Online plan for doctors widens scope Legislators move to add information, delay implementation

'A ring of fairness'

Point of contention is pending lawsuits in malpractice cases

March 15, 1997|By Marcia Myers | Marcia Myers,SUN STAFF

An online service that would give consumers instant access to records on Maryland physicians is shaping up to provide far more information than originally envisioned, but the public may have to wait nearly two years to tap into it by computer.

In recent weeks, the momentum behind the idea has shifted from the state physicians board to Annapolis, where legislators are rewriting the proposal in elaborate fashion.

Senate President Thomas V. Mike Miller, who rarely sponsors bills, has proposed the "consumer health information act" to streamline public access to many state health records.

A similar bill by Del. Henry B. Heller, a Montgomery County Democrat, is moving through the House. Although each contains controversial elements, the bills have won general favor from a wide range of supporters -- consumer groups, senior citizens, union members, state health officials and physicians.

The bills go well beyond the original plan, conceived by the state Board of Physician Quality Assurance, to create online physician profiles that would include malpractice, disciplinary, education and licensing information.

Both bills call for lengthy studies to gauge the potential impact on physicians of putting the information online. They would prohibit releasing the records in that form for nearly two years. In the meantime, consumers could get them on paper.

Testifying yesterday before members of the Senate Finance Committee, all of whom have signed on as co-sponsors of the bill, Miller said that in an age of managed care, it is critical to improve consumer access to health records.

"We consumers want to be able to make informed choices," said Miller, a Prince George's County Democrat.

His plan would speed the process by funneling information on doctors from a string of mostly obscure agencies to a single office, where he says consumers could "one-stop shop" instead of scrambling to find the records piecemeal.

His bill would also expand the scope of the office to include report cards and other information about health maintenance organizations.

Like Heller, Miller seeks to substantially broaden the doctor profiles. Both bills would crack open physician disciplinary actions taken by hospitals and health maintenance organizations -- records now closed to the public -- and include criminal histories of physicians.

Doctors would be given space to write about themselves and respond to charges or allegations.

The most controversial feature -- lists of pending malpractice suits -- remains a point of contention.

Numerous doctors groups testified yesterday against that aspect in Miller's bill, but said they would support an amended version that addressed those concerns and a few others. Afterward, Miller said he expects the bill will be changed.

"I would prefer something different, but it has a ring of fairness," he said of the proposal to exclude unresolved malpractice suits.

Although pending malpractice suits are public record and available from the physician board on request, doctors argue that they are groundless 80 percent of the time and would confuse and mislead consumers. The state's largest physician association, the Medical and Chirurgical Faculty of Maryland, is waging a vigorous campaign to block online access to them.

Backing off plan

And the physicians board, led by strong objections from state Health Secretary Martin P. Wasserman, has backed off its plan to list them online, although the public still could request them in writing. It can take up to 30 days to receive the information through that process.

Malpractice claims without a conclusion would be almost useless to consumers and could do real damage to a doctor's professional reputation, Wasserman testified yesterday.

"There comes a point where we're trying to protect the consumer from himself," he said in an interview later. "Until a case is resolved, it is just a rumor. I think rumors are baseless."

Heller's bill would go further -- preventing the board from releasing the information in any form.

Miller said, "That a claim has been filed does not mean guilt, but if you see a pattern, then it will kindle a spark in your mind to maybe look into this yourself. I think it's important that we have it. If an error is going to be made, then it's better to protect people from breaches in good standards of care."

Daniel J. Pontious, executive director of the Maryland Public Interest Research Group, agreed.

"Consumers are smart enough to be able to interpret the information if it's put in the proper context," he said.

Miller's bill specifically prohibits putting the information online before January 1999, but he envisions accelerating that timetable. "I would like to see it move ahead as soon as possible."

Cost of service

The service would cost $837,000 to $1 million, mostly one-time costs, according to the physicians board. Miller has suggested paying for it by raising the cost of the $520 physician license, which must be renewed every two years. Doctors object to that idea, saying it would cost an extra $40 to $100 each time they renew.

Wasserman also wants the information disseminated from within his agency, rather than through the attorney general's health advocacy unit, as proposed by Miller.

No decision has been made about whether to go forward with a limited online service this year if neither bill passes, Wasserman said. The physicians board had expected to put the information online this spring.

Pub Date: 3/15/97

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