The Incompetent Doctor, And How to protect Yourself

Two nurses who lost their hospital jobs and endured criminal prosecution after reporting a physician to the Texas healing Board over patient safety concerns will receive 5,000 each in a settlement of a federal lawsuit they had filed against their old employer, the physician, and other parties [Lowes, 2010].

Every physician in California has a recurring bad dream of finding their name on the monthly "discipline" list of the California healing board, the regulator of doctors in the state. The report includes a brief report of the offense, and the punishment. Of the 30 or so actions reported, about 90% are linked to alcohol or drugs, ordinarily resulting in probation and rehabilitation. A few offenses are linked to fraud, with the remaining punishments due to incompetence, ordinarily so egregious as to be frightening.

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In reality, these problems are the tip of an iceberg. For every performance taken, who knows how many are not reported, or don't rise to the level of discipline? Some follow in malpractice suits, but these rarely follow in physician suspension or retraining.

The report quoted above illustrates how difficult it can be to report and discipline even one bad physician. Two nurses risked their careers by complaining about what appears to be clear incompetence. That physician used his friendship and influence with the hospital administrator and local officials to both avoid the charges and to get the nurses fired from their jobs.

Although the nurses finally prevailed in court, the physician has remained in practice, although he under investigation.

How can society in general, and your family in particular, make sure your physician is doing a good job?

Physician groups and hospital staffs do a much better job policing themselves than state healing boards. In large groups, physicians have substantial ethical, financial, and legal incentives to monitor, value and heighten the care they are giving. Excluding the impaired or incompetent physician makes very good sense.

One of the few beneficial aspects of Obamacare is that it contains financial incentives to force physicians to form groups, which will be far more productive than bureaucracies and recite boards in enhancing quality.

In the meantime, you can probably safe yourself and your family by using doctors who are affiliated with larger groups and larger hospitals. Although there are exceptions, it is far less likely an impaired or incompetent physician will be practicing with others. Counter-intuitive as it might seem, avoiding the local "Marcus Welby" practitioner may be the key to insuring good care. Nurses in Texas Whistleblower Case settle for 0,000.

Reference:

Robert Lowes, "Nurses in Texas Whistleblower Case settle for 0,000," Medscape healing News, August 12, 2010.

The Incompetent Doctor, And How to protect Yourself

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