Opinion: Putting patient safety first

By LORI NERBONNE

Published: 05-09-2023 6:00 AM

Lori Nerbonne, RN, is co-founder of New England Patient Voices (formerly NH Patient Voices).

On April 14, the NH Attorney General’s (AG) office issued a report on their investigation into the NH Board of Medicine’s (BOM) practices. This was a result of the Boston Globe Spotlight series that exposed the lack of transparency that patients in New Hampshire face (as opposed to Massachusetts and other states) when trying to access information about their doctors.

New Hampshire laws currently prohibit lawsuit settlements and verdicts, complaints, and disciplinary actions issued by hospitals from being posted publicly on the BOM website. The report, which can be accessed at www.doj.nh.gov, is worth reading.

Multiple national news headlines and TV mini-series have exposed how dangerous doctors across the country have gone on to practice for years, unscathed (Dr. Christopher Duntsch or ‘Dr. Death,’ Dr. Larry Nassar, Dr. George Tyndall, Dr. William Husel, and many others). These cases, and the one here in New Hampshire about Dr. Yvon Baribeau, have shown that Boards of Medicine across the U.S. are failing in their mission to protect the public. Repeat offenders are allowed to keep practicing.

Among the NH AG’s recommendations are to amend New Hampshire laws to make “Letters of Concern” issued by the Board, malpractice settlements, verdicts and disciplinary actions available to the public on the Board’s website. The report states, “policymakers should consider reforms, such as greater transparency in the disciplinary process,” as well as other changes to bolster the board’s investigatory tools.”

One of the arguments against transparency mentioned in the AG report and repeated by legislators on the Health & Human Services oversight committee charged with looking into remedies, is that a mere settlement doesn’t prove a doctor is dangerous, and could hurt “good doctors.” The report states that posting settlements “does not afford a consumer or member of the public any context to discern a frivolous claim from a meritorious one.”

These sentiments are dismissive of the public’s ability to make informed decisions based on the volume of complaints, disciplinary actions, settlements, or lawsuit verdicts a provider has. Yet we are very capable in doing this every day for much less important decisions on sites like Yelp, Google and others. A roofer or plumber who has one or two bad reviews in comparison to one that has 25 should and does give us pause. The same should apply to our medical providers. Choosing a physician, surgeon, or specialist can be and often is a life-altering decision. A patient shouldn’t feel forced to seek out a surgeon in Massachusetts in order access basic background and licensing information.

Elected officials in New Hampshire have the power to change this. But it appears they do not feel a need for urgency. Recently, HB 454 was introduced as a solution and recommends designating a “public transparency advocate” who will continue to study this issue further and then produce yet another report. It fails to give the Board any power to be more transparent. It was passed by the House and Senate.

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I know I speak for many colleagues when I say as a nurse, it has always felt unsettling that nurses and doctors who work in hospitals often know who the dangerous doctors are. This should not be privileged information for a select few. The Board’s very mission is to protect the public. Providing a protective shield for dangerous doctors is anti-patient safety. Exposing disciplinary actions and malpractice allows a provider’s record to speak for itself. It does not hurt good doctors. Research on malpractice shows over a 20 year period, only 1.8% of practicing physicians were responsible for half of all the money paid out for malpractice. (PSQH analysis).

Publishing this information would help the entire medical profession by weeding out the few bad apples spoiling it for the majority of good doctors. Most important, it would drive patients away from them.

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