rely on word of mouth in much the same way they did a century ago?

In short, it's because doctors have better lobbyists.

For years, medical society lobbyists managed to defeat attempts by well-meaning legislators to force the medical board to disclose more information to patients. But after a series of lax enforcement cases publicized by the media embarrassed Raleigh power brokers, the legislature finally passed legislation mandating the disclosure of more information to patients.

Now a high-level brawl is being fought between the state's patients and its doctors over how to go about it. The North Carolina Medical Society, a group that represents 11,000 doctors across the state, wants to keep lawsuit and settlement information from patients whose lives it could save.

The medical society is campaigning to have "minders" decide what information patients can see. The society wants to appoint teams of two doctors in each specialty to comb through malpractice cases and second-guess them. If they get their way, instead of seeing a full list of the malpractice lawsuits, judgments and settlements in a doctor's recent past, if the team decides that a doctor "met the standard of care" in a case, even if he lost in court or settled it, patients wouldn't be allowed to know about it.

The society says that certain docs who take on a lot of high-risk cases might have more lawsuits. But doctors with a history of negligence also tend to have a high number of lawsuits.

I've long suspected that the medical society has a hidden motive for wanting to hide malpractice cases from patients. When the medical board doesn't take action against a doctor, all the charges or complaints against him or her remain confidential. That leaves consumers with just one place to go to find out about doctors' track records -- their county courthouse. And records of settlements often aren't available.

In 2006, just seven doctors out of the 27,000 who are licensed here had their licenses revoked by the medical board, and 55 had them temporarily suspended. Contrast that with the 500 malpractice cases a year filed in North Carolina, around 200 of which result in payouts.

Because malpractice attorneys must spend $25,000 to $50,000 of their own money to prepare a case, it's difficult to find many willing to file the so-called frivolous suits we've read so much about. A 2006 Harvard School of Public Health study in the New England Journal of Medicine found that most malpractice cases are meritorious, with 97 percent involving injury and 80 percent of the claims involving physical injuries resulted in major disability or death.

So if patients could see the relatively large numbers of suits a small number of doctors rack up in sharp contrast to their peers in similar specialties, state legislators might start asking why these doctors haven't been disciplined by the board. The answer is, of course, that in North Carolina, doctors can kill a couple of people during procedures patients aren't supposed to die from -- or have performed on them in the first place -- and get back their licenses. My guess is that the medical society would rather you not know that.

Right now, the medical society is urging doctors to e-mail the medical board to encourage them to bar this information from the public. The board needs to hear from patients as well before June 30. E-mail the board at rules@ncmedboard.org.

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