Monday, September 27, 2010
The National Practitioner Data Bank - Information Could Be More Damaging Than Reliable
The National Practitioner Data Bank (NPDB) is like an amplification system to announce to the world, without checking the fairness or integrity of the source, that a physician has a problem and that a disciplinary action has been inflicted. Have you heard of guilty till proven innocent? Here, there is even no chance to prove innocence. Guilty, period! The problem is that the peer review process in the hospitals is so flawed that it does not measure up to a proper “due process”. You may very well be denied the right to the equivalent of an impartial jury. As mentioned in another post, it is quite possible to manipulate this process and to end up in an unfair disciplinary action even though a physician or a surgeon might be completely competent or even better than the rest. I call it, voting someone out in an elimination game. Despite the shaky standards of the process, the results are considered valid and the law obligates a hospital to report the damaging information to the National Practitioner Data Bank. Essentially, any hospital or competitors who have the power and lack of integrity as to inflict an adversarial action against you as a physician, will also have the ability (actually by law, the obligation) to report you to the National Practitioner Data Bank, which would make such damaging information available to other health authorities, hospitals, etc. No one would second-guess the reasons of the damaging information or disciplinary action, and to be on the safe side, everyone will avoid you like the plague. You cannot be hired or employed anywhere else unless someone is willing to stand up for you against the odds. All that started as a result of a process that can easily be abused against anyone who practices medicine, particularly invasive procedures like surgery, cardiology, radiology, etc. To provide an efficient mechanism of spreading damaging information about physicians (that is, NPDB) while having loop-holes and loose criteria of incriminating a doctor in a hospital peer review is nothing short of defaming. When quality improvement means carrying a whip or assassinating a career rather than creating an environment of transparency, openness and constructive auditing, I hope you all realize that we, in the US, have a serious problem. This is a harsh punitive and potentially vindictive environment, not a constructive one.