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Our View: Prescriptions for change

The Minnesota Board of Medical Practice can't tell you if a doctor has been convicted of murder. It can't provide the current addresses of hundreds of doctors whose licenses have expired, or tell you if they're still practicing or even still aliv...

The Minnesota Board of Medical Practice can't tell you if a doctor has been convicted of murder. It can't provide the current addresses of hundreds of doctors whose licenses have expired, or tell you if they're still practicing or even still alive. It can't say if a doctor has been hit with zero, or one, or many malpractice suits, regardless of outcome. And none of the state's health regulatory boards or the state Department of Health can tell you which practitioners were responsible for the medical mistakes reported by hospitals each year.

The agencies either can't tell you or they won't, but the result is the same: Medical consumers seeking information about the people they need to trust with their lives are left in the dark.

"It sounds like we need a little sunshine," said state Sen. Tarryl Clark, DFL-St. Cloud, the incoming assistant Senate majority leader, when given a briefing of the lapses at a recent meeting with the News Tribune's editorial board.

The subject matter may include brain surgery, but the possible solutions are simple. Here are eight, including several for the Legislature to consider in the coming session.

1. Conviction information on practitioner profiles

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The News Tribune searched hundreds of practitioner profiles on the Minnesota Board of Medical Practice Web site ( www.bmp.state.mn.us ) and found that the criminal conviction section for each was blank, even for a doctor convicted of stabbing her son to death and others found guilty of highly publicized crimes.

Board of Medical Practice spokeswoman Ruth Martinez said the statute governing the board does not address murder or other violent crimes unrelated to patient care. That law obviously should be amended.

Martinez also said the law only requires licensees to report criminal convictions that occurred within the past year. That too should be changed, both for existing licensees and those who apply for Minnesota licenses who have criminal acts in their past.

2. Update of licensing boards' data

Hundreds of practitioners on the Board of Medical Practice Web site are listed as "Inactive," with many entries giving the wrong addresses of doctors who have left the state. A simple improvement is for the board to use the designations "Moved," "Retired," or "Deceased" -- the latter currently included on some entries but missing from others, including several doctors born in the 19th century.

The chaotic collection currently posted is a ripe opportunity for identity theft, especially for imposters looking to impersonate doctors no longer in the state.

Practitioners, including those who move cross-country, have a responsibility to tell the board of their whereabouts rather than just letting their licenses lapse. Penalties for those who fail to notify the board should be considered.

3. Malpractice informationon physicians' profiles

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Several states have Web sites that include information about malpractice suits filed against physicians. The amount of detail ranges from the Oregon Board of Medical Examiners' Web site, which gives a description of the allegation, date and settlement amount, to Massachusetts' yes-no answer to whether a doctor has had a recent malpractice claim.

Lawsuits already are publicly available, but nearly impossible for consumers to check without traveling to multiple county courthouses around the state.

The Minnesota board should match Oregon and make the full descriptions available on the Web. The information is readily accessible to the board -- but not the public -- through the National Practitioner Data Bank.

4. Reasonable tort reform

In Illinois, Gov. Rod Blagojevich agreed to a deal with the state's medical society in which the state would post malpractice information in exchange for a $500,000 cap on noneconomic damages in suits against physicians. No quid-pro-quo should be needed in Minnesota; the state has few malpractice suits -- an average of 137 a year -- and the information already is public.

It is not unreasonable, however, to impose some sort of restraint on lawsuits. Rather than a monetary cap that could set an unfair, one-size-fits-all restitution for medical mistakes regardless of severity, a restriction could be considered to limit those sued to only the person and/or institution directly responsible for the error.

5. Sharing actions of other state medical boardss

The Federation of State Medical Boards culls disciplinary actions against doctors from every state. The information is available to all state boards and should be posted on the Minnesota Board of Medical Practice site, listing out-of-state actions against any current or former licensee in the state. Several states already do so.

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6. Disclosure of individuals responsible for mistakes reported by hospitals

The state Department of Health is restrained by law from immediately disclosing to regulatory boards information about practitioners who make serious mistakes. Immediate information-sharing with the boards is an obvious failsafe and double-check that would help minimize mistakes.

In adverse events resulting in death, disclosure of the practitioner or practitioners responsible should be made public and the case expedited by the licensing board.

7. A national standard defining medical mistakes

In 2003, Minnesota became the first state in the nation to adopt all 27 categories of mistakes identified by the National Quality Forum, including surgery on the wrong patient or body part; items left inside patients after operations; death of a normal, healthy patient immediately following surgery; as well as falls, burns, wrong meds and other avoidable errors. Eleven states use some or all of the NQF standards, which now have been expanded to 28.

The standards should be embraced by all states under the direction of federal legislation. Equally needed is a guide to implementing and tabulating the error reports to set a standard applicable to all states.

8. An informed public

Even if the reforms on this page are enacted, they will mean little if medical consumers don't access the information or act on it.

The overwhelming majority of doctors, nurses, therapists and assistants perform yeoman's work, curing conditions once thought hopeless. But they need informed patients as partners in treatment.

Health-related businesses and groups ranging from drug companies to medical associations spare no expense in telling the world about their latest products, programs or positions. They must make an equal effort to inform patients and family members about whatever information is available for them to make what may be the most important decisions of their lives.

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