WASHINGTON - In a database kept secret from patients, the government has recorded the names of nearly 500 doctors and dentists across the country who have been slapped with at least 10 disciplinary actions and malpractice payments over the last decade.
One of every seven U.S. doctors and one of every eight dentists has at least one malpractice payment or disciplinary report in the National Practitioners Data Bank, which the Department of Health and Human Services has been compiling since 1990.
Consumer advocates and a key congressional Republican are pressing to disclose the names to help patients shop for doctors. Medical experts oppose such a release, fearing the data is skewed by malpractice insurance settlements.
''I don't feel that I'm dangerous to my patients at all. I feel like I've always acted in my patients' best interests,'' said Dr. Gary Hall, a Phoenix ophthalmologist who has paid $5.3 million in malpractice claims and is listed 27 times in the federal database.
Hall was censured last year by the Arizona Board of Medical Examiners, fined $15,000, placed on three years probation and barred from performing one type of eye surgery, radial keratotomy.
Being identified as one of the doctors with the most records in the database ''makes you look very guilty,'' he acknowledged. But he said most of the malpractice cases were settled by insurers ''for economic reasons'' without his consent.
Federal law requires insurance companies, hospitals and state and federal health care regulators to report malpractice payments and disciplinary actions against doctors, dentists and other health care providers. It is a voluntary compliance system - with no auditing by the government - and nearly 60 percent of hospitals have yet to make a report.
The government provides a version of the database to the public, but strips out the names of doctors and dentists and other identifying information. That's because the 1986 law that created the database allows the identities and most details of the malpractice payments and disciplinary actions to be shared only with insurance companies, hospitals and federal and state health regulators.
Although many states disclose their disciplinary actions against doctors, patients don't have a single national repository where they can check their practitioner's history.
That may soon change.
Rep. Tom Bliley, R-Va., chairman of the House Commerce Committee, is considering releasing over the Internet the names of the 200 doctors and dentists with the worst records, according to a committee aide, who spoke only on condition of anonymity.
At a committee hearing earlier this year, Bliley said it's ''unconscionable that consumers have more comparative information about the used car they purchase or the snack foods they eat than the doctors in whose care they entrust their health and well-being.''
The doctors' lobby opposes the release.
Dr. Thomas Reardon, president of the American Medical Association, said the raw data on malpractice payments ''is not reflective of competency or quality.'' He said only one malpractice settlement in five concerns negligence.
''The concept of the databank was to collect data for licensing and credentialing'' of doctors, he said, ''not for release to the public.''
Bliley's push to open the database follows decisions by 41 state medical boards since 1996 to begin disclosing on their Web sites the names of doctors they discipline.
The New York Daily News and The Hartford Courant used that information and court records earlier this year to identify doctors with large numbers of malpractice payments or disciplinary actions. The Associated Press used the national database with no names to calculate the national figures and used state records to identify doctors.
The Daily News identified 15 medical practitioners with the most malpractice lawsuits in the state of New York. Four have had their licenses suspended. The Courant identified Hall and seven other doctors nationwide with at least $3 million in malpractice payments and 25 or more reports in the databank. Four still are practicing.
AP's review of court records and state disciplinary records found:
-Michigan dentist Thomas Neumeier had 37 malpractice payments totaling $550,000 over three decades before the state licensing board put him on probation for three years in 1996.
Neumeier sees 12 to 14 patients a day, and blames most of his troubles on a single lawyer who helped patients file more than 20 lawsuits against him. ''I could have fought every one of these cases, and nine-tenths of them I would have won,'' the dentist said.
-Oklahoma City surgeon Joe Dan Metcalf faced more than 30 lawsuits and was ordered to pay nearly $300,000 in malpractice judgments in the early 1990s, state and court records show. His license was suspended for one year in 1996 after he pleaded guilty to illegally importing silicone-gel breast implants. A five-year probation was imposed in 1997.
-In Wisconsin, three-fourths of the 54 doctors who made malpractice payments of $1 million or more in the 1990s faced no disciplinary action from the state.
''The filing and paying of a malpractice action does not mean a doctor is bad,'' Patrick Braatz, administrator of Wisconsin Health Professions and Services Licensing. ''That doesn't mean the doctor is good, either. You have to look at the underlying facts of each case.''
Hall, the Phoenix ophthalmologist, said he wouldn't object to allowing patients access to the data if the government put the numbers into context. For instance, Hall said, the 27 complaints against him amount to less than 0.1 percent of the eye operations he has performed since 1982.
Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, said opening the database would provide patients with a central place to check records of prospective doctors or dentists.
''It needs to be in one place and it needs to be nationally based,'' said Wolfe, whose consumer group compiles a report every two years on state-disciplined physicians. ''When you go to the state, all you get is the disciplinary actions taken by that state against doctors licensed in that state.''
Howard Manes, a Long Island, N.Y., orthopedic surgeon, said information in the database ''could be misleading to the layman unless they have access to both sides of a particular case.''
With 26 reports in the database, including $3.9 million in malpractice payments, Manes said his own practice has suffered since he was identified by both the Courant and Daily News.
''I'm sure it's had some detrimental effect but I still have a very good practice and my patients still have confidence in me,'' he said.
Manes blamed his large number of malpractice payments on the large volume of patients he sees and on the fact that Long Island has the most malpractice cases per resident in the country.
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On the Net:
National Practitioner Data Bank: http://www.npdb-hipdb.com/
House Commerce Committee: http://www.house.gov/commerce/
AP Web site with additional doctors' data: http://wire.ap.org
