National practitioner data bank: information on physicians

Adverse action reports against optometrists: perspectives from the National Practitioner Data Bank over 18 years

PURPOSE

The aim of this analysis is to describe characteristics of National Provider Data Bank (NPDB) adverse action reports against optometrists.

METHODS

NPDB public use files were analyzed for details of reported optometrist adverse actions from 1991 through 2008. Types of actions, basis for actions, and reporting source were identified, along with geographic and demographic data.

RESULTS

Between 1991 and 2008, a total of 216 adverse actions against optometrists were recorded nationally. Exclusion from Medicare or another government program accounted for 92% of all reports; the remaining 8% were related to unfavorable privileging decisions. Most cases with identifiable explanations were the result of either defaults on student loans (55%) or charges of fraud and abuse (39%). Over two thirds of all reports originated in just 12 states, and 74% involved younger optometrists (age 30 to 49). Repeat offenses were reported for 38% of sanctioned optometrists.

CONCLUSION

NPDB reported adverse actions against optometrists are infrequent but most commonly involve exclusion from Medicare or similar government programs. Student loan default, particularly by younger optometrists, is the single most common cause, followed by allegations of fraud and abuse. Because this national database is permanently archived and widely used by licensing and credentialing bodies, optometrists should endeavor to be ethically responsible and strive to avoid behaviors that mandate such action reports.

Stability and infrequency of radiologic technologist malpractice payments: an analysis of the National Practitioner Data Bank

PURPOSE

The aim of this study was to describe characteristics and trends of radiologic technologist (RT) malpractice payments.

METHODS

National Practitioner Data Bank data files were analyzed for details of RT malpractice payments from 1991 through 2008. Payment amounts, sources, and allegations were all identified and summarized, along with geographic and demographic data.

RESULTS

Between 1991 and 2008, a total of 155 RT malpractice payments were reported nationally, ranging from $750 to $11.5 million (median, $57,500; mean, $293,655 +/- $1,305,091), with 153 (99%) <$1 million. Adjusting for outliers and inflation, payments changed little over the 18-year interval. More than half of all cases originated in 8 states, with per capita payments most common in Louisiana and New Jersey. Alleged errors in diagnosis accounted for one third of all cases.

CONCLUSION

Malpractice payments on behalf of RTs are very infrequent (on average, <9 nationally each year) and usually relatively small (almost half <$50,000). Frequency and mean adjusted payment have remained stable over nearly two decades, likely related in part to "deep pocket" shielding by hospitals and radiologists.

The National Practitioner Data Bank: issues in plastic surgery

BACKGROUND

The purpose of this article is to increase awareness among plastic surgeons of the applications and implications of the National Practitioner Data Bank.

METHODS

A literature review using PubMed and Google was conducted regarding the history, function, and outcomes of the National Practitioner Data Bank, a federally maintained database of malpractice payments and disciplinary actions involving licensed healthcare providers. Particular attention was paid to institutional reporting requirements, the process of querying the data bank, and controversies regarding the effectiveness of the data bank as they apply to physicians.

RESULTS

Many physicians in practice and training remain unaware of the requirements of the data bank. Specifically, situations in which an institution must report to the National Practitioner Data Bank on a physician's behalf can be surprising, such as payment to a patient in settlement of written claim without the suggestion of malpractice, denial of additional credentialing, and suspension of privileges for greater than 30 days. Mandatory and voluntary querying of the National Practitioner Data Bank also varies among entities. A listing with the National Practitioner Data Bank can have consequences for licensure and credentialing throughout a physician's career, and reporting requirements begin as an intern. Lastly, it is not clear that the existence of the National Practitioner Data Bank has improved the quality of health care in the United States.

CONCLUSION

Knowledge of the requirements and limitations of the National Practitioner Data Bank is useful for plastic surgeons because of the diverse implications of its contents for their current and future practices.