A man with back pain was advised to have a spinal fusion by a well-regarded surgeon to whom he had been referred by another doctor. The procedure, which fuses individual vertebrae together in the hope of alleviating pain, is serious, as all surgery is. The patient wanted to make sure this surgeon was a good choice, so he researched the doctor online.
The reports were good, and he had the surgery.
And now he regrets it.
We’ve written about spinal fusion as an often ill-advised procedure, or at least one about which professionals aren’t in agreement, but that wasn’t the problem here. As it turned out, despite the patient’s due diligence, he had been unable to learn that the surgeon had numerous malpractice lawsuits pending against him.
His story was told in the Washington Post, which made clear that finding out useful, relevant information about a doctor is a challenge, but also something anyone considering a significant procedure or establishing a patient-provider relationship should do.
The Post story interviewed Dr. Michael Carome, director of the Health Research Group at Public Citizen, a consumer advocacy organization. Unfortunately, he said, there’s no foolproof way to vet your doctor, but there are ways to learn objective data about a physician that’s far more helpful than Yelp or a provider’s website.
State medical boards are a good place to begin. Most have web sites where you can search for individual physician licenses, but the range of information beyond that depends on the individual state board. Some offer information about disciplinary actions taken against a physician and payments made for medical malpractice lawsuits; some don’t. If your state’s info menu seems a bit sparse, you might be able to learn more by contacting the medical board directly, and requesting it.
For a list of state medical boards and contact information, link here.
Board records disclose only settlements that have been made; they don’t disclose pending lawsuits or investigations that are underway. And, as we’ve noted before, states vary in how aggressive they are in going after problem doctors.
As Carome told The Post, “Too often, medical boards give problem physicians a slap on the wrist — like a letter of reprimand, probation or a suspended license that is then immediately reinstated — so that they can continue practicing.”
So if you see something on a doctor’s record that seems minor, it might indicate a larger problem, and Carome advises asking questions.
Although you can get basic information free on medical board sites, you might also want to invest in a more thorough report via Docinfo. A feature of the Federation of State Medical Boards (FSMB), it offers information such as where a physician attended medical school, year of graduation, licensure history, board specialties, location, alternate names and disciplinary actions taken against him or her. Each report costs $9.95.
Federal law requires that suspended licenses must be reported to the National Practitioner Data Bank (NPDB), and although those records aren’t publicly available, hospitals and state medical boards can access them. Sometimes you might see some of that information, often not. But if you learn that your doctor has moved his or her practice from one state to another with an odd frequency, ask why; sometimes, the doctor is trying to stay ahead of the disciplinary curve.
Some independent websites also offer valuable information about individual physicians. Healthgrades.com is free for patients, and is subsidized by advertising from drug makers, medical device manufacturers and hospitals and doctors who pay extra to highlight their products and services.
Its doctor reviews are collected from patients as well as from information from the Centers for Medicare and Medicaid Services (CMS) and state medical boards, according to one of its executives. But like medical boards, Healthgrades’ information about lawsuits concerns only those that have settled, so a doctor with pending lawsuits can still seem “clean.”
And there’s always Dollars for Docs and Prescriber Checkup, both sponsored by the investigative news site ProPublica, which we’ve covered before. The first tracks money doctors receive from drug companies, and the second compares their prescribing habits of particularly dangerous medicine with those of their peers. (It also looks at how they prescribe brand versus generic drugs, so you can see how much their prescribing habits cost you.)
The point, of course, is to tease out any conflicts of interest, or situations that invite them. A doctor whose primary interest isn’t your good health is not a doctor you want to see.
If you do find information on the Internet that concerns complaints or lawsuits yet to be resolved, be skeptical. Dr. Daniel Spogen, board member of the American Academy of Family Physicians, told The Post that sometimes a doctor does everything right but the outcome is disappointing, and someone files a lawsuit. But unless you know the facts, you don’t know the whole story.
Of course, a long record of multiple lawsuits is never a good sign. And that’s the red flag the patient with the back problem couldn’t see before going under the knife. Anyone can make a mistake, but the people who make a lot of them shouldn’t be able to hide.