Masking malpractice

December 20, 2005

The Maryland Board of Physicians is responsible for the licensing of 17,000 doctors and investigating possible incidences of malpractice. As Sun reporter Fred Schulte's three-part investigation makes clear, there are serious questions about how well the board is accomplishing the latter task. It's a complex matter requiring the balance of often competing interests including public health, confidentiality of records and the economics of insurance. But the board's shortcomings are troubling nonetheless. Maryland needs to rethink the standards by which physicians with a history of malpractice lawsuits are investigated, strip away some of the excessive secrecy surrounding this process, and commit more resources to protecting the public health.

These issues are certain to spark intense interest during the upcoming legislative session. At this time last year, the rising cost of physician malpractice insurance was considered a crisis for the state and caused Gov. Robert L. Ehrlich Jr. to call for a special session to address the matter. The ensuing debate was heated - but not always particularly illuminating. Scant attention was paid to the relatively small number of doctors who generate a high number of insurance settlements - and whether the state was doing an adequate job of weeding them out of the profession, or even informing consumers about them.

Lawmakers expected a tougher physican watchdog when they created the board nearly three years ago. But legislators also made compromises. One of those was to shield most records and investigations from the public, and this poses a problem. While lawsuits aren't the ideal way to judge a doctor (some aren't justified but result in financial settlement to the plaintiff anyway), far more information regarding an individual doctor's history of claims and outcomes ought to be made public. And board rules that cause a doctor to be automatically investigated only when there are at least three malpractice awards of $150,000 or more in the previous five years appear to be lax when compared to the policies endorsed by other states.

Admittedly, there is a balance to be struck. Doctors who take on high-risk specialties should not be treated unfairly. But it's the interests of consumers - not of lawyers or physicians or insurance companies - that should be paramount. As a recent state audit noted, the board is well-intentioned and committed, but lacks the tools to do its job well. That includes the money to hire more staff and to offer better pay to attract qualified investigators - and, of course, a lot less secrecy.

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