Patient safety bill would publicize doctors' names
BY RIDGELY OCHS
Gov. David A. Paterson introduced a wide-ranging patient safety bill yesterday that would give the state more authority in health investigations and, for the first time, make public names of doctors under scrutiny.
The bill follows the case of Dr. Harvey Finkelstein, a Long Island doctor whose poor infection control practices led to transmission of at least one case of hepatitis C.
“Our analysis of the Finkelstein case was that the action didn’t go fast enough, so we asked ‘How do we compress the time?'” said Health Commissioner Richard Daines.
Daines said the bill would give the state Department of Health a “crisper statement of authority” to speed up the investigation process and would ensure doctors are aware of infection-control practices.
The health department came under fire in November after it was revealed that because of legal delays and complicated lab tests, it waited three years before telling the public that Finkelstein, a pain management doctor in Plainview, had infected at least one patient with hepatitis C by reusing syringes in multidose vials. More than 10,000 patients were notified of their possible exposure to tainted syringes.
Finkelstein also had 10 malpractice settlements in a decade, which critics said should have triggered a probe by the Office of Professional Medical Conduct, the health department agency that investigates and sanctions doctors.
Under the governor’s bill, for the first time the department would reveal the names of doctors being probed. Currently, unless and until a physician is found guilty, no one knows if a doctor has been investigated.
The bill also requires that OPMC regularly review malpractice claims and payouts to see if a doctor should be investigated and would require that health plans report when they have terminated a contract with a doctor because of “impairment or misconduct.”
The bill would also give the health department more power in conducting a public health investigation, authorizing it to order a physician to cease any practice deemed dangerous. And failure to provide records could lead to charges of professional medical conduct. The department can now subpoena records, an often lengthy process. “They are going to have to respond promptly and appropriately. It gives more teeth and authority to our request to review medical records,” said health department spokeswoman Diane Mathis.
The bill would also require every medical student to complete infection control training and show proof of it. The coursework would include how to prevent hepatitis C transmission, not just hepatitis B and HIV.
And the bill calls for the health department to study whether restricting use of multidose vials is viable and would improve infection control. In January, Daines wrote to the U.S. Food and Drug Administration calling for eliminating drugs in multidose vials. He said yesterday he had not received a response from the FDA.
State Sen. Kemp Hannon (R-Garden City), who heads the Senate’s health committee, said he had introduced a similar bill two weeks ago. “We’ll negotiate,” he said, referring to the governor. “It will be a top priority to get a bill this year.”
Hannon’s bill calls for an OPMC investigation to be triggered when a doctor has had five malpractice cases, a mandatory infection control curriculum with an emphasis on doctors in ambulatory care practices and requiring single use syringes.
Assemb. Andrew Raia (R-East Northport), a member of the Assembly’s health committee, praised Paterson’s bill. “I got to tell you: I commend the governor. He’s listened to the people.”
Arthur Levin, head of the Center for Medical Consumers, called it “the most improvement in physician discipline” in more than a decade. “I hope this will pass without the legislature doing too much to it.”
How doctors will view the bill was unclear. Dr. Michael Rosenberg, president of The Medical Society of the State of New York, which represents more than 25,000 doctors, made no specific reference to the bill in a statement yesterday, saying that the society “looked forward to working with the governor and legislature to achieve our shared objectives.”
Among the highlights of the patient-safety bill unveiled yesterday:
Requires the state to make public charges in any discipline proceeding when they are served on a physician. Such charges are now undisclosed.
Authorizes state to release information about any public health threat to come to light during an investigation. Now, such information is made public only after the doctor under investigation is found guilty.
Provides that a physician’s failure to respond to records requests from state or local health departments constitutes “professional medical misconduct.”
Provides that courses in infection-control practices now required by physicians, physicians assistant and specialist assistants now also be required of medical students in these disciplines.
Commissions a study on the viability of restricting the use of multiuse medicine vials and requiring the use of “disposable medical equipment” engineered for single use.