Recent law a step toward transparency for physicians

Patty Skolnik didn't know much about the doctor that at one time she had said was responsible for her son's death.

But after a 4-year crusade inspired by her ordeal, you have a way to know yours.

On May 31, all Colorado physicians must be in compliance with a recent state law, the Michael Skolnik Medical Transparency Act, that requires them to publicly report certain business dealings, malpractice actions, disciplinary matters and crimes in order to practice medicine here. The information is compiled in physician profiles that are listed in a searchable database maintained by the Colorado Department of Regulatory Agencies.

The database is one of the most comprehensive physician information sources in the nation.

The law is the latest example in a growing list accountability measures in health care reform. "You can go to Carfax and find out everything about a used car. This is kind of like Docfax," Skolnik said.

But some physicians are worried people may draw wrong conclusions about them based on yes/no questions and notations without explanation. "I think it's fair to say that there is apprehension about how the information is going to be used," said Janet Burch, the administrator at Pikes Peak Nephrology Associates, a six-physician practice in Colorado Springs, "but I think overall there's an understanding that this information is needed."

Michael Skolnik died 5 years ago, severely brain damaged and mostly paralyzed. His death came 32 months after what his parents say was determined to be an unnecessary brain surgery that was botched. Although Patricia Skolnik has told the story countless times to politicians, physician groups and others across the country, she still chokes up.

"He'd just turned 25," she says, crying. "It just stops my breath. It takes my breath away still."

Over the course of a malpractice suit that was later settled, the Skolniks learned there had been previous lawsuits against the doctor, and that he'd relocated his practice in several states in recent years. Skolnik was confident in the case, she said, but the couple settled to avoid the prolonged emotional strife of court hearings.

Michael had been a healthy 22-year-old college student who passed out one day after school. Skolnik said the tiny cyst that led to the operation appeared to others to have been harmless.

Although any doctor can make a mistake, Skolnik believes she'd have chosen a different doctor at the time, had she known of his pattern of moves and malpractice lawsuits, and that Michael would be alive today. She declined to name the doctor, still practicing in Colorado, saying "I'm not out to destroy his life."

Instead, she's taken on the system as a whole. She quit her job to organize Colorado Citizens for Accountability and push for legislation. She's now taking the idea to other states.

Her message comes at a time when people are especially receptive. Colorado is among 21 states and Washington, D.C., that have similar transparency laws on the books. There are now hospital and nursing home report cards, and several companies provide ratings and ways for people to give opinions on their health care experiences.

"This is the age of transparency," said Alfred Gilcrest, chief executive officer of the Colorado Medical Society, which represents about 7,000 licensed physicians. "The public is pretty fed up with the health care system right now."

The Colorado Medical Society supports the law and worked closely with Skolnik on the final version now in place, he said.

At the same time, though, physicians are concerned about what emphasis the public puts on these profiles. Malpractice settlements, for example, often are reached as business decisions, less costly alternatives to prolonged legal battles even though a physician may not believe he or she is at fault.

It also has caused some headaches for some doctors. Most have found the information-gathering process to be rather painless, said Edie Sonn, public affairs director of the state Medical Society. But some doctors travel among states to fill in as temporaries at hospitals and practices until permanent physicians are hired. For them, pulling together this information for multiple licenses has proven burdensome, Sonn said.

The doctors' profiles will not be audited, but the Department of Regulatory Agencies will investigate complaints of untruthfulness, said Susan Miller, who oversees health care licensing. Doctors are subject to $5,000 fines for each violation and could lose their licenses if they've tried to hide information, she said.

About 13,000 physicians have completed their new profiles, and Miller expects up to 4,000 more in the coming days.

Skolnik said the law is intended to empower consumers and keep physicians on their toes, not to punish doctors. She say the vast majority of physicians are "excellent."

Her concern is the small percentage who are, in her words, "doing harm repeatedly."

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Call Newsome at 636-0198. Visit the Pikes Peak Health blog at pikespeakhealth.freedomblogging.com and the Gazette's Health page at Gazette.com/health

WHAT PHYSICIANS MUST REPORT

• Name, aliases, current address, and telephone number.
  
• Information regarding all medical licenses ever held.
  
• Current board certifications and practice specialty or specialties.
  
• Affiliations with hospitals and health care facilities.
  
• Current ownership interests in health-care related businesses that amount to $5,000 or more a year.
  
• Current health-care related employment contracts.
  
• Public disciplinary actions against a medical license.
  
• Agreements and stipulations to temporarily cease medical practice.
  
• Involuntary hospital or health care facility privileging actions dating back to 1990.
  
• Involuntary surrender of a Drug Enforcement Administration registration.
  
• Criminal convictions or plea arrangements for felonies and "crimes of moral turpitude" dating back to initial licensure in any state or country.
  
• Judgments, settlements and arbitration awards for medical malpractice claims dating back to 1990.
  
• Refusal by an insurance carrier to issue medical liability insurance.

SOURCE: The Colorado Department of Regulatory Agencies.

ON THE WEB

www.askdora.colorado.gov (view Physician Profile Web lookup under Popular Pages).
www.patientsrighttoknow.org
www.coloradocitizensforaccountability.org