Is it a doctor or a life? You can’t know nothing about doctors.

Medical Committee: “Oh, I will laugh and not talk.”

In the United States, the National Physicians Alliance is a complex internal organization composed of government regulation and peer review by states. Their main job is to issue and supervise doctors. They are responsible for collecting and researching complaints and reports from patients, medical institutions, courts, and law enforcement agencies. But these important tasks are usually done by volunteer doctors or even volunteers without professional knowledge.

Editor’s Note: In a long-form report from the Consumer Report, sponsored by the Consumers Union, the United States is still a country with frequent medical malpractices, largely due to the mechanism of failure. Since 1990, there have been approximately 1.25 million doctors in the United States. Among them, 190,000 doctors have caused more than one medical accident, and 50,000 doctors have been punished by different degrees in the state medical committee. Perhaps, many people will say that this is nothing compared to China? Xiao Bian believes that this simple comparison between the two countries is meaningless, but what makes sense is the rigorous attitude and meticulous thinking embodied by the publisher of the report, the American Consumers Union.

Leonard Kurian is a Southern American obstetrician. In one operation, he mistakenly removed a patient’s healthy ovaries and left the lesions. The patient was suffering for weeks after surgery and found the truth through the examination. In addition, Corinne directly caused the death of two patients because of his wrong diagnosis and treatment.

You might think that this doctor probably gotten out of the way. this is not the truth! He is still retained as a medical practitioner and continues to be treated under the supervision of the Medical Council, which is a medical review.

Medical examination, English for Probation, is a punishment for doctors who are not practicing medicine. The period is usually several years. The doctors in the examination period are still qualified to practice medicine and are subject to follow-up supervision and inspection by the Medical Committee. There are still problems within the doctor, the doctor may be revoked license, but may also be extended for review.

In the United States, 66% of the public believe that doctors who are in the medical review period should refrain from receiving patients.

In the highly developed United States, thousands of doctors are being subjected to “medical review” for drug abuse, sexual harassment, and medical malpractice, but they have not been “off the shelf” by the relevant authorities. According to a poll from the US Consumer Report, 66% of respondents believe that doctors in the medical review period should be banned from practicing medicine. In addition, 82% said that these doctors should be required to take the initiative to tell patients that they are undergoing review and explain the reasons.

In fact, from the data on medical accident compensation, the doctor’s practice and professional level can also be seen indirectly. According to the National Physician Database (NPDB):

Since 1990, there are 1,247,500 doctors with medical qualifications in the United States.

15% of the doctors have at least one medical accident compensation

And 2% of the doctors caused 50% of the compensation expenses.

In fact, in many cases, medical incidents are “private”, so the actual number is actually much larger than the data in this database.

In general, most doctors who are qualified to practice medicine are still very good. However, the majority of the American imperialists have said that they have a history of black history, but they are still fa, fa, fa!

Eighty-two percent of Americans believe that doctors in the medical review period can tell the patient and explain why.

Regulatory system

In the case of Dr. Corinne, a 25-page investigation report details the misconduct of the doctor during his 40 medical practice, but the medical committee only imposed a penalty of 7 years of medical review: as long as he After completing the relevant training and being able to write a detailed medical record, he can continue to practice medicine, and nothing more.

What is the reason for these doctors who have made serious mistakes to remain in their posts for medical review, rather than being revoked? Can this ruling process be more transparent and credible? And make it easy for the public to get relevant information?

“Being self-management and discipline is the core definition of any professional organization,” said Professor Jim E. Sabin from Harvard Medical School. “For the medical committee, it exists to be responsible to the public, not to shelter these doctors.” Obviously, the experts in the medical committee have always had to pass through these problematic doctors.

The Consumer Reports magazine launched a Safe Patient Project to change the current government regulatory system for doctors. Lisa Mc Giffert, the person in charge of the project, said, “Doctors in the review period should take the initiative to inform the patient. This is their responsibility and obligation, not the other way to let the patients investigate them.”

Last fall, the Consumer Report attempted to allow the California Medical Board to establish such a mandatory requirement, but it was rejected by the Medical Council because it would increase the burden on doctors and undermine doctor-patient relationships.

The magazine captures and digs into a publicly available data from the California Medical Board that contains all the cases of doctors who have undergone medical review since September last year. For example, a family doctor and her cardiologist husband prescribed more than 4 million unit doses of hydrocodone for 15 months without justification. You can also find bad records in the records such as drunk driving and alcohol abuse during night shifts. These records were exposed to the Consumer Reports and caused strong repercussions in society.

Doctor information nowhere to be found

It is difficult to obtain the medical records of these doctors on the websites of the medical committees of the states. In fact, only a small number of organizations in hospitals, doctors, law enforcement agencies, and insurance companies have access to the national medical practitioner database managed by the US Department of Health and Human Services. The general public has no authority.

For a long time, the American Medical Association (AMA) has been lobbying government officials to ban the National Physician Database (NPDB) from being open to the public. They believe that this is unfair to doctors. AMA Chairman Steven J. Stack stated in a statement against the Consumer Report that the database is “intrinsically flawed” and that the database “does not help the patient.”

In contrast, the National Physicians Alliance is a physician organization committed to achieving social justice and advancing health care system reform. The organization believes that the medical industry’s review reporting system should be more open to consumers because it may help patients pick the right doctor. How to find a balance between information disclosure among doctors and consumers is the key to advancing this reform.

At the same time, the American Medical Association recommends that consumers go to the medical committees of more than 50 states in the United States to find “the information they want.” Eric Fish, a legal counsel at the US Federal Medical Council, said that the state’s medical committees have their own unique channels to provide this information. They may be placed in piles of meeting minutes, and some state medical committees use separate classifications to store these review information.

However, even if consumers open the correct website, they will find it difficult to find a specific doctor’s information, and the information about the doctor’s bad records is not complete.

The Consumer Report rated the websites of the medical committees on the information sophistication and user experience. The rating report lists the top five states—California, New York, Massachusetts, Illinois, and North Carolina, and the bottom five states—Wyoming, Montana, Hawaii, and Indiana And Mississippi. On the site of the worst Mississippi Medical Board in the rating report, the information was fragmented and vague.

In addition, consumers want to get a doctor’s details, they must pay $25 each time. Even in the better-ranked states of California and New York, trying to investigate a doctor’s review history requires searching and downloading lengthy PDF documents, and finding critical information in the legal terminology is a very difficult task.

Unreliable third-party evaluation site

When people are looking for a doctor or an expert, they usually ask relatives or friends or doctors they know. When a consumer wants to confirm a doctor’s word of mouth, they go to the online doctor evaluation website like Healthgrades and Yelp to find the answer.

For example, Dr. Corinne mentioned above, until today, we still can’t find the latest bad records about him on the website of Yelp. Crain scored 4/5 on Yelp. Several patients have almost perfection for Crain, although there are also a few negative reviews.

According to Morgan Remmers, senior business development manager at Yelp, Yelp rated doctors based on user-evaluated data. It did not check the medical records left by a doctor in the medical committee or elsewhere.

Yelp is the largest review site in the United States and landed on the New York Stock Exchange on March 2, 2012. Yelp can actually be seen as a mobile vertical community with the theme of local consumption.

On Healthgrades, Crain’s score was 3.4/5. This website provides information on whether a physician has a medical accident compensation statement or a medical committee’s sanctions. However, to find this information requires the user to have considerable understanding and observation. In the “Medical Committee Punishment History” column, “The relevant penalties imposed by the Medical Committee on the doctor in recent years have not been found in the Healthcares database.”

Healthgrades is a medical quality online assessment and service company

Representatives of Healthgrades also claimed that they have 100 external sources of information to ensure the accuracy and timeliness of the data. The facts show that the complete report of the medical committee on Crain is not included in the website. Healthgrades did not show any lawsuit against Dr. Crain’s medical malpractice, but he wrote his name in 18 lawsuits in the Los Angeles court.

For consumers, if you want to find a good doctor for you, you obviously can’t refer to these user evaluation websites. At the same time, you can find a list of certified doctors through your insurance company; search for doctors’ bad records on the Federal Medical Council website; and get a comprehensive understanding of the doctors and their hospitals’ evaluation information from Consumer Reports magazine. The doctor’s situation.

Real case: Who is responsible for the death of the patient?

After she was pregnant with her third child, Ms. Cynthia Mora found the obstetrician Curry (who was still) on the site. They found that Dr. Corinne received rave reviews on the website and they chose the doctor. Obviously, Mora and her husband did not know that the doctor was once warned by the medical committee.

In the last weeks of pregnancy, she went to the hospital for emergency treatment because she felt abdominal pain, where she gave birth to a healthy baby girl. But postpartum pain has not been alleviated. On the fourth day after giving birth, Mora had a high fever and suffered severe pain. Two days later, she died of complications such as bacterial infections, kidney failure and cardiac arrest, and the culprit was the rupture of the cecum.

The medical committee found that Crain ignored the symptoms of the female cecal rupture and insisted on another diagnosis that did not match the symptoms. In addition, before Mora was discharged from the hospital, he did not perform a series of checks to confirm her physical condition. Corinne later admitted that he had never seen a nurse’s record of some symptoms of the patient and claimed that it was his style of practice.

The report also mentioned that he did not begin treatment until Mora was re-delivered to the hospital for ten hours. During this time, he received seven calls from nurses and family members, but he stayed in his office.

Corinne does not recognize the Medical Commission’s allegations against him, nor does he intend to make any justification. When asked why Dr. Crain was still able to continue his practice, Cassandra Hockenson, a head of the California Medical Board, declined to discuss any details of the case. She said that in general, the medical committee believes that if a doctor can still practice medicine under some monitoring and specific circumstances, he will consider penalties for medical examination.

Real case: deprived right to know

Most of the hospitalization decisions made by the California Medical Board contain some bad personal behaviors and professional issues. But not every case is explained so clearly. For example, a trained tumor surgeon, Scott Eisenkop, was mentioned in the observation report. In 1996, Scott successfully cured a patient’s throat cancer, but at the same time, the side effects caused facial paralysis, dry mouth and hair loss. In addition, patients also need to take seizure drugs to control the disease.

In 2012, Scott was complained about a non-standard operation during an operation. During the investigation of the medical committee, one of his surgical assistants mentioned that when the operation was at a critical moment, Scott had a few minutes of performance “incoherent and loss of judgment.”

Some experts said in his assessment of his condition that he might have been a seizure at the time. Recently, he reported to the consumer organization that it was not epilepsy. The so-called “muttering” was just that he could make a sound when he needed it.

In the report, the medical committee also wrote that Dr. Scott is “a distinguished surgeon with great reputation and is willing to dedicate himself to his medical career.” At the same time, the medical committee realized that he might bring danger, He was sentenced to a 10-year medical review. The Medical Council stipulates that unless he continues to receive medical assessment and treatment, he will continue to practice medicine and will not be able to work continuously for more than ten hours. When he is undergoing surgery, he must have another doctor ready to take over.

However, the committee did not ask Scott to inform the patient about his condition and punishment, nor did he stop the operation permanently, even if he was still affected by epilepsy from time to time.

Scott believes that he has no obligation to tell the patient about his situation. As long as he insists on taking the medicine and rest on time, he can continue the operation safely.

In 2013, a patient took Scott to court because the doctor mistakenly removed her healthy ovaries during an operation. The lawsuit mentioned that the surgery caused permanent irreversible damage to her. She believes that she should be informed of Scott’s condition before the operation. The names of the medical center where the operation was performed and the California Medical Board were in the lawsuit because they still allowed him to perform surgery because they knew about Scott.

Scott said that the patient’s claim was unfounded and that there were no errors in the operation.

What annoyed the patient was that she knew almost nothing about Scott before the operation. Before arranging the operation, she hoped to see Scott and was told that he was too busy at work. At the time, she didn’t want to investigate Dr. Scott’s thoughts. She said: “In my generation’s concept, doctors are like God, they will not make mistakes.”

She did not know that during her surgery, a formal complaint letter about Scott was being tried by the California Medical Board. “If I knew about it, I would never agree to let him do that surgery.”

Layer-by-layer approval regulatory system

When the patient thinks he or she has been harmed, he can submit a complaint to the state medical board. After the complaint is confirmed by the investigation, both doctors and patients will be notified, the complaint will be further processed, and a final decision will be made, and then a hearing will be arranged to collect feedback.

Generally speaking, if there is drug abuse, treatment is not standardized, unreasonable prescribing or overdosing, does not meet the requirements of “medical continuing education”, constitutes a felony or entrusts an unqualified person to act on behalf of the class, the MC will consider Relevant penalties and sanctions are imposed on doctors.

In the 2014-2015 financial year, the California Medical Board received a total of 8,267 official complaint letters and publicized the penalties for 1,381 doctors, 86 of whom received a lighter warning and 136 doctors. After a certain period of medical review, 14 people were temporarily disqualified from practicing medicine, 45 were permanently revoked, and 85 doctors ruled that their licenses were waived directly before the announcement.

The penalties are so low, in part because public responsibility for proof is heavy. Kim Kirchmeyer, executive director of the California Medical Board, said the complainant needed to provide clear and convincing evidence that the violation did occur and that the complaint letter met certain requirements.

Former NPDB database director Robert E. Oshel believes that this figure reflects the doctor’s cover of these doctors. “The main body of the MC’s ruling is mainly specialist doctors. Unless they are under great public pressure, they will not consider these punishments for doctors.”

“The Medical Board has a sophisticated mechanism to effectively prevent information from being fully disclosed. For example, they will only disclose medical disputes and related doctors who are paying more than a certain amount, or doctors who have caused many medical incidents for some time.” Consumer Report “In this report, “a doctor who is “small mistake” may never appear on the published list.”

William Newkirk is a California lawsuit for medical malpractice lawsuits. He sees an imperfect medical regulatory system, which is mainly limited by the number of staff and budget. He told reporters: “The medical committee usually does not punish doctors unless they repeatedly commit crimes. Therefore, your complaints should be written very compelling and you must have very convincing evidence.”

When the patient thinks that he is being invaded by a doctor and is preparing to file a complaint with the medical committee, he must first understand what violations have occurred that the other party will receive the attention and attention of the medical committee, and then appeal through the police, lawyers and local medical committees. Collect enough and necessary evidence and materials to prove the doctor’s misconduct.

This article is excerpted from the US Consumer Report. Author: Rachel Rabkin Peachman Compilation: Yuyu DeepTech Deep Technology Editor, reprinting requires authorization