Patricia Helfrich, Baltimore: Why are they [the state Board of Physicians] permitted to operate in secrecy? If they are so far behind, get some more people or get some people who can get it done. Pain, suffering and life is involved. Why don't they have statutory deadlines?
Schulte: This seems to be simply a case of "we've-always-done-it-that-way" syndrome. Apparently, nobody has raised this (open disciplinary proceedings) as an issue so the board hasn't had any incentive to change. But legislative auditors in Maryland recently pointed out that 19 of 22 states they surveyed have open hearings. There is a statutory mandate for completing so-called "peer reviews," in which doctors evaluate their colleagues. But that doesn't extend to the whole process.
Willy Shapiro, Baltimore: Are the "averages" given in your article normalized with respect to specialty and practice size? In other words, a surgeon who sees 1,000 patients inherently is in a higher risk of malpractice than an internist who sees 200.
Schulte: We checked the specialties of many of the doctors with the most claims using public records. It was not possible for us to get any information about caseload because there is no public source for this.
Stuart Levene, Baltimore: What is the best source or sources to find out about any complaints, disciplinary actions, malpractice suits and all other negative information about a medical doctor?
Schulte: As the articles noted, finding this information is difficult in Maryland. The Board of Physicians' Web site contains "profiles" of individual doctors. This is the only place to find out about disciplinary actions, which should be posted on the profile. The full disciplinary order can be downloaded so you can read it and draw your own conclusions.
Those profiles also list malpractice cases -- but very few of them. This is because of the criteria for disclosing cases set by the legislature. Any court judgment or arbitration award must appear. But most cases are settled, and the formula requires that a doctor have three settlements of $150,000 each within five years before any of them appear. That's only a tiny few doctors.
There's another place where you can find out how many claims have been filed against a doctor: That's the Health Care Alternative Dispute Resolution Office, at 6 St. Paul St. in Baltimore. (410-767-8200 or 1-800-492-1951; on the Web: www.mdarchives.state.md.us/msa/mdmanual/25ind/html/42healc.html) Claims can be looked up by name of the defendant or the person who filed it. Consumers can visit the office or obtain copies for $15 each.
Doug Bamford, Street: What is the average time it takes for a malpractice case to be acted on in Maryland once filed with the court after the Alternative Dispute Resolution Process has been bypassed, and how long has the ADRP been in effect?
Schulte: The arbitration office has existed since 1977. I don't have a figure for the length of time. Some cases are settled fairly quickly and others drag on for years.
J.D. White, Potomac: What states have the best, most open and most effective physician disciplinary systems? How does funding per licensed physician compare for the medical disciplinary boards, say in D.C., Maryland and Virginia?
Schulte: Many experts in the field shy away from trying to compare the effectiveness of one board to another. You can get some information about policies at various boards off the Federation of State Medical Boards Web site.
Schulte: This seems to be simply a case of "we've-always-done-it-that-way" syndrome. Apparently, nobody has raised this (open disciplinary proceedings) as an issue so the board hasn't had any incentive to change. But legislative auditors in Maryland recently pointed out that 19 of 22 states they surveyed have open hearings. There is a statutory mandate for completing so-called "peer reviews," in which doctors evaluate their colleagues. But that doesn't extend to the whole process.
- Regulators overlook dozens of doctors faced with an unusually high number of malpractice claims or payouts.
- About 120 physicians across Maryland have been the focus of five or more negligence claims in the past decade.
- A slow and spotty disciplinary process results in few tough penalties for errant doctors.
- State rules and legal practices deprive Marylanders of facts needed to make informed choices about doctors.
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Schulte: We checked the specialties of many of the doctors with the most claims using public records. It was not possible for us to get any information about caseload because there is no public source for this.
Stuart Levene, Baltimore: What is the best source or sources to find out about any complaints, disciplinary actions, malpractice suits and all other negative information about a medical doctor?
Schulte: As the articles noted, finding this information is difficult in Maryland. The Board of Physicians' Web site contains "profiles" of individual doctors. This is the only place to find out about disciplinary actions, which should be posted on the profile. The full disciplinary order can be downloaded so you can read it and draw your own conclusions.
Those profiles also list malpractice cases -- but very few of them. This is because of the criteria for disclosing cases set by the legislature. Any court judgment or arbitration award must appear. But most cases are settled, and the formula requires that a doctor have three settlements of $150,000 each within five years before any of them appear. That's only a tiny few doctors.
There's another place where you can find out how many claims have been filed against a doctor: That's the Health Care Alternative Dispute Resolution Office, at 6 St. Paul St. in Baltimore. (410-767-8200 or 1-800-492-1951; on the Web: www.mdarchives.state.md.us/msa/mdmanual/25ind/html/42healc.html) Claims can be looked up by name of the defendant or the person who filed it. Consumers can visit the office or obtain copies for $15 each.
Doug Bamford, Street: What is the average time it takes for a malpractice case to be acted on in Maryland once filed with the court after the Alternative Dispute Resolution Process has been bypassed, and how long has the ADRP been in effect?
Schulte: The arbitration office has existed since 1977. I don't have a figure for the length of time. Some cases are settled fairly quickly and others drag on for years.
J.D. White, Potomac: What states have the best, most open and most effective physician disciplinary systems? How does funding per licensed physician compare for the medical disciplinary boards, say in D.C., Maryland and Virginia?
Schulte: Many experts in the field shy away from trying to compare the effectiveness of one board to another. You can get some information about policies at various boards off the Federation of State Medical Boards Web site.
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