[ Medical School Resources | Appendices | Discussion ]
From This Won't Hurt (And Other Lies My Doctor Tells Me), "Today, healthcare is the largest industry in America... yet is the last bastion of nonconsumerism in this country. We still get less information about doctors, hospitals and drugs than we do about any other consumer service or product." In mid-1996, the Orlando Sentinel conducted a four-month study of hospital disciplinary actions, as well as 18,400 medical malpractice claims, and more than 370 court cases. The series reports:
(1) hospitals' systems of self-regulation were so undependable and shrouded in secrecy that patients unwittingly went to doctors with questionable skills; (2) hospitals frequently withheld adverse information about doctors; (3) patients rarely knew whether doctors had a large number of paid malpractice claims against them; and (4) in the public and private systems that are supposed to protect the public, 'a small but active group of the state's 30,000 practicing physicians continue to injure patients and pile up paid [malpractice] claims.'
According to an article in JAMA, the medical profession has adopted an "ostrich-like attitude" concerning medical error and its prevention. "Of all the self-interested policies that created the massive crisis our entire health system faces today," one commentator writes in New Physician, "perhaps the most devastating has been the medical profession's evasion of public accountability...." From the British Medical Journal: "Doctors do not want their dirty linen catalogued."
The lack of public disclosure of information about dangerous doctors stems from a single source: powerful political pressure upon state and federal agencies by physicians and their trade groups. The AMA, for example, "vociferously opposes the release of malpractice information." From Ms.:
[The AMA] has long argued against public disclosure of doctors' records on the grounds that consumers do not understand them and that it unfairly damages physicians' reputations. 'What they're saying is that the reputation and positions of physicians are more important than the public interest....' Whose well-being comes first, physicians' or patients'?
A new word is coined in Academic Medicine - iatrocentrism - "meaning that oaths and codes of ethics notwithstanding, the fiscal and social interests of the individual physician and of the medical profession have traditionally been placed before those of the patient."
In 1986, Congress tried to stop shady doctors from wiping the slate clean every time they moved by creating the National Practitioners Data Bank, a computerized storehouse of transgressions by all the nation's doctors. The only flaw? No one was allowed to look at it! Hospitals had access, individuals didn't. As reported in the Washington Monthly, "Most of the blame for the public shut-out lies with the AMA, which has spearheaded a relentless assault on the Data Bank. As one architect of the Data Bank put it, the Mighty AMA: 'Opposes this thing every step of the way.'"
And when the AMA talks, congressmen listen. The Washington Monthly found 77 members of congress receiving gifts of $10,000 or more from the AMA. According to the Chicago Tribune, the AMA's political action committee has, spent $14 million on Congressional candidates over the last ten years, with over twice as much money going to Republicans as to Democrats.
Massachusetts however, had the guts to plow through a consumer protection initiative which provides a comprehensive look at over physicians licensed to practice medicine in Massachusetts. The Massachusetts Physician Profiles web site registered an estimated 35,000 "hits" on the first day it appeared. In every other state though, according to the Berkeley Medical Journal, physicians continue to block public access to professional history. "You can find out all kinds of information on the Internet about lawyers, even car mechanics, yet vital background information on your doctor is not available."
 Inlander, CB. This Won't Hurt Allentown, People's Medical Society, 1998.
 "Medical Discipline: Shroud of Secrecy." Health Letter Public Citizen's Health Research Group.
 Blumenthal, D. "Making Medical Errors into 'Medical Treasures.'" JAMA 272(1994):1867-1868.
 New Physician 20(1971):164.
 British Medical Journal 310(1995):621.
 Haas, Jack Becoming Doctors Greenwich Jai Press, Incorporated, 1987:125.
 Warner, J. "Who's Protecting Bad Doctors?" Ms. 1994(January/February):56-59.
 Link, EP. "The Social Ideas of American Physicians." Academic Medicine 69(1994):25-26.
 Greenberg, D "Club Med" Washington Monthly 23(1991):10.
 Horton, R. "The Sacking of JAMA." The Lancet 353(1999):252-253.
 Hsu, JC. "Physicians Continue to Block Public Access to Professional History." 1996(Spring).