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Same Doc, Different Profile

— State med board sites have wildly differing information

MedpageToday

This story is part of a major investigation by ڴŮ and the Milwaukee Journal Sentinel into physicians who had public actions against their licenses in one state, but are able to practice elsewhere with "clean" licenses.

North Carolina and Georgia share a border and many physicians.

But they couldn't be farther apart when it comes to reporting physician transgressions.

North Carolina has a 52-person staff, paid out of licensing fees, and maintains one of the most detailed medical board websites in the nation.

In Georgia, the medical board is supported by the state's general fund, a scenario that pits it against other priorities whenever it comes time to cut the budget. It has a staff of 31.

While Georgia's website purports to include any discipline from any state, physicians themselves are charged with reporting information about out-of-state discipline.

"That is their responsibility," said Patricia Sherman, manager of the Office of Investigations & Enforcement for the state's medical board. "And, yes, it's our responsibility to police that, but we don't have the staff to do that. We don't have the staff to look at 44,000 profiles on a regular basis."

The result: 26 physicians who hold licenses in both states had negative marks on their North Carolina records but received no public action in Georgia.

That's the biggest imbalance between any two states, according to an analysis by ڴŮ and the Milwaukee Journal Sentinel that found at least 500 physicians have been publicly chastised in one state while able to practice free and clear in another.

Consider:

On North Carolina's site, the profile for one orthopedic surgeon includes details of a malpractice lawsuit stemming from a surgery he performed on an 87-year-old woman. He inserted a nail designed for the patient's right side into her left hip, causing pain and requiring a follow-up surgery.

His profile includes a copy of a letter of concern from the medical board, which notes that the state fined him $1,000 for the mistake.

For the same physician, Georgia's site lists nothing.

Instead, it reads:

"This physician has indicated that he/she has NO medical settlements against his/her license."

And:

"This physician has indicated that he/she has NOT had any final public disciplinary action or second subsequent final private reprimand taken against him/her by a licensing board regulating his/her medical or any other license in this state or any other state."

The discrepancy doesn't sit right with Carol Cronin, executive director of the Informed Patient Institute, a Maryland-based nonprofit group that produces its own physician "report cards" from various sources, including state medical boards.

"Given that state medical boards are supposed to protect the public, it is truly concerning that where you live shapes what you can learn about dangerous doctors," she said.

'Tell the world about it'

In North Carolina, even matters that are not considered disciplinary are included on the state website.

In 2006, the state's medical board worked with the lawmakers to expand the board's powers, allowing it to issue and post "Public Letters of Concern." Physicians view it as a black mark on their record.

Medical board spokeswoman Jean Brinkley said it is used when "the board believes that there was some evidence of a violation of our medical practice act, but for whatever mitigating factors, can't act." She noted the action "still allows the board a way of saying, 'Hey, we want to bring this to the public's attention and show them that it occurred.'"

The board's chief legal officer, Thom Mansfield, said making the information public is important.

"We could do it all private -- suspend a person's license or impose other discipline, and not tell the world about it," he said. "But this is 2018. We can easily let people know information that is, for most people, readily available.

"Let them know what the content and character of their physicians is, so they can make more informed healthcare decisions."

Because of those letters, patients can see that Travis McCoy, an Asheville obstetrician, paid a $1 million malpractice settlement in 2014 after he performed a surgery on a woman, in what the medical board called a "failure of surgical judgment." The patient died later that day.

They can see that Walter Uyesugi, a radiologist who generally practices in Hawaii but has licenses in dozens of states including North Carolina, failed to diagnose a lung problem in a patient who was undergoing liposuction.

As a result, the patient went to an emergency room later that day, where she needed a tube inserted into her lung to recover. The state's letter said the care "may have caused a delay" in treatment and "failed to conform to standards of acceptable medical practice."

They can see the details of a physician who handed out a blank prescription pad to colleagues; or of another whose patient was given a higher dose saline solution, resulting in brain damage; or of a third who lied about his qualifications, overdosed a patient on two drugs and billed for procedures he never performed.

Each of these physicians is also licensed in Georgia.

There, the physicians are listed as facing no discipline, anywhere. The few records that include malpractice payment amounts have no details about the nature of the underlying offense.