Latest calls for easier public access to information on physician performance and quality is a reminder to clinical laboratories and pathology groups of the trend to greater transparency on provider outcomes
If any clinical laboratory executive or pathologist still doubts that more transparency of provider outcomes is a topic of interest to patients, they have only to look at Consumer Reports, well-respected for its advocacy on behalf of consumers. Consumer Reports is using multiple ways to educate their readers about medical errors and how the medical community makes it difficult for consumers to learn about physicians who have been involved in state medical board investigations.
Consumers Union advocates for increased public disclosure of information about such issues as:
• medical errors; and,
Safe Patient Project Pushes for Provider Accountability
In its March cover story, Consumer Reports noted that thousands of U.S. doctors continue to treat patients while facing medical probation. The report alludes to patients who experienced dire medical consequences after apparently being treated by doctors facing state disciplinary procedures.
Lisa McGiffert is Director of the Consumers Union’s Safe Patient Project. McGiffert believes that patients should not have to struggle to discover if their doctors are on probation.
“The onus shouldn’t be on patients to investigate their physicians. Doctors on probation should be required to tell their patients of their status,” McGiffert said in the Consumer Reports article.
State Medical Boards Fail at Providing Easy Access to Physician Backgrounds
Medical boards are state government agencies responsible for licensing and disciplining doctors and investigating complaints about them, explained a Consumers Union statement. While most U.S. doctors have “clean” records, thousands of other physicians are put on probation for a variety of offenses, Consumers Union also pointed out.
Consumer Reports and the IPI analyzed medical board websites to learn if patients can easily obtain information about their doctors. Then, they rated the sites on a scale of 1 to 100 with 100 representing a website offering a quality search for doctors’ background information. According to the Consumer Reports/IPI review, the state medical board websites that received the lowest scores are:
• Mississippi 
• Indiana 
• Hawaii 
• Montana 
• Wyoming 
• Arkansas 
• Alaska 
• New Mexico 
• Utah 
• Rhode Island 
“One of the core defining points of what a profession is, is that it takes responsibility for regulating itself. Can that be uncomfortable for the medical profession? Yes, it can. That’s unfortunate—the discomfort—but the responsibility of an agency like a board of registration is to the public,” declared Jim Sabin, MD, Director of the Ethics Program at Harvard Pilgrim Health Care, in the Consumer Reports story.
Hundreds of Doctors in California Treat Patients While on Probation
According to the Consumer Reports article, as of September 29, 2015, out of 100,000 practicing physicians in California, 446 of them were on probation. Their offenses include practicing medicine while using illegal drugs, sexual misconduct with patients, and negligence that led to surgery errors and wrongful deaths, reported KATU News Portland.
These physicians were able to continue practicing medicine so long as they took certain steps, such as:
• completing an ethics course;
• treating female patients only when a chaperone is present; and
• submitting to drug testing.
Consumers Union Reaches Out to California Medical Board
The Consumers Union filed a petition in the fall with the Medical Board of California urging it to require doctors who are on probation to notify people they treat, according to a report by the Bakersfield Californian.
More Advocates for Consumer Safety and Health
It can be challenging to investigate a physician’s background and the results of any disciplinary actions taken. For patients interested in checking into the disciplinary records of their physicians, Consumer Reports suggested starting with these transparency sources:
• Docinfo.org: operated by the Federation of State Medical boards;
• The Informed Patient Institute (IPI): a nonprofit organization providing consumers with information about healthcare quality, patient safety, and healthcare costs; and,
• Medicare’s Physician Compare for Medicare-eligible patients.
Pathologists Often Know Which Are the Best and Worst Physicians in Their Cities
There is an interesting side note to the Consumers Union Safe Patient Project. Many clinical pathologists who serve as laboratory directors of the nation’s clinical labs know which physicians in their community regularly fail to treat their patients in a consistent manner according to care protocols appropriate to the health conditions of these patients.
Clinical pathologists gain these insights because they see the daily flow of lab test orders from physicians and can recognize when a physician consistently fails to order a test that would be most appropriate. With equal frequency, pathologists will also notice that a physician has a pattern of ordering lab tests that are not useful or are unnecessary, given the patient’s presentation.
Another way pathologists can identify physicians who regularly fail to provide appropriate care to their patients is because pathologists will see cumulative lab test results on a patient and understand that the physician has not followed up those test results in ways that will move lab results in the direction that represents improved health for that patient.
One example of this is when a clinical pathologist can see all the hemoglobin A1c results for a physicians’ population of patients. The pathologist may notice that this physician, compared to his or her peers, has a much higher proportion of diabetic patients whose A1c test results are in the very high range and are thus candidates for clinical intervention.
Efforts by such groups as Consumer Reports to make it easier for patients to access the disciplinary records of their physicians is just one aspect of the wider trend of transparency in provider prices, outcomes, and quality. At some future time, clinical labs and pathology groups can expect that information about their prices and quality will be readily accessible to consumers, patients, and journalists.
—Donna Marie Pocius