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Unmasking 'Questionable' Doctors

Consumers * Report says medical misdeeds too often go unchecked.

August 14, 2000|JANE E. ALLEN | TIMES HEALTH WRITER

A Northern California ob-gyn who failed to deliver a fetus quickly enough when tests indicated it was in distress, and who induced labor without a medical reason in a woman only 35 weeks pregnant, continues to practice medicine with the state's approval.

The doctor was among more than 20,000 physicians nationwide deemed "questionable" in a four-volume report from Public Citizen, a nonprofit watchdog group.

"This happens all too often," Dr. Sidney M. Wolfe, director of the organization's Health Research Group, said of the decision to let the doctor keep treating patients. He noted that New York, where the doctor was also allowed to practice, revoked his license over the California cases.

The national report, coauthored by Wolfe and released last week, listed 28,000 actions taken against doctors from 1990 to 1999. It concludes that the United States has an inadequate system for protecting Americans against medical misdeeds, and that state disciplinary boards are too lenient.

It also criticized limited public access to such information, saying it's critical to patients' chances of choosing a good doctor.

The annual report, "20,125 Questionable Doctors," lists 2,670 disciplinary actions against 2,309 California physicians.

The state ranks 20th nationwide, with 4.04 serious disciplinary actions, such as license suspension, revocation, probation and surrender, for every 1,000 doctors. That's an improvement from the 1991 ranking, which placed the state 37th.

In the Richmond, Calif., ob-gyn's case, the Medical Board of California, which licenses and disciplines doctors, had initially moved to take away Dr. Daryl E. Murdoch's license based on seven incidents of negligence and incompetence between 1983 and 1993.

But in March 1997, the board opted instead for seven years' probation, with the conditions that he not provide obstetrical services and that he take additional courses, training and testing. He was allowed to continue seeing gynecology patients.

Murdoch could not be reached for comment despite several attempts.

Public Citizen is pushing for broader public disclosure and easier access to doctors' histories.

Access varies by state, but in California, the information available to the public--profiles on the board's Web site--contain only the sanctions, not details of the cases that led to them.

The doctor "knows what he's done. The board knows. Unfortunately, they don't bother telling the patients in California what [the doctor] has done," Wolfe said.

Although details are available on request, consumers must ask for information on a particular doctor and can only get the documents through the mail. They must also pay a small fee.

But medical board spokeswoman Candis Cohen said the board may soon provide more complete records. It intends to expand online doctor profiles to contain all the disciplinary documents involving a doctor, including formal charges brought by the board and decisions by administrative-law judges, which the board can accept or reject.

The California disciplinary actions were culled from the medical board reports, Osteopathic Medical Board of California records, and files from Medicare and Medi-Cal, the federal Food and Drug Administration and federal Drug Enforcement Agency.

Wolfe's organization has long advocated opening up the National Practitioner Data Bank, a federal repository of disciplinary actions and medical malpractice actions that is closed to the public. It's accessible to state medical boards and hospitals and to HMOs, which check it before offering employment to doctors.

In its 2000 report, Public Citizen recommended that Congress require cooperation and routine data-sharing among state medical boards and other organizations that monitor doctors' conduct.

It termed inexcusable the fact that many Americans still don't have an easy way to get such information. In addition to the Northern California case, Wolfe cited several examples in which doctors in other states were allowed to provide ongoing patient care despite offenses such as incompetence, overprescribing drugs, substance abuse or sexual misconduct with patients.

One of the most egregious cases involved a Virginia physician who inseminated a woman with semen from a known HIV-positive man; the woman contracted the AIDS-causing virus. The doctor, who received a reprimand, later moved to North Carolina, where Wolfe said, "to my knowledge, he's practicing . . . and was never disciplined by the North Carolina board."

Copies of the four-volume Public Citizen report can be obtained for $407.50, while copies of regional editions are $23.50 and can be obtained by calling (877) 747-1616. Much of the report, except individual doctor listings, is available online at http://www.questionabledoctors.org. For more information on California doctors, check the Medical Board of California Web site at http://www.medbd.ca.gov.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Doctor Discipline in California

Public Citizen's report analyzed 2,670 serious actions taken against 2,309 California doctors between 1990 and 1999.

California doctors were disciplined for 1,674 offenses, including:

Substance abuse: 36

Sexual abuse or sexual misconduct with a patient: 57

Misprescribing or overprescribing drugs: 92

Substandard care, incompetence, or negligence: 380

Criminal convictions: 258

Disciplinary action taken against license by another state or agency: 450

Other offenses: 374

*

Source: "20,125 Questionable Doctors" from Public Citizen's Health Research Group.

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