Almost 900 Maryland doctors have been disciplined since 1990 for everything from fraud to assault to errors in prescribing drugs. But few patients may know this because they have not been able to get speedy access to this kind of information.
That's about to change. Next spring Maryland expects to become the first state in the nation to make disciplinary and malpractice records of physicians instantly available to the public, to the chagrin of more than a few doctors.
The records, compiled by the state Board of Physician Quality Assurance on every doctor in Maryland, will be available to anyone equipped with a personal computer and a modem.
That step will place Maryland among the leaders of a national effort to help consumers make faster, better informed decisions about their health care.
Computer access would follow a highly touted doctor-profiling service begun last month in Massachusetts. That service provides among other information a physician's malpractice record by fax or mail.
Similar programs are being considered in New York, California, Florida and Wisconsin. But no state boards offer online profiles.
The Maryland system will supply instantly information that is already allowed to consumers. The state board now requires a written request for information, which means a reply may take as long as a month to reach a consumer by mail, though the typical wait is 10 days.
"Obviously, the sooner they get this information, the more value it has to them," said Dr. Israel Weiner, who was instrumental in the project and who recently stepped down after eight years as board chairman. "There are meaningful differences between doctors, and I think the consumer is entitled to know that."
Maryland's online service may come as a surprise to physicians. The board did not notify medical associations about the service until last month, nor were they invited to discuss the idea, since the computer files will contain information already available to the public, officials said.
The online service took root over the past two years as the state board upgraded its computer system, said J. Michael Compton, the panel's executive director.
Board officials believed the service would provide information faster to consumers, while saving the board significant time and labor. The state Board of Public Works approved the service without opposition. The $760,000 cost for the overall computer upgrade is being financed with physician licensing fees.
Many of the calls will come from hospitals checking on physician job applicants, and from people such as Pam Bricker of Potomac, who went shopping for a new doctor for her husband two weeks ago. By telephoning the state physician panel, she was able to learn a doctor was board certified and how long he'd been practicing. She stopped short of writing a request for the doctor's complete file.
"This would make a world of difference," she said of the new system. "The more educated a consumer is, the better. And I think physicians will improve, too. If doctors know you're willing to log on and make sure everything's in order ."
Doctors are just beginning to hear of it. "I think the reaction [among physicians] will be very negative in most quarters," said Dr. Ronald L. Ginsberg, a Baltimore gastroenterologist. "People are very well aware of discrepancies that can exist between what's on paper and the reality."
Replies Compton, the state board's executive director: "This information has been public -- we're just making it more accessible. I think for the peace of mind of the consumer, it's very important."
Each doctor's computer file will supply a basic history: medical schools attended, specialties, hospitals where the doctor has privileges, whether he is board certified.
The file will list all disciplinary charges or orders against a doctor, and include the effective date, the type of misconduct, and any sanctions or fines issued. To obtain the full text of a disciplinary charge or order against a doctor, consumers still must file a written request with the state and wait for the document to arrive by mail.
The online file will also list all malpractice claims recorded with the state Health Claims Arbitration Office, and a case number for those who want to read the claim file.
Some doctors said that type of accessibility is troubling. Consumers will be able to surf through the records of physician neighbors, acquaintances, or any other doctor who pops into their head, said Dr. Timothy T. Flaherty, a member of the American Medical Association's board.
"It's just the sense that it seems to be more public," Flaherty said. "If a person writes in a request, they probably want very specific information. It's not just someone browsing through the neighborhood out of curiosity."
The more contentious issue is that some data, including frivolous malpractice complaints, may unfairly taint doctors. Some consumers undoubtedly will draw negative conclusions if they see a string of malpractice claims. But how many will do the extra research to determine whether a case had merit?
Such a list can be useless in high-risk specialties where lawsuits are common, said Ginsberg, who has never faced a malpractice or disciplinary complaint. Even when there's a settlement, it might be a payment for the convenience of an insurance company, not a sign that the doctor erred, he said. "The raw data is very misleading."
The prospect of consumers seeing every complaint also could cause many doctors to avoid high-risk cases for fear of being sued.
Dr. Alex Azar, an ophthalmologist who is president of the Medical and Chirurgical Faculty of Maryland, recalled performing surgery on a waterman on his own back porch because the man had a phobia about leaving Smith Island.
"If I was going through life continually worried about being sued, I don't think we'd do things like that," he said. "You have to wonder if they'll find anyone who will want to take care of the difficult cases."
The profile service in Massachusetts shows only malpractice claims in which a doctor paid. The amount is not listed, but it is characterized as either high, low or average for the doctor's specialty.
In other states, criminal histories and sanctions filed by hospitals are part of doctor profiles. Compton said the Board of Physician Quality Assurance has not ruled out including hospital disciplinary actions, although that might require action by the General Assembly.
Pub Date: 12/15/96