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PAGE ONE -- Physicians' Files Could Be Unsealed
Assembly considers opening records
William Carlsen, Chronicle Staff Writer
When Massachusetts put its doctors' once-secret records -- from
malpractice
settlements to hospital disciplinary actions -- on the Internet last
week, the
Web site registered an astounding 35,000 ``hits'' on the first day.
A bill currently before the California Legislature seeks to make the
same
information available here. If it passes, most experts expect it to
be just as
popular as the landmark Massachusetts disclosure law.
But if the state's powerful medical lobby has its way, a key piece
of the
doctors' records will be missing when California consumers dial a
telephone
hotline or call up a Web site on their computer screens. Doctors'
groups are
opposed to public disclosure of any malpractice settlements recorded
against
individual physicians.
The pending legislation, which closely parallels the Massachusetts
law, faces its
first major test before the Assembly Health Committee in Sacramento
tomorrow.
``People have a fundamental right to know about their doctors,'' said
Assemblywoman Liz Figueroa, D-Fremont, who drafted the bill. ``You can
find out all kinds of information on the Internet -- about lawyers,
even car
mechanics -- yet vital background information on your doctor is not
available.''
Under current law, consumers can call the California Medical Board, the
agency that licenses the state's 78,000 doctors, and discover basic
information
about a doctor, including board disciplinary actions and malpractice
judgments
imposed by a court or jury.
For the first time, Figueroa's bill would make public all
malpractice settlements
larger than $30,000 as well, and any serious discipline by hospitals
against a
state- licensed physician -- and put it all on the Internet, where
anyone with a
computer can easily access it. The doctor's training, specialties,
hospital
affiliations and the insurance plans he or she accepts would also be
included.
Heavy negotiation over the bill has already resulted in compromises
by both
sides, a development that bodes well for passage of some kind of public
disclosure measure this year.
For example, the California Medical Association had long opposed any
public
release of hospital actions against doctors, arguing that these
``peer reviews''
are private and not subject to the rigorous process of the state board's
disciplinary procedures.
Current law requires hospitals to report disciplinary actions -- such as
revocations of a doctor's staff privileges -- to the medical board,
but the
information is closely guarded and not available to the public.
The CMA has reluctantly agreed to the part of Figueroa's bill that
would make
public such hospital discipline reports -- called 805s after the
section of the
law.
``This is big, big news,'' said CMA Associate Director Scott Syphax.
He noted
that only a few years ago, disclosure of 805s was stripped from a
reform bill in
the first legislative committee because of the CMA's adamant
opposition.
``We've come to the table on this in the interests of disclosure,''
he said.
COMPROMISE ON BOTH SIDES
Figueroa has also compromised, dropping her original proposal that all
malpractice settlements by a doctor of any amount be disclosed and
raising the
threshold to those over $30,000.
That still doesn't satisfy the doctors' groups, who oppose any
release of
settlement information on the grounds that such data provides no
indication of a
doctor's competence but can unfairly tarnish his or her reputation.
``A settlement is not a finding of fault,'' said lobbyist Tim
Shannon, who
represents doctors' malpractice insurers. ``Many malpractice suits
are nuisance
cases without merit that insurers settle rather than bear the high
cost of going
through a trial. A doctor has to sign off on those. But do you think
they will if
they know it will be publicly disclosed and could unfairly harm
their reputation?
``This provision will cause a lot of unnecessary litigation to drag
through the
courts,'' he added.
But Figueroa and her supporters insist that settlements must be
disclosed.
``About 90 percent of all malpractice suits are settled,'' said
Jamie Court of
Consumers for Quality Care. ``So that's the really important
information people
want to know about doctors.''
Court added that severe monetary limits on malpractice suits enacted
by the
Legislature in the 1980s have eliminated all but the most serious
cases. ``There
are few, if any, nuisance malpractice suits being filed these
days,'' he said.
Figueroa said that she is not so concerned about the amount of the
settlement
as she is about whether there is a pattern. ``I'm willing to talk,''
she said.
``Maybe we can agree not to disclose if there is only one or two
settlements
but start with the third.''
The doctors may be willing to talk as well after seeing the
steamroller that
thundered out of Massachusetts last year with the passage of the state's
revolutionary disclosure law. The sweeping nature of its disclosure
requirements stunned medical groups across the nation, and similar
bills are
now pending in half a dozen states.
THE MASSACHUSETTS EXPERIENCE
The Massachusetts law followed a series of newspaper exposes on
allegedly
incompetent doctors. After the state's Legislature passed what
doctors viewed
as a draconian law that included disclosure of every complaint filed
against a
doctor -- a bill vetoed by the governor -- the Massachusetts Medical
Society
sponsored the current law.
``The public perception was that we were trying to cover up for bad
doctors,''
said Dr. Joe Heyman, the group's president. ``So we decided to
sponsor a bill
we thought was fair and did the job. I think it's been pretty
successful.''
``Successful?'' asked Wayne Mastin, the director of the state program.
``Phenomenal is more like it.'' The program started last November with a
telephone hotline the public could call to request a ``doctor's
profile.''
On Thursday, it went on the Internet. Mastin said that during the
first six
months of operation they sent out 52,000 profiles. ``The first day
on the
Internet, we had 35,000 hits,'' he said.
Under the requirements of the law, the ``doctor's profile'' includes
a general
disclaimer that malpractice settlements are not findings of fault.
It also includes
data about the rate of malpractice suits for each specialty.
Obstetricians, for
example, have a higher average rate of lawsuits than pathologists.
Exact monetary figures for any settlements are not given. Instead, the
settlements are recorded by date, going back the last 10 years, and the
amounts are characterized only as ``above average,'' ``average'' or
``below
average.''
``We believe that these provisions keep things in perspective,''
said Heyman,
who added that the response by doctors to the program has been generally
good.
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