Medical board backs reforms

Nonpunitive system for reporting errors gets panel's support

Legislators wary of plan

September 09, 2001|By Greg Garland | Greg Garland,SUN STAFF

OCEAN CITY - The state medical society voted yesterday to push for changes in the way Maryland regulates doctors, proposing a less punitive system that the society argues will encourage more thorough reporting of medical mistakes.

The society's 163-member policy-making body voted at its annual convention to propose the new regulatory scheme. Supporters say it would improve medical care and patient safety; critics contend it would protect bad doctors who harm patients from accountability and appropriate sanction.

"I think this opens a whole new avenue of debate and discussion on the issue how do we improve the quality of medical care for Marylanders," said Dr. Arthur Blumberg, president of the Medical and Chirurgical Faculty of Maryland, or MedChi, the professional society that lobbies for doctors.

MedChi Executive Director T. Michael Preston said, "As of today, MedChi is committed to transforming Maryland's system of regulating physicians in a way that embraces the National Academy of Sciences' recommendations for improving patient safety."

MedChi's proposal occurs at a time when legislators are calling for reforms of the current regulatory system, which some say is ineffective and too tightly controlled by doctors.

Legislators who handle health care issues in the General Assembly have said they were disturbed by an article in The Sun last month that raised questions about weaknesses in the current system.

The article focused on a Baltimore obstetrician/gynecologist, Dr. Ghevont W. Wartanian, who has faced 18 malpractice suits in the past two decades, nine of which have led to total payments of more than $2 million. Wartanian, who contends he practices good medicine, has never faced disciplinary action or had his practice restricted, records show.

There was mixed reaction to the MedChi proposal yesterday from key legislators who deal with health care issues. They said that some aspects of the plan have merit, but voiced concerns that there are not enough safeguards to protect consumers.

"I think what we can do is take this as certainly a good starting point to put together the kinds of reforms we believe are necessary and advantageous for everybody," said House Speaker Casper R. Taylor Jr., an Allegany County Democrat.

Added Del. John Adams Hurson: "The proposal from MedChi is good to put on the table, but we're going to have to go much further than what they are looking at."

Hurson, a Montgomery County Democrat, heads a Maryland House committee that has oversight over the Board of Physician Quality Assurance, the regulatory board responsible for licensing and disciplining physicians. Hurson's committee plans hearings this fall to look at ways to restructure the board to make it more effective.

The MedChi proposal would protect physicians who report errors they make from facing punitive action.

Depending on the error, a physician could be directed to get retraining in a certain procedure or have his license restricted. A physician who failed to comply would be reported to the disciplinary board for possible sanction.

Hurson and Del. Michael E. Busch, an Anne Arundel Democrat who heads a separate House committee that also deals with health care matters, said they would prefer that medical errors be reported in a more systematic way.

But Busch said there still has to be accountability for major medical problems, such as a doctor operating on the wrong leg of a patient or when a physician who has shown a pattern of bad practices.

Busch also said he thinks that MedChi, a trade association, should not play a role, as it does now, in Maryland's disciplinary system. He said the regulatory board needs to be independent from MedChi.

Under the current system, MedChi conducts nonbinding elections in which Maryland doctors vote for candidates to fill 10 of the 15 seats on the regulatory board. The names are then submitted to the governor, who makes appointments.

MedChi also solicits physicians to volunteer to conduct peer reviews for the board in cases that involve a doctor's professional competence.

In the proposal adopted yesterday, MedChi recommended that it no longer have any involvement in the balloting process, but vowed to defend the organization's role in handling peer reviews.

"We feel very strongly that there is no evidence to support criticism of MedChi's role in peer review," said Preston. He said the peer reviewers reach their conclusions about the care a doctor has provided without interference from MedChi.

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