Alliance for Patient Safety

                            All that is necessary for the triumph of evil...
                                                                ... is for good men to do nothing.

                                                                                                   Edmund Burke

Excerpts of Summary of GAO and OIG reports re: Circulation of FALSE information regarding Physicians by the National Practitioners Data Bank, NPDB

Report by Bruce Wilken, Vicky Trompler, MD, JD, and Brad Areheart

II Accuracy of the NPDB

There have been numerous studies that call into question the accuracy of the information found in the NPDB. For example, even the Department of Health and Human Service’s 2003 Annual Report recognized that the use of the “corporate shield” may “mask the extent of substandard care and diminish [the] NPDB’s usefulness as a flagging system.” The corporate shield occurs when attorneys arrange for the name of a health care organization to be substituted for the name of the practitioner when medical malpractice payments are arranged. Under current NPDB regulations, a report is not filed if a practitioner is named in the claim but not the settlement. The Department said that the extent of how often this loophole is used “cannot be measured with available data.”

II.A General Accounting Office Reports

In 2000, the GAO released another report concerning the NPDB entitled National Practitioner Data Bank: Major Improvements Are Needed to Enhance Data Bank’s Reliability. This report began by noting that “[b]ecause NPDB information can affect a practitioner’s reputation and livelihood, the integrity of the data bank’s information has been of great concern.” This concern arose because “[s]ince its beginning in 1990, questions have arisen about NPDB’s operational efficiency and effectiveness.”

The 2000 GAO report also found that 30 percent of the state licensure actions were submitted late and 11 percent contained inaccurate or misleading information on the severity or number or times practitioners had been disciplined.

There was also inaccurate information in about one-third of the clinical privilege restriction reports the GAO reviewed.

The GAO also noted the “corporate shield” problem, which is echoed in the NPDB’s 2003 Annual Report that noted the Department had still been unable to address the problem.

Importantly, the 2000 report concluded that practitioners had difficulty getting wrongly reported information corrected.

As an anecdote, the GAO found a practitioner who had disputed a report and supplied evidence of its error. Even though the state that reported the practitioner reported the mistake to the NPDB, the inaccurate information had not been expunged. The GAO noted that this was of particular concern to the practitioner “because this was the only information the NPDB had on this individual.”

II.B Office of Inspector General Reports

In 1995, the OIG published a report that found similar unwillingness of over half the hospitals in the country to comply with the NPDB reporting requirements as seen in the OIG’s 2000 report.

In 1997, the OIG published a report that found that the Drug Enforcement Administration (DEA) was not reporting practitioners who voluntarily gave up their Controlled Substance Act registration number at the threat of having it revoked or suspended. This report found that the DEA was actually sanctioning three times the amount of practitioners as it was reporting.

In 1999, the OIG published a report that said “[t]here are indications that hospitals may not be complying with the reporting.

III Conclusion

While the National Practitioner Data Bank has been successful at amassing an enormous amount of information regarding physicians and other health care practitioners, various studies have shown that problems such as underreporting, over-reporting, and inaccurate reporting call into question the reliability of the data bank as a true depiction of a physician’s competence.

The studies cited herein display the difficulties in challenging an inaccurate report.