Medical board's Web site tells less public data than ever
BY FRANK X. MULLEN JR
http://www.rgj.com
Four years ago, a Reno Gazette-Journal investigation of the state’s medical board concluded that it was easier for consumers to find out information about their building contractors than it was for them to get information about their doctors.
At the time, the Nevada Board of Medical Examiners pledged to revamp its Web site to a better job of informing the public about doctors. But this year, the Web site contains less information about doctors’ records than it did in 2004.
That’s because the board removed malpractice settlement and judgement information from doctors’ online records in 2005. That year, the panel also voted against other recommendations for improving the site, such as including a doctor’s educational credentials in his or her Web listing and electronically linking summaries of the disciplinary records to online copies of the records themselves.
But with the medical board under fire over the hepatitis C outbreak in Las Vegas that has been traced to unsanitary practices at an endoscopy clinic, the panel is set to reconsider the reforms it rejected three years ago.
“The board had decided to do the minimum (on the Web site) required by law,” said Drennan “Tony” Clark, the board’s executive director. The law mandates the Web site include an alphabetical listing of disciplined doctors, licensed doctors and doctors whose licenses have been revoked.
Clark said the issue of putting more data on the site has been revived in the wake of the Las Vegas health crisis, and the matter will be on the board’s June agenda. He noted that consumers can get such information by calling the board.
“I’m assuming the board will vote to put the malpractice data back (online), and perhaps include the educational information, as well,” he said.
One lawmaker said the board’s change of heart is overdue.
State Sen. Randolph Townsend, R-Reno, who was among those lawmakers who spearheaded board reform measures in the 2004 legislative session, said the statute covering the medical board’s Web site wasn’t overly specific.
“We were trying to give regulatory agencies a little flexibility,” Townsend said. “Obviously, they did not utilize that flexibility to put more information on the Web site.”
He said the idea was for the board to “put more information online, not less” so that patients would be better informed about their doctor’s qualifications and performance.
He said if the board doesn’t act to improve its site, another amendment to the law might be needed.
“If we have to spell it out, then we’ll spell it out,” Townsend said.
Board under fire
Gov. Jim Gibbons wants three doctors serving on the state Board of Medical Examiners to resign as part of his housecleaning efforts following the hepatitis outbreak. He also has asked for Clark’s resignation as the board’s executive director.
The panel members, Drs. Javaid Anwar, Daniel McBride and Sohail Anjum have refused to step down, as has Clark, who said he serves at the board’s pleasure, not the governor’s.
In light of the health crisis and the attempted shakeup of the board by the governor, an expert in medical boards said it’s logical that the panel now might carry out reforms that it previously deemed unnecessary.
Dr. Sidney Wolfe, director of the health care research group at Public Citizen, an advocacy organization in Washington, D.C., said it’s been his experience that it takes a crisis to change the behavior of medical boards.
“A crisis tests regulatory authority,” he said. “Maybe it takes things like the hepatitis scare to wake up the Legislature and the public and focus attention on the board.”
He said consumers have a right to know not only that their doctor has a medical license or has been disciplined by the board, but also to know about the physician’s hospital sanctions, education, malpractice payouts and employment history.
“That lack of information on the Nevada board’s Web site may serve the doctors, but it doesn’t serve the public,” Wolfe said. “It’s important that patients can get to the public information available about their doctors so that they can make informed decisions. The board is depriving people of very useful information.”
He said he’s unaware of another state taking malpractice information off its board Web site once it decided to include it.
“We’re not talking about allegations or complaints here,” Wolfe said. “These are final actions: money paid out by the doctor’s insurance company or actions taken by a hospital board. Why shouldn’t the public know about that?”
He said omitting malpractice data also relieves the board of being questioned about doctors who have multiple lawsuit settlements but no board disciplinary action.
“That’s pretty self-serving on the board’s part,” he said.
Other problems with site
Public Citizen’s 2006 study of medical board Web sites ranks the Nevada board 35th out of 65 sites in terms of information availability and ease of use. The group examined medical doctor boards, osteopathic boards and combined medical boards.
The Nevada Board of Medical Examiner’s Web site allows consumers to type in a doctor’s name and link to a file containing the physician’s address, specialty and summaries about whether the doctor has been disciplined by the board.
If disciplinary action was involved, the consumer may then call the board and request copies of the disciplinary actions at a cost of 60 cents per page. Those documents take weeks or months to be sent to the consumer.
In 2004, the Federation of State Medical Boards recommended that Nevada link the doctors’ Web listings to computer files of the disciplinary records that are already in the board’s computer system. The board’s staff told the panel in 2005 that such links could be set up, but the board took no action, deciding instead to stick only to what is required in the statute.
The board’s Web site summarizes disciplinary actions against doctors, but when the actions are based on malpractice the summary usually cites the language of state law such as “conduct that brings the medical profession into disrepute” or “failure to use reasonable care, skill or knowledge” in the practice of medicine.
If the consumer sends away for the board’s full decision, the details become clear. The doctor may have been disciplined for anything from a records error involving Medicaid to leaving a surgical instrument in a patient to misdiagnosing a patient who later died.
Critics of the medical board said disciplinary actions should be reported in plain language.
“The full board order should be available online,” Wolfe said. “Consumers need to know exactly why the disciplinary action occurred, not get vague statements that blot out the details.”
Townsend noted that the medical board and other state agencies involved in the Las Vegas hepatitis scandal are on the agenda for a Legislative Commission hearing on April 16. He said the board members will be asked about the hepatitis scare, as well as questions raised by its Web site and its responsiveness to the public.
“People have a right to information about their doctors,” he said. “And they should be able to get it without jumping through hoops.”
