In my law practice as a Houston, Texas medical malpractice attorney, one of the most common questions I hear from clients is “How can they let this doctor keep hurting people?”
At first glance, existing laws seem to require hospitals to be vigilant in monitoring the competency of physicians practicing medicine in their facilities. If you scratch the surface, though, you will find that this is not necessarily the case.
For example, federal and Texas laws require hospitals to check physicians’ competency or credentials before granting them staff privileges to practice medicine and provide services in a hospital. This information is privileged and unavailable to patients or the public.
Existing laws also require hospitals to monitor physician quality of care and re-check credentials on an annual basis. Hospital peer review committees are responsible for reviewing the quality of care provided by physicians on the medical staff. As the committee name suggests, its membership is made up of peers, colleagues, or friends of the doctors whose care if being reviewed.
Any problems with a doctor’s quality of care resulting in an adverse action on the right to practice medicine at a hospital must be reported to the National Practitioner Databank.
While all of these measures seem somewhat helpful in promoting safe patient care, closer consideration shows that the requirements are largely there to protect hospitals and doctors. After all, absolutely none of the information uncovered by hospital credentialing and peer review efforts is available to patients and the public. Instead, various laws make the information privileged and essentially top secret.
These legal protections are completely unique to medical doctors and, in my opinion, show the influence and sway that their powerful lobbyists have with lawmakers in Austin and Washington, DC.
As a patient, would you like to know if your surgeon had been sanctioned or had his or her staff privileged reduced by a hospital for providing substandard care? Of course, because you would likely use this information to select a doctor with a better track record.
Even after medical malpractice causes a severe injury to a patient, the doctors’ hospital personnel file remains under lock and key. This makes it largely impossible to determine whether the medical negligence was an isolated incident or a pattern of poor care endangering numerous patients.
To that point, as a medical malpractice lawyer, I have had a number of occasions where we represented multiple clients against the same doctor, for different acts of negligent care. Only after filing those lawsuits were we able to put together the pieces of how this doctor made the same type of life-threatening mistakes over and over. It defies explanation how a hospital fulfilling its responsibilities would not have uncovered this truth much earlier, and with fewer patients being harmed.
This reveals yet another weakness of the self-regulation system that we have in place regarding monitoring the quality of physician care. In other words, with secrecy and no public accountability, how can one have any real assurance that hospitals are legitimately meeting the peer review and credentialing processes required by law? The answer: You cannot.
A recent story about the U.S. Department of Veterans Affairs (VA) hospital system demonstrates the problem.
In November 2017, the U.S. Government Accountability Office issued a report finding that VA hospitals failed to report a whopping 90% of potentially dangerous medical providers in recent years to the National Practitioner Databank.
As I mentioned earlier, any time a new doctor applies to work at a hospital, the law requires the hospital to verify the doctor’s credentials, which includes checking the National Practitioner Databank. The VA’s failure to report quality of care issues allowed bad doctors who were disciplined or sanctioned by a VA hospital to leave that hospital and go apply to work at another hospital without anyone knowing about their quality of care issues.
Of equal concern, the General Accountability Office report found that VA administrators also failed to report any of the problem doctors to state medical boards that could suspend or revoke their licenses to practice medicine.
What you can do
While hospital and national databank information about doctors remains privileges and inaccessible to patients and the public, there are still some things that you can do to promote your own safety.
First, do some research on your potential physicians. You can look them up on the Texas Medical Board website, which will show when and where they graduated from medical school, what residency and fellowship training they have, the hospitals where they practice, and recent disciplinary actions by the Board.
Any time we investigate a new medical malpractice case, this is the first place we start. It is not uncommon to find Texas doctors practicing in specialties where they have no formal training. We recently found that a doctor advertising himself as a wound care doctor only had training in family medicine. In another case, a physician working in a freestanding emergency room only had training as a pediatrician.
Second, ask friends, coworkers, and family members for doctor recommendations. Beware, though, that some providers are competent to provide some types of care, but not others.
Finally, talk with your doctor and ask appropriately probing questions. Ask how many times the doctor has treated your condition, performed a proposed surgery or treatment, and what his or her complication rate has been.
We are here to help
If you or a loved one has been seriously injured from a medical mistake or malpractice, call Painter Law Firm at 281-580-8800 for a free consultation about your potential case.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who focuses his practice on filing medical negligence and wrongful death lawsuits against hospitals, doctors, surgeons, anesthesiologists, physician assistances, nurse practitioners, pharmacies, and other healthcare providers. In 2017, he was named as one of Houston’s top lawyers by Houstonia magazine and H Texas magazine.
