On physicians with multiple malpractice claims

The Wall Street Journal published a lengthier piece outlining some of the struggles that the Indian Health Service (IHS) has had with recruiting physicians. While the vacancy rate for the industry is reported to be 18%, the vacancy rate for IHS was found to be 29%. It appears that in light of the recruiting challenges, IHS has hired physicians that it might not have hired otherwise: physicians that other hospitals and medical groups would not employ.

The article brings up many interesting issues. At a policy level, one question is whether the federal government (which pays out malpractice claims) is actually saving money by keeping salaries at the level that they are (the article lists several 6-digit malpractice claims that the government paid out). A second issue is that IHS and other hospitals have access to a government database called the National Practitioner Data Bank, which flagged most, if not all of, the mentioned doctors. However, records from the National Practitioner Data Bank are not publicly available and as a result, patients are reliant on the judgement of hospital administration. In cases where hospital administration struggles to fill vacancies, patients may feel betrayed, as some of those interviewed for the article seem to feel. A policy change could require that the data bank is open to the public, allowing engaged patients to make more informed decisions for themselves (and less reliant on the judgement of hospital administrators). The article also mentioned that licensing occurs on a state basis, meaning that a physician who has been disciplined multiple times in one state can still operate with a clean license in another state. Perhaps a more national method of licensing and credentialing is in order.