As attorneys with a great deal of experience in representing injured victims in cases involving substandard medical care, we were not surprised to learn about a recent major national study which found that hospitals are under-reporting doctor incompetence. The report by Public Citizen, the national consumer advocacy organization, chronicles the failures of the National Practitioner Databank to protect patients from physicians who have histories of medical incompetence. The group concludes the study with several important recommendations for making hospital peer reviews and physician incident reports more accessible to the public.

Entitled “Hospitals Drop the Ball on Physician Oversight,” the report made national headlines when it was released on May 27, as it included several appalling examples of the failures of hospital peer reviews and physician disciplinary reporting. These included an orthopedic surgeon who left the operating room to cash his paycheck at a bank while the patient was left under anesthesia with an open incision. In another example, a physician whose medical license had been revoked in Texas and suspended in Oklahoma was able to obtain surgical privileges at a hospital in Hawaii, where he inserted and implanted a screwdriver instead of a titanium rod to stabilize an injured spine. The patient was left a bedridden, incontinent paraplegic and subsequently died.

A member of a state medical board who requested anonymity advised Public Citizen that “hospitals often avoid reporting by fashioning by-laws in such a way that reporting can be avoided . . . and hospitals are giving doctors leaves of absence instead of suspensions in order to avoid reporting.” The report also quotes Dr. Ira Williams, a board certified surgeon and chairman of a department and executive committee at Methodist Hospital in Madison, Wisconsin, who wrote that “hospital peer review committees prefer to stay in the shadows.” He said that the first priority of these committees is to preserve the rights and privileges of doctors. “Because licenses to practice give doctors a monopoly on medical care, the characteristics of a monopoly are obvious in medical organizations: arrogance, complacency, and abuse of power,” he concluded.

Sid Wolfe from Pubic Citizen said that “about half of the hospitals in the country have never reported one doctor out of the couple of hundred thousand doctors who are on the staffs of those hospitals. It's just not believable. The only answer is the hospitals are not doing their job disciplining and reporting doctors.”

The report concludes with various recommendations that our firm also supports. These include civil fines for each instance of a hospital's failure to report medical incompetence by a physician, and authorizing the Medicare and Medicaid programs to suspend hospitals that do not complete peer reviews from participation and payments. One can only hope that in the future, these and other recommendations will be implemented to break the code of silence that protects incompetent physicians.