Data Bank No Threat to Incompetent Physicians

Data Bank No Threat to Incompetent Physicians

AORN JOURNAL APRIL 1991, VOL. 53, NO 4 Letters to the Editor Data Bank No Thseat to Incompetent Physicians I n her January editorial, “AORN’s vis...

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AORN JOURNAL

APRIL 1991, VOL. 53, NO 4

Letters to the Editor

Data Bank No Thseat to Incompetent Physicians

I

n her January editorial, “AORN’s vision of the future has no room for archaic notions,” Ms Palmer raised the threat of ruined reputations in evaluating the National Practitioner Data Bank. A far more realistic threat is that the public may be lulled into believing the data bank will eliminate the incompetent practitioner problem. She states that the bank will make it difficult, if not impossible, for incompetent physicians to obtain clinical privileges without disclosing previous incompetent behavior. My own assessment is that the data bank will offer a meager improvement over the current situation. As is pointed out in the editorial, the data bank was established to keep records of malpractice awards, license and/or privilege revocations, and censures by professional organizations. The problem is that incompetent practice rarely leads to official sanctions of the type recorded by the data bank. Malpractice awards are not a reliable indicator of competency levels. Juries swayed by courtroom dramatics often award damages in cases in which the practitioner acted in a competent manner. In the worst malpractice cases, insurance companies often reach private settlements before legal action is taken. Incompetent practitioners often avoid litigation because they a r e able to manipulate patients and their families. Anyone who has worked in a health care institution knows of

physicians who possess meager technical skills but who enjoy a full patient load because of good bedside manners. Governmental license revocations are not a reliable index of incompetency either. Many licensing boards are reluctant to take legal action except in the most flagrant cases because of the threat of lawsuits for defamation of character and restriction of trade. Fear is the major problem with identifying and controlling the incompetent practitioner. Physicians are reluctant to act against fellow physicians, even to the extent of depriving them of referrals, for fear that, in retaliation, their own referrals will be cut. Nurses do not act because they fear they may loose their jobs or be subject to other retaliation. Hospital administrators a v o i d revoking privileges because they fear adverse publicity and lawsuits. Until health care administrators and professionals begin policing their own ranks, there will be no workable way to weed out incompetent practitioners. The data bank will track a few of the worst cases, but the majority of incompetent practitioners will be allowed to continue to provide a substandard level of care to the public. MARCHWARN,RN STAFFNURSE BOONEHOSPITAL CENTER COLUMBIA. Mo