7 takeaways from our year-long investigation into the country’s broken medical license system

Some peddled opioids and others sold snake oil treatments. Some had sex with vulnerable patients. Still others botched surgeries or were implicated in patients’ deaths.

A year-long investigation by the Milwaukee Journal Sentinel, USA TODAY and MedPage Today has revealed that failures in the country’s medical license system are widespread and leaves hundreds of potentially dangerous doctors practicing with clean records in some states despite documented disciplinary problems in other states.

Meanwhile, patients are kept in the dark – even as more of them become victims – thanks to a disjointed and antiquated discipline tracking system that is often shrouded in secrecy.

Here are the key takeaways from our Bad Medicine investigation.

1. Troubled doctors can escape past discipline by crossing state lines.

Even after being caught and disciplined in one state, doctors are free and clear to practice in another state. Many hold a fistful of medical licenses from different states.

Our investigation found at least 500 physicians who’ve been publicly disciplined, chastised or barred from practicing by one state medical board, but are allowed to practice elsewhere with a clean license.

See the whole story: Prescription for secrecy

Case studies: Learn more about mobile doctors

2. In face of long odds, some doctors simply surrender their license. But some keep practicing elsewhere.

Surrendering a license to the state medical board is often done by doctors in the face of overwhelming evidence of misconduct such as repeated surgical mishaps, churning out improper opioid prescriptions or years of having sex with patients.

A license surrender can spare a doctor the time, expense and reputational harm that might come with formal charges and a hearing before a state’s medical board.

Typically it comes with no restriction on practicing elsewhere, leaving the burden on other states to keep up with disciplinary records 

Our investigation found more than 250 doctors who surrendered a medical license in one state were able to practice in another.

Here’s why: as with other matters in the broken world of doctor discipline, states following up on what their licensed doctors are up to in other states is spotty at best.

Some states don’t even search a national database of troubled physicians. And, voluntary license surrenders can mean the records about what happened remain secret.

See the whole story: Docs who give up their licenses in one state can still practice in another

3. Despite disciplinary action, doctors still taking millions in Medicare checks from taxpayers

Even after losing their medical license or being barred from receiving state-funded health care payments, our investigation found at least 216 doctors still able to bill Medicare for treating elderly patients. In 2015 alone, taxpayers paid those 216 doctors more than $25 million via Medicare.

Medicare is part of the U.S. Department of Health and Human Services — the same federal agency that operates the National Practitioner Data Bank, which tracks discipline against doctors, including sanctions by state medical boards. Yet connection after connection is missed. So, Medicare keeps paying millions to troubled doctors it could know about if it were checking the agency’s own database.

One New York doctor still getting payments from taxpayers is only allowed to treat women with a chaperone present after not contesting charges of inappropriate sexual interactions with a female patient. He’s settled at least three malpractice cases, including one for failing to diagnose the cancer that eventually killed a patient. He was paid more than $280,000 through Medicare in 2015, the last year the government has released complete payment data. Other individual doctors who faced serious sanctions were paid as much as $1.4 million that year.

See the whole story: More than 200 doctors stay on Medicare rolls despite disciplinary actions

4. There’s a tool to help states track problem doctors. Few use it.

For three decades, the federal government has built and kept up a database of malpractice payments, discipline and other actions taken against doctors. Its purpose: help state medical boards track trouble in the pasts of the physicians they license. There’s just one problem: they rarely use it.

In 2017, about half of state medical boards checked the database fewer than 100 times, according to federal records of their searches. Thirteen medical boards didn’t check the database even once.

Congress created the National Practitioner Data Bank in 1986, saying it would improve healthcare quality and reduce fraud and abuse.

It’s a nationwide repository that captures malpractice payments, state disciplinary actions, restrictions placed on doctors by health insurance plans or hospitals – among other actions – against doctors, nurses, dentists and other health care workers. There are 1.3 million records dating back to 1990.

The data bank logs more than 7 million searches a year. But state medical boards – which oversee about 950,000 doctors nationwide – only searched 137,000 times last year. And more than two-thirds of those searches were conducted by just 2 states, Wyoming and Florida, which have set up automated searches flagging them of changes in doctors’ records.

See the whole story: There’s a tool to help states find problem doctors. Why do so few use it?

5. Where you live determines what you find out about a doctor

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