Maryland's vow to safeguard patients has been undercut by breakdowns in the state system established to oversee doctors.
- 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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This wasn't what lawmakers had in mind three years ago when they created the Maryland Board of Physicians, giving it broad powers to enforce standards of medical care and the duty to tell the public about doctors' malpractice claims histories.
The board has failed to wield its authority to scrutinize dozens of physicians who have been the focus of unusually high numbers of malpractice claims or substantial insurance settlements. About 17,000 doctors practice in Maryland.
Malpractice claims and payments by themselves are not proof of substandard care, legal experts and doctors caution, and in some cases may reflect the risks involved in medical procedures.
But regulators in Maryland are out of step with their counterparts in a growing number of states that flag patterns of malpractice claims and payments for review. Several states also make public much more malpractice information.
"We've got to get more aggressive to do something about doctors who are not providing good care," said Nelson J. Sabatini, former secretary of the state Department of Health and Mental Hygiene.
In its investigation of how well the state protects and informs medical consumers, The Sun examined the Board of Physicians, the role played by the General Assembly, and malpractice claims going back more than 10 years.
Among the newspaper's findings:
Legislators established the Board of Physicians in 2003 amid criticism that doctors with extensive malpractice claims histories were escaping regulatory scrutiny by the panel's predecessor, the Board of Physician Quality Assurance.
The Assembly set aside five positions on the new board for consumers and eliminated the role of the state medical society in the disciplinary process.
Gov. Robert L. Ehrlich Jr., who appointed the board's 21 members after the legislation passed, said at the time that his administration is "committed to ensuring quality patient care for Marylanders." He declined to comment on The Sun's findings.
Maryland lawmakers will get a chance to re-examine doctor oversight when the Assembly convenes next month. The legislation that created the Board of Physicians expires in 2006, requiring an evaluation of the panel's performance.
A doctor's historyDr. John P. Kostuik, former chief of spinal surgery and chairman of the orthopedics department at Johns Hopkins Hospital, has had 17 malpractice claims filed against him since 1993 -- among the most of any Maryland doctor over the period. In each case, Kostuik denied any negligence.