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National Practitioner Data Bank

The National Practitioner Data Bank (NPDB) is supposed to promote patient safety by encouraging reporting, but in fact it mostly is only another system distracting the community from finding real solutions. The assumption is that more will be reported if information about dangerous doctors is kept private. Such a minute percentage of what is wrong gets reported that it is time to stop pretending that the NPDB is a significant actor in the field of patient safety. It might be that no one else is doing a better job, but that only points out how poor of a job anyone is doing. The NPDB is not reducing injurous and criminal activity in medicine in any substantial way.

When it comes to errors and abuse, privacy protects doctors, sunshine protects patients. But the information is kept private.

According to NPDB literature, the need to encourage the peer review process and improve the quality of healthcare led to legislation establishing the NPDB. The intent of Title IV of Public Law 99-660 is to improve the quality of healthcare by encouraging hospitals, state licensing boards, professional societies, and other healthcare entities, to identify and discipline those who are incompetent or who engage in unprofessional behavior. Additionally, the law is supposed to protect the public by restricting the ability of incompetent practitioners to move from State to State.

For the few who are found guilty, this might be true. But it is not difficult to find examples of doctors who weren't allowed to practice in one state but had no trouble setting up in another. And the real problems are the doctors who have managed to get away with being problems. If you've been raped by a doctor, think how empowering it would be to discover that someone else complained that she also had. I'm sorry if such a system will create discomforts for doctors, but currently they can get away with violence against patients in front of witnesses who won't testify. When medical professionals won't testify about violence against patients, even in private, it's time for sunshine.

A system that does not inhibit even unfriendly practices needs sunshine, not a white wall of silence. The National Practitioner Data Bank is not the answer, and in certain ways it distracts the system from finding an actual solution.