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Doctors: Malpractice site unfair

Plans by the N.C. Medical Board to post all doctors' malpractice histories on its Web site have drawn criticism from physicians who say the information would be misleading and unfair.

About 870 physicians, encouraged by the state's medical society, have sent e-mails and letters in opposition to the board, which is soliciting comments from the public through Monday. So far, about 75 people have contacted the board in support of the change.

The medical board, which licenses and regulates doctors and physician assistants, has been criticized in the past for failing to protect people from bad doctors. To increase public confidence, the board pushed for a new state law that requires collection and publication of doctors' medical malpractice histories as well as other background information, including criminal records.

Plans are for the Web site to disclose all malpractice settlements or judgments going back seven years. Payment amounts and information that identifies patients would not be published.

Despite the overwhelming response from doctors, who can send e-mail from a quick link on the N.C. Medical Society Web site, the medical board believes most citizens support the publication of malpractice data. A recent random survey of 1,000 N.C. residents showed 81 percent in favor.

Thom Mansfield, director of the board's legal department, said he has heard from about half of the 25 states that already publish malpractice information, and all of them say similar concerns raised by doctors beforehand have “not turned out to be true.”

Comments on the board's plan can be made in writing or in person Monday at a 10 a.m. public hearing in Raleigh.

A final board decision on posting malpractice payments is expected in July. It then goes to the legislature's Rules Revision Commission, which could refer it to the legislature early next year. If the plan is adopted, North Carolina's medical board would be the 26th to publish malpractice information. (South Carolina does not.)

Malpractice claims and dispositions are already public in county courthouses where they are filed, but settlement amounts are often kept confidential. The medical board's expanded physician profile would make the information more easily accessible.

The medical board already posts its disciplinary actions on the Web site, www.ncmedboard.org. Under the new law, it would also publish suspension or revocation of doctors' hospital privileges, convictions of felonies and some misdemeanors.

The N.C. Medical Society, a private association representing about 11,000 doctors, supports the publication of more information in physician profiles, but opposes publication of all malpractice records.

“There are many medical malpractice payments that are made for reasons unrelated to poor medical care,” said Steve Keene, the society's general counsel. “It's very frequently cheaper to settle a medical malpractice case than to litigate it, even if you know that the medical care was good…. Only payments associated with poor medical care should be included.”

Keene said the medical board already reviews records in malpractice cases to see if medical care is below standard, and should include that analysis to give the public more context.

The medical board would allow doctors to add a “brief statement” explaining the circumstances of the malpractice claim. But Keene said “a sentence or two is no substitute for the substantive review…Why not sort out for the public those payments that are related to poor medical care and post those?”

The medical board plans to include a disclaimer saying that malpractice payments don't always suggest negligence and that some specialties, such as obstetrics and neurosurgery, draw more suits than others. It would also indicate whether the malpractice payment led to a disciplinary action by the board.

Mansfield said only about 4 percent of N.C. doctors and physician assistants will show up with malpractice records, and most will have only one payment. More than 32,000 physicians and physician assistants practice in the state.

Many physicians also believe that only future malpractice payments should be published. Keene said doctors might not have agreed to settle cases in the past if they had known the outcomes would be made public.

Jerry Allen, a Goldsboro lawyer who defends doctors in malpractice cases, agrees that publishing all malpractice payments, small or large, will make it more difficult to persuade doctors to settle out of court. That could also be bad for plaintiffs who have legitimate complaints who would like to settle “for some reasonable amount of money,” Allen said.

If the proposed rules are adopted, it would take a year for the medical board to collect all the data and post it.

Plans by the N.C. Medical Board to post all doctors' malpractice histories on its Web site have drawn criticism from physicians who say the information would be misleading and unfair.

About 870 physicians, encouraged by the state's medical society, have sent e-mails and letters in opposition to the board, which is soliciting comments from the public through Monday. So far, about 75 people have contacted the board in support of the change.

The medical board, which licenses and regulates doctors and physician assistants, has been criticized in the past for failing to protect people from bad doctors. To increase public confidence, the board pushed for a new state law that requires collection and publication of doctors' medical malpractice histories as well as other background information, including criminal records.

Plans are for the Web site to disclose all malpractice settlements or judgments going back seven years. Payment amounts and information that identifies patients would not be published.

Despite the overwhelming response from doctors, who can send e-mail from a quick link on the N.C. Medical Society Web site, the medical board believes most citizens support the publication of malpractice data. A recent random survey of 1,000 N.C. residents showed 81 percent in favor.

Thom Mansfield, director of the board's legal department, said he has heard from about half of the 25 states that already publish malpractice information, and all of them say similar concerns raised by doctors beforehand have “not turned out to be true.”

Comments on the board's plan can be made in writing or in person Monday at a 10 a.m. public hearing in Raleigh.

A final board decision on posting malpractice payments is expected in July. It then goes to the legislature's Rules Revision Commission, which could refer it to the legislature early next year. If the plan is adopted, North Carolina's medical board would be the 26th to publish malpractice information. (South Carolina does not.)

Malpractice claims and dispositions are already public in county courthouses where they are filed, but settlement amounts are often kept confidential. The medical board's expanded physician profile would make the information more easily accessible.

The medical board already posts its disciplinary actions on the Web site, www.ncmedboard.org. Under the new law, it would also publish suspension or revocation of doctors' hospital privileges, convictions of felonies and some misdemeanors.

The N.C. Medical Society, a private association representing about 11,000 doctors, supports the publication of more information in physician profiles, but opposes publication of all malpractice records.

“There are many medical malpractice payments that are made for reasons unrelated to poor medical care,” said Steve Keene, the society's general counsel. “It's very frequently cheaper to settle a medical malpractice case than to litigate it, even if you know that the medical care was good…. Only payments associated with poor medical care should be included.”

Keene said the medical board already reviews records in malpractice cases to see if medical care is below standard, and should include that analysis to give the public more context.

The medical board would allow doctors to add a “brief statement” explaining the circumstances of the malpractice claim. But Keene said “a sentence or two is no substitute for the substantive review…Why not sort out for the public those payments that are related to poor medical care and post those?”

The medical board plans to include a disclaimer saying that malpractice payments don't always suggest negligence and that some specialties, such as obstetrics and neurosurgery, draw more suits than others. It would also indicate whether the malpractice payment led to a disciplinary action by the board.

Mansfield said only about 4 percent of N.C. doctors and physician assistants will show up with malpractice records, and most will have only one payment. More than 32,000 physicians and physician assistants practice in the state.

Many physicians also believe that only future malpractice payments should be published. Keene said doctors might not have agreed to settle cases in the past if they had known the outcomes would be made public.

Jerry Allen, a Goldsboro lawyer who defends doctors in malpractice cases, agrees that publishing all malpractice payments, small or large, will make it more difficult to persuade doctors to settle out of court. That could also be bad for plaintiffs who have legitimate complaints who would like to settle “for some reasonable amount of money,” Allen said.

If the proposed rules are adopted, it would take a year for the medical board to collect all the data and post it.

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