Legal Actions

 Legal action is a slow process. Public servants like police and teachers are sometimes suspended with full pay while an investigation proceeds, to protect both the public and the people charged. However doctors continue to practice while they are investigated.

For example a cardiologist was charged by a whistleblower suit in July 2011, and the entire suit was secret for 3½ years, while the Justice Department investigated until December 2014. At that point the suit became public, but the evidence will only come out in a trial. The trial may happen in 2015 or 2016 unless it is settled before then. Meanwhile the doctor continues to practice and in 2012 Medicare paid him four times as much as any other cardiologist. Investigations and trials are slow, since they hinge on dueling judgments by different experts.

While investigations proceed, consumer reviews provide one way for potential patients to hear about concerns. Other doctors in the area may be another source, but 60% of male doctors and 67% of female doctors do not necessarily tell patients when another doctor is substandard (they fear retaliation). 9% of doctors do not tell patients about mistakes which harm them.

Some state boards provide information on malpractice suits as well as disciplinary actions in the DocInfo  and DocFinder lists, but usually patients have to search the web or state court records. Each state has its own system for searching court records. Malpractice suits are often settled without a real finding of who was right, since the participants cannot predict which expert a jury will believe.

Lawsuits against makers of drugs and devices are summarized at DrugDangers.com, which is maintained by a law firm. Most are in state courts.

Federal court records (such as Medicare fraud) are easily searchable at Pacer (Public Access to Court Electronic Records, 10 cents/page. $2.40 per audio file of court hearings). Even malpractice cases can appear in federal court when patients and medical suppliers are in different states.

A free archive holds many Pacer records, and Pacer cancels costs under $15 per calendar quarter, so you can do most simple searches without cost.

The doctors indicted by Medicare's fraud team appear in Pacer. The highest-volume surgeon for knee replacements is in Pacer as a co-defendant in one federal case in 2014, which became part of a settlement agreement. Patients can ask for information and decide if it matters to them.

The weight loss surgeons reported by the LA Times are in Pacer because of a 2012 whistleblower suit and a suit by the same surgeons against a health insurer. Of two doctors named in the NY Times article on heart surgery, one is in Pacer since he sued the hospital for suspending him; the other is not. The spine surgeon reported by the Washington Post does not appear in Pacer, since the whistleblower suit was filed against the hospital. The three surgeons named by USA Today all appear in Pacer. The cardiologist named by the Justice Department in 2015 appeared in Pacer starting December 22, 2014.

Thus Pacer provides a lot of information, though not a complete list of problems. Searches cost 10 to 50 cents, depending on length. Once you find a case, the "Case Summary" tells you the parties and their lawyers; the "History/Documents" lists documents. I usually click that and then select "Only events with documents" and "Display docket text." From the resulting list you can click the number in front of any document to see its cost and decide whether to view and print it. There's no extra cost for going back to look at a document you already paid for in the same session, though repeating a search costs money, since they do a new search each time.

There is a far more complete list of problem doctors which Congress does not want you to see. The National Practitioner Data Bank lists "800,000 license and hospital disciplinary reports and past malpractice payment reports for clinicians" 1990-2014. Congress forbids showing the list to patients or referring doctors. The federal government shows the list to those it thinks "need to know the most - the hospitals that are considering hiring [doctors] or the licensing board." Malpractice attorneys point out its gaps, but still would find access useful in building cases. There is a public version without names and addresses if you agree to their Data Use Agreement, and a 2011 version without that agreement, but still lacking names and addresses. The size of the list ranges from 900 adverse actions in Hawaii to 50,000 in Texas over the last decade. Several reporters have used the list for stories. Public Citizen used it to summarize doctor's sexual misconduct, and found that Canada has much better reporting and that many state medical boards let doctors continue to practice after hospitals discipline them.

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