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GOP bristles at charge it's out to punish doctors

House Republicans deny that a plan to make a malpractice database public is retaliation against the AMA over patient rights legislation.

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© St. Petersburg Times, published March 1, 2000

WASHINGTON -- The American Medical Association has fought for legislation allowing patients to sue their managed care plans for negligence. The Republican leadership in Congress has fought just as hard to make sure such a bill never passes.

Could this be why a House panel is considering whether to open to the public a federal database of doctors who have been accused of malpractice?

"I hope it's not punishment or retaliation" for doctors' strong support of managed care legislation, said Dr. Thomas Reardon, AMA president.

Steve Schmidt, spokesman for the House Commerce Committee, which will hold a hearing today on the National Practitioner Data Bank, called any suggestion that Republicans are retaliating against the AMA "just silly."

"We look forward to the AMA explaining why patients shouldn't be able to log on to the Internet" and find out if their doctor has been involved in a malpractice suit or disciplinary action, Schmidt said.

The AMA argues that the information in the database is meant to be evaluated by health care professionals and could be misleading to the public.

"Just because a physician has been sued doesn't mean there was negligence or he's a bad doctor," Reardon said. "Maybe he gives excellent medical care but he settled a case" because it was the easiest course to take.

The database is used by hospitals, licensing boards and other medical entities to determine whether physicians have been the subject of malpractice lawsuits or professional sanctions.

House Commerce Committee Chairman Tom Bliley, R-Va., thinks opening the database to public scrutiny is a "very good idea, as people are being asked to make more and more complicated decisions about their health care," said Schmidt, his spokesman.

"If you're a good doctor, you really have nothing to fear from this," Schmidt said. He said the database could be reconfigured to address doctors' concerns about misleading information.

But the AMA has questioned why House Republicans are bringing up the issue now, 14 years after the legislation authorizing the database was passed.

"It's interesting," Reardon said of the timing. "If the motivation is punishment, then we have come to a very sad state of affairs in the United States Congress."

Congress has been deadlocked for eight months over legislation to expand patients' rights to sue their health plans for denial of care. The health insurance industry has argued that such legislation would open health plans to a flood of lawsuits and drive up costs for every insured person.

The Senate passed a bill that would not expand the right to sue. The House, with support from Republicans who have defied their party leadership, passed a bill that significantly expands the right to sue.

Negotiations between the two chambers on reconciling the different bills have been stalled.

Doctors want patients to have more say because they have long chafed under managed care plans' restrictions on their ability to make medical decisions. To hold down costs, managed care plans often require doctors to get approval from a health plan bureaucrat before ordering expensive tests or treatments.

As for the AMA, Reardon insists it "wants patients to have good information." But he said the AMA thinks that states are more qualified to maintain public databases for doctors within their borders.

Schmidt said such a plan would create a patchwork of information. He said a national database is needed because doctors who are sanctioned in one state may move to another.

"People think the AMA is about protecting patients' rights," Schmidt said. "This clearly shows that it's not. In this case, it's about protecting doctors."

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