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Proposal could require more information on doctors 

Medical disclosure

The N.C. Medical Board is poised to adopt rules that could add meat to its online doctors' profiles and put the it among a growing number of states that disclose malpractice payments.

If the physician-dominated board approves the rules, all doctors and physician assistants licensed in North Carolina would be required to disclose online how many malpractice settlements or judgments they've had within seven years. The profiles also would include felony convictions and certain misdemeanor convictions.

The board's move would allow the public to gain access to information previously found by venturing to a county courthouse, and it would let patients learn of cases that never made it to a courtroom, said R. David Henderson, the board's executive director.

But the proposal has doctors' advocates apoplectic. The N.C. Medical Society, which is waging a letter-writing campaign, says the new disclosures could mislead patients and lead to more costly, lengthy malpractice litigation.

"[We] support transparency," said Bob Seligson, the society's executive vice president. "We don't support the reporting of information that is unrelated to the issue of substandard care."

The state medical board in recent years has been roundly criticized, in these pages and elsewhere, for not disclosing more about doctors' histories. One of the most vociferous critics has been Public Citizen, a consumer advocacy group founded by Ralph Nader. The consumer group, which has consistently given the state board low ratings for a lack of disclosure, believes medical boards have a responsibility to maintain public physician profiles that disclose malpractice payments.

"It's obviously an important piece of information for patients," said Dr. Sidney Wolfe, director of the organization's Health Research Group, based in Washington, D.C.

The Federation of State Medical Boards, an umbrella group of which the N.C. board is a member, since April 2000 has recommended the practice.

"It was recognized that it would be probably controversial in the professional community but that it was something, in the interest of transparency, could be valuable information, if put in the correct context," said Lisa Robin, the federation's senior vice president of member services.

As proposed, physicians' profiles would include a disclaimer that malpractice suits don't necessarily indicate the quality of a doctor's care. They won't include, however, the amount of the settlement. "The dollar amount really does not correlate well with whether or not there was any negligence or the degree of negligence," said Henderson.

The profiles also will allow doctors to provide brief explanations. But the N.C. Medical Society doesn't believe that context will be enough. A spokesman for the doctors' professional association said it supported the legislative action that authorized such changes but disagrees with how the medical board wants to implement them.

The society opposes posting all malpractice payments and instead favors only the public disclosure of those cases that have resulted in disciplinary action by the medical board.

But do medical boards stop all negligence? "I think that there's appropriate mechanisms in place for the medical board," Seligson said. "They have the resources to follow up on a complaint."

History seems to indicate exceptions. Reports in Creative Loafing and elsewhere have found instances of errant doctors who continue to practice, coming back to the profession even after being punished for pushing fraudulent AIDS cures or even sexually assaulting patients.

The board would rely principally on doctors to disclose payments, though insurance carriers would also notify the board. The board also receives annual information from the National Practitioners Data Bank, said Mansfield. If doctors don't report malpractice cases, the board could reprimand them or even revoke their licenses, although the latter is a rarely used.

Relatively few doctors will be affected -- Henderson estimated only 4 percent will have settlements to disclose.

Web sites that give information about doctors have proliferated in recent years, from free medical board profiles to pay sites like Healthgrades.com. In 1996, Massachusetts' medical board was the first to include physician profiles on its Web site.

The N.C. medical board did not have information on how many people access its doctor search function.

The board is now soliciting comments on the proposed rules. Henderson said the new required information could be online by fall 2009.

The public can view the proposed rules at www.ncmedboard.org. Comments will be accepted until June 30 at rules@ncmedboard.org or P.O. Box 2007 Raleigh, N.C., 27619.

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