Physicians wary of new national database that makes liability data public

While physicians encourage patients to do their homework before choosing a doctor, they warn that HealthGrades Inc.'s new public national database of medical liability records might not tell the whole story.

The independent health care ratings company in March launched what it calls the first national database to combine all available public liability records. The data include closed claims reported through state agencies, such as medical boards or health departments, in 15 states: California, Connecticut, Florida, Idaho, Indiana, Massachusetts, Maryland, North Dakota, New Jersey, New York, Oregon, Tennessee, Virginia, Vermont and West Virginia.

The records detail whether the outcome was a judgment, settlement or arbitration award, and the exact amount or range of payment, depending on the state's reporting standards. HealthGrades consolidates the liability data with other background information on the doctor into a "physician profile" that patients can buy. The report includes other background information on a doctor, such as specialties, board certifications, state and federal disciplinary actions, and patient surveys.

"The goal is to give consumers a complete picture of that physician," stated Sarah Loughran, who is executive vice president of HealthGrades.

The liability data are not meant to stand alone as a litmus test of quality care, she said, but are intended to help patients make an informed decision by putting all the data in one place.

Doctors don't deny that patients should have access to the public records. But medical liability claims are more complex than a one-dimensional paper report, doctors say.

"Patients need to look at this discerningly with their physician. It's just part of a picture," said American Medical Association board Chair-elect Edward L. Langston, MD.

Doctors pointed to more meaningful ways patients can get information on quality health care. For example, cases often settle because it is more financially beneficial than a drawn-out lawsuit, said Dr. Langston, a family physician in Lafayette, Ind. And some doctors are sued more frequently simply because of the nature of a high-risk specialty.

"Just because you are being sued doesn't mean you are a bad doctor," Dr. Langston said.

Sandra Bressler, vice president of the California Medical Assn.'s Center for Medical and Regulatory Policy, questions the accuracy of the information in HealthGrades' database. The Medical Board of California offers physicians the opportunity to correct misinformation, she said, which might not be updated into the HealthGrades database.

State data already available

Doctors also say patients already can access the information free of charge through state Web sites. Oregon Medical Assn. Past President John Moorhead, MD, said he doesn't see patients frequently using liability data to choose a doctor and noted that every state reports differently.

"You need more depth to be able to interpret the information," said Dr. Moorhead, an emergency physician in Portland, Ore.

He said patients can get more insight into a doctor's quality of care through state and specialty medical societies, even family and friends.

Loughran acknowledged that some challenges exist in putting the available data together for public access because states vary in how much detail they provide and how long it stays on a physician's record.

But she said some state Web sites are difficult for patients to navigate. In addition, by combining the records, patients can see if their doctor had claims in another state, which local agencies don't track.

And it's what patients want, Loughran said, referring to a Kaiser Family Foundation study published in the March issue of HealthLeaders Media. The survey found that 70% of patients consider the number of medical liability claims filed against a doctor to be a significant indicator of competence.