The federal government needs to prevent the ripple effects of a new Oregon law from protecting bad doctors,
says.
A medical liability reform bill spearheaded by Gov. John Kitzhaber could protect bad doctors, says the Ralph Nader group Public Citizen.
Earlier this year, Gov.
spearheaded a new law to substitute for caps on malpractice verdicts demanded by Republican lawmakers.
The first statewide law of its kind,
allowed facilities, doctors and patients to settle malpractice claims or injuries through mediation before any lawsuit is filed. In March, the Oregon Legislature approved it overwhelmingly, hailed as significant tort reform.
On Tuesday
, a consumer advocacy group founded by Ralph Nader, said the new law hurts public safety by making it easier for bad doctors to escape their past. Though malpractice cases are often settled out of court, they must be reported to a national database so clinics, states, and hospitals can review the records of new hires from out of state. The Oregon law, set to kick in in 2014, would put a stop to that for cases that are mediated.
"Physicians do move around, particularly physicians who get into trouble," said Dr. Michael Carome, head of Public Citizen's Health Research Group. Under the new law, "they're not going to be adequately screened," he added -- particularly if other states follow Oregon's lead.
Carome wrote U.S. Health and Human Services Secretary Kathleen Sebelius calling for her to require mediation payouts be reported to the National Practitioner Data Bank, just as malpractice settlements currently are.
"The Oregon law seeks to create a loophole that would allow physicians to avoid reporting to the Data Bank any malpractice payments," he wrote.
Supporters of the law, including the Oregon Medical Association and the Oregon Trial Lawyers Association, helped Kitzhaber, an emergency room physician, pass the bill. They argued the new program improves medical care by requiring malpractice claims be shared confidentially with the Oregon Public Safety Commission, allowing it to highlight problems.
A top Kitzhaber health adviser, Mike Bonetto, said disclosing the mediation payouts to the federal government, just like any malpractice settlement, could discourage doctors from participating in the program. That in turn could hurt patients' safety and their ability to use Oregon's mediation process.
That said, he said the governor agrees bad doctors need to be held accountable. So Oregon and other states interested in the program will work with the federal government to compromise on how and whether mediation payments need to be reported.
"This was never an attempt to circumvent the databank process," he said. "I think there really is a middle ground there."
An earlier version of the bill had made reporting of medical errors mandatory. However,
led Kitzhaber to weaken the provision to get it passed.
Most medical errors are system errors and not the doctor's fault, contends Dr. William "Bud" Pierce, a Salem oncologist and immediate past president of the Oregon Medical Association who led the push for the bill.
But studies show the majority of errors go unreported under the current system, which is why doctors' need "some kind of cover so they can participate," Pierce said.
While he is pro-transparency and understands Public Citizen's concerns, Pierce is not sure what balance best serves the public.
"That's what we're struggling with," he said. "I don't think we really have an answer yet."
--Nick Budnick