Tuesday, May 31, 2011

Statistics of Physician Elimination - Career Destruction

Out of curiosity, I visited the National Practitioner Data Bank's (NPDB) website, and I found the "NPDB Summary Report" at
It is actually a good source of information.

The NPDB Summary Report starts by stating: "The following is a summary of reports submitted and accepted into the NPDB for each professional category. This data covers the period from September 1, 1990 through April 2, 2011. Professional categories which were not available for the entire time period are noted."

Then there is a "Data Disclaimer": Reports of adverse clinical privileges and professional society membership actions against practitioners other than physicians and dentists, (e.g., chiropractors, psychologists, podiatrists) are submitted voluntarily.

I pointed my attention then  to the column "LICENSURE,CLINICAL PRIVILEGES, PROFESSIONAL SOCIETY MEMBERSHIP, AND PEER REVIEW ORGANIZATION REPORTS.  I chose some categories just to have some idea as to how many individuals in which professions are subjected to that career assassination.

Dentists: 20,239
Nurse Midwife: 94
Nurse Practitioner: 921
Hospital Administrator: 0
Licensed Practical or Vocational Nurse: 78,421
Nurse Anesthetist: 337
Osteopathic Physician (DO): 8,129
Osteopathic Physician Intern/Resident (DO): 153
Physician (MD): 82,683
Physician Intern/Resident (MD): 588

So, the safest on that regards is to be a Hospital Administrator.  Interesting.  And, being a trainee resident or even an intern is no reason for mercy.  Career destruction and elimination based on arbitrary criteria is just the way it is, no matter how junior or advanced in the career someone is.

Breakdown of MD by State, from highest to lowest number of physicians (MDs) whose careers, livelihood have been threatened with career capital punishment. 

CA    10,019
NY    6,561
OH    4,414
TX     4,111
FL     3,885
IL      3,647
VA     3,411
PA     3,004
AZ    2,591
MI    2,525
NJ    2,481
GA    2,262
CO    2,088
MA    2,074
MD    2,025
WA     1,877
NC    1,832
KY    1,661
LA    1,399
MO    1,377
TN     1,299
AL     1,152
OR    1,116
IN    1,107
MN    1,021
OK    979
WV     972
SC     958
WI     936
IA    918
CT    897
MS    751
KS    748
NV    606
UT     565
AR    539
NM    523
ME    429
DC     393
NE    381
ND    376
NH    354
AK    343
RI     334
VT     296
ID    285
HI    278
WY     178
DE    164
SD     149
PR     44

Notice that these are raw numbers. To transform those into meaningful statistical values, in the very least I need a denominator.  Actually deciding what the denominator should be is not easy.  Is it the population of the state? The population of a certain age? The number of practicing MDs? If so, the current number of MD"s, realizing that the data cover from 1990 till 2011, so, which MD population would be used, etc. 

Regardless, for someone to become a physician, one endures a lot that is well known to everyone.  And not too many really would be willing to pursue that route if they know that more than 90,000 were kicked out.  And they were not kicked out by an objective, fair or impartial process, but were eliminated and destroyed by a flawed process that is open for exploitation and abuse, executed by their peers and called  the"peer review".  There is nothing Holy about it.


  1. Excellent job. God bless you for your work and efforts! Dr collegue

  2. Excellent work, but very discouraging! thanks for your hard work. We need to keep our collective chins up


  3. Thanks. The problem is that there are no rules. A disciplinary action against a physician, followed by a NPDB reporting, essentially the career capital punishment, could be imposed with no constitutional due process. There are no guidliens as to what actions would warrant destroying a physician's career and shattering the physician's life and family with no mercy. With more than 90,000 MD physicians targeted for career destruction, I think it is safe to say that practicing medicine in the US (particularly specialties like surgery and gynecology) is a very costly gamble. The environment of practicing medicine in the US has changed with the destruction of the patient-physician relationship and the anti-physician hostile punitive culture that is like cancer. I hope I am wrong.

  4. Yes, all of that is true. But, why hasn't anyone studied this problem to come up with different ideas and perhaps some of them would work?

    We are doctors. We are scientists. We like to explore new ways of thinking especially if the old ways don't work.

    Yes, there is HOPE. Really. And is it "too late"? Often that is not the case.

    Richard Willner, CEO
    The Center for Peer Review Justice

  5. Two things need to change. The first is that there needs to be a way to see how many NPDB adverse actions have been reported by each hospital. Since many hospitals have none, more than one should certainly raise flags that something strange may be going on.

    The second is that it is now possible to walk away from an investigation, and yet doing so is as much a career killer as losing your license would be. And since the instigating administrator will never admit this and even some lawyers may not realize this this should not be allowed to continue. Since walking away is equivalent to being found guilty it should be mandated that you must be found guilty or at least sign numerous forms saying that you have been encourage to undergo a fair hearing.

  6. Another pernicious thing about an NPDB report is the fact that no one will admit that that is the reason for denial of privileges. I assume that the hospitals are attempting to avoid litigation, but that makes the situation totally untenable. How can one attempt to explain the situation if no one will talk to you?

    The whole process is entirely unfair. And numerous reports on the web talk about how wonderful and protective the whole system is. I am certain it has it's uses buy for the mere accusation of poor practice should not be capable of killing a physicians career. We work incredibly hard for many many years and for this to be entirely destroyed forever by some adminstrator spending 4 or 5 hours time is unconscionable.

  7. It is a shame that there is no forum where those of us that have been data banked can meet, discuss things and perhaps organize. Unsupported allegations should not be allowed to end a medical career. Even a fair hearing only requires a preponderance of the evidence, which I understand to mean greater than 50/50 chance. My guess is that careers can be ended by something as simple as no completing charts in a set amount of time. How irrational is that?

    Karyn Bloustein meilma1@hotmail.com

  8. Regarding a forum, I am not aware of any. However, you are welcome to join me on facebook www.facebook.com/people/Shammed-Doc/100001893544204