Tolerating Medical Errors

Medscape has an article this week regarding what happens when physicians are accused of sexual misconduct with patients. Despite recent high-profile cases involving Olympic athletes, most physicians who are accused never see court, and may be given a “probation period” by the state Board of Medical Examiners, and then allowed to return to practice full time as if nothing had happened. That true even in California, the state regarded as having the most strict supervision of doctors.

According to one law firm, sexual misconduct leads the list of reasons for a doctor to lose a license in Texas.(5) There are no national data on either the number of doctors subject to disciplinary action or the reasons. The other reasons cited in the Texas report include

  • Substance abuse
  • Insurance fraud
  • Patient abuse
  • Medication violations
  • Unethical behavior and malpractice

Unfortunately, toleration of sexual misconduct fits into a pattern of allowing doctors to practice after committing serious errors — in the US. Other countries are less permissive.

As an example, in EU, anesthesiologists are allowed no errors in the operating room. The first error results in a loss of license. The joke is that after that loss, they come to the US to practice. Or maybe that’s not such a joke. Anesthesiology is the most error-prone area of medicine in the US.

Within the US, doctors who lose their license in one state are able to retain licenses in other states and continue to practice. Typically, doctors will surrender their license rather than face revocation, and regulators in other states in which they practice may never hear about any disciplinary action. In one notable example, a doctor removed the wrong organ in surgery in Louisiana and then moved to California and repeated the error with a different patient.(2)

One recent news investigation identified 500 doctors who had been disciplined for errors or misconduct who are practicing in another state today. The errors ranged from having sex with patients to causing death.(3)

This is not a comprehensive list. Many regulators are reluctant to impose serious sanctions on medical offenders. Even in cases of sexual misconduct, very few appear to result in criminal complaints. We simply don’t know the extent of the problem.

This isn’t a small problem. According to a study by Johns Hopkins University earlier this year, medical errors account for 250,000 deaths in the US each year.(6) Other estimates place deaths due to errors at up to 440,000 per year. It’s the third leading cause of death behind heart disease and cancer. There are no estimates for sexual misconduct, fraud or non-lethal patient mistreatment.

Disciplinary action also is no barrier to a doctor receiving payments from Medicare. Apparently, CMS isn’t informed about misconduct either.

Consumers for the most part have no way to know if a doctor has faced disciplinary action or not.(3)

While there are many excellent doctors in the US, the failure to police the bad ones adequately tarnishes the entire profession.


Sources:

  1. https://www.medscape.com/viewarticle/906978?nlid=126835_381&src=WNL_mdplsnews_181228_mscpedit_wir&uac=153634BV&spon=17&impID=1846392&faf=1
  2. https://www.medpagetoday.com/special-reports/states-of-disgrace/76584
  3. https://projects.jsonline.com/news/2018/2/28/is-your-doctor-banned-from-practicing-in-other-states.html
  4. https://www.usatoday.com/story/news/2018/11/30/medical-board-license-discipline-failures-7-takeaways-investigation/2092321002/
  5. https://www.thehartlawfirm.com/blog/common-reasons-doctors-lose-their-medical-licenses.cfm
  6. https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

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