N.C. Medical Board plans new rules to allow patients to see if doctors have made malpractice payments

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RALEIGH – In about a year, people across North Carolina will be able to go online and see whether their doctor or a doctor they’re considering seeing has made malpractice payments, if rules developed by the N.C. Medical Board are implemented.

The rules, which could face legislative review next year, would require doctors and physician assistants to report all malpractice payments made after Oct. 1, 2007, that are greater than $25,000. The board’s rules, which have already gained the approval of the Rules Review Commission, which monitors administrative rulemaking in state government, have faced sufficient opposition to delay implementation until the General Assembly has enough time to take a look at them.

“It’s just a way of becoming transparent,” said Jean Fisher Brinkley, a spokeswoman for the medical board. “We’re beefing up the online profiles for physicians and physician assistants.”

Those online profiles will also include other information, such as whether they’ve been convicted of a crime or have been disciplined by a medical board in another state or by a government agency.

Mike Edwards, a spokesman for the N.C. Medical Society, said that while transparency is good, there needs to be a distinction made between malpractice payments that are awarded because of poor quality care and those that are awarded because of “nuisance suits” or other economic reasons, such as a doctor determining to settle a lawsuit because making a payment would be less expensive than the legal costs of fighting a the lawsuit in court.

“The medical board has the expertise, they have all the evidence at hand,” Edwards said. “They’re doctors. They know what proper care is and isn’t.”

Brinkley said that the medical board doesn’t think that’s a workable proposition.

“It’s sort of fraught with problems to do it that way,” Brinkley said. “Malpractice is a very emotional subject for both practitioners and the patients involved.”

She said that the rules call for information about malpractice payments to be put in context. For example, information on the doctor will also tell if the malpractice payment led to any disciplinary action being taken by the medical board.

“You can sort of connect the dots,” Brinkley said.

The information on the doctor will also tell how common malpractice payments are for a particular specialty, she said. For example, obstetricians generally have more such payments that most other doctors because of the nature of the practice. Emergency medicine physicians and neurosurgeons also tend to have more such payments than most other doctors, she said.

Brinkley said that the $25,000 threshold wasn’t chosen arbitrarily. She said that the medical board learned that a lot of malpractice insurance companies don’t even consider payments of $25,000 or less when underwriting insurance.

That will also allow the bulk of the payments to be made public since 90 percent of all malpractice payments are more than $25,000, Brinkley said.

Edwards said that the medical society also had some qualms with the retroactivity of the rules, requiring disclosure of payments dating back to Oct. 1, 2007.

He said that some malpractice settlements included confidentiality clauses in their contracts. Edwards said that some doctors might have chosen to have fought the claims in court if they’d known that the settlement would be made public.

Brinkley said that the Oct. 1, 2007, date was selected because that’s the effective date of the current law that required the medical board to develop the malpractice disclosure rules. Doctors knew at that time of the likelihood that their malpractice payments would become public record, she said.

It will take some time to get the software and computers ready for the new malpractice information to go online, Brinkley said. In addition, it will take some time to gather the information from the physicians and physician assistants.

Brinkley estimated that the information would be available online around the fall of 2009.

She said that most of the state’s 30,000 doctors and 3,000 physician assistants don’t have malpractice payments. She said that over the last seven years, less than 4 percent of all such medical professionals have made malpractice payments.

“That means 96 percent have perfectly clean records,” Brinkley said.

Barry Smith can be reached at bsmith@link.freedom.com.

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