Friday, March 25, 2011

Victimizing the Target Physician - the Next Level

The National Practitioner Data Bank (NPDB) is supposed to be a mechanism to expose those rogue monster doctors wherever they go, stigmatize them, flush them out of the profession, and kill their careers and livelihood.  As we know, the data that the NPDB promulgates, which drives those physicians to such horrendous fate, is simply derived from hospitals' disciplinary actions.  This is a huge amplification of the effects of a flawed system.  We know that most hospitals' systems in the US are not equipped with fair or impartial mechanisms.  We know that good physicians get caught in the flawed process like a mouse in a trap or a fly in a spiderweb.  No escape. No constitutional due process.  No impartiality. No fairness.  We know that the standards of the process are so low that anything can be used against the physician, with success, and immunity is enjoyed by the attackers.  A hearsay can trigger an action. A complication that can be the unfortunate consequence of treating a risky patient despite every effort would be just perfect. The NPDB entry is the Badge of Shame.  You may think that the NPDB reporting is the end of story?

Comes the next level of destruction.  "Continuous Query" formerly known as Proactive Disclosure Service (PDS).  Let that adversarial report be pushed to subscribing institutions within 24 hours.  Let everyone know, almost immediately, that a hospital has eliminated a physician.  Let the stigma stick before there is any chance to remedy.

As described on the NPDB-HIPDB website: "24 hours a day, 365 days a year. Continuous Query keeps you informed about the adverse licensure, privileging, Medicare/Medicaid exclusions, civil and criminal convictions, and medical malpractice payments on your enrolled practitioners. By enrolling all practitioners with which you interact, you receive email notifications within 24 hours of a report received by the Data Bank, and you always have access to Data Bank information on enrolled practitioners. Keep in mind that Continuous Query is only for querying on practitioners, not health care organizations.  Then there is a Note: "Continuous Query meets legal and accreditation requirements for querying the Data Bank."

Furthermore, it is dirt cheap.  Currently, the annual charge is $3.25 for each practitioner, for each Data Bank.

Shouldn't we really make sure first that we have an impartial and fair process before going to the extremes in career destruction?

Whether we acknowledge it or not, practicing medicine in the US is becoming a hostile and malicious environment, and is only getting worse.  This is NOT an exaggeration.  Be well informed.  You can easily become the next target and victim.  If that happens, you'll be surprised how vulnerable you will be, how helpless you will be, how you will be immediately marginalized by cascading events and a ripple effect, almost like a chain reaction.  And schadenfreude is so prevalent, sadly.