It’s time for a viewpoint by one of the few physicians who “get it.”
Doctor Levitt, now retired, spent 32 years in the trenches as a neurosurgeon in Florida. He was also chief of medical staff at his hospital for five years. He knows of what he speaks.
How many bad doctors are among us? How many have a proven record of hurting many patients more than the average physician? This is my area of interest.
I was a strict chief of staff of two hospitals over a five-year period and looked upon my mission as protecting patients. If you reform or remove doctors identified as dangerous, overall health care should improve, because 61% of all harm to patients in hospitals is attributable to errors – diagnostic and therapeutic – of physicians.
To answer my opening question, there is an estimate of the proportion of bad doctors – 2%, a deceptively small number. It is derived from the National Practitioner Data Bank. It holds records of license actions by state medical boards, hospital disciplinary actions and, most importantly, malpractice suit payouts for America’s 650,000 doctors.
A retired former statistician for the bank, Dr. Robert Oshel, has shown that during the first 20 years of the NPDB’s existence, roughly from 1990 to 2010, that 2% of US doctors are responsible for 50% of the payouts in medical malpractice cases. The other half of the payouts are the responsibility of what I call the competent but fallible 98%. The hard core 2% commit errors at a rate 49 times that of their other colleagues.
The 2% are a special group. They are very hard to reform. Because 138,000 patients die each year of preventable errors in American hospitals, we could potentially save half by removing that hard core from our midst. The names of the 2% are a closely held secret of the NPDB. It would take congressional action to disclose the identities of the doctors and to keep them from practicing, Congress could do the latter by eliminating them from the Medicare and Medicaid programs.
There is a financial side to the problem. The former head of Medicare and Medicaid, Dr. Donald Berwick, has estimated that 300 billion dollars each year are wasted on improperly administered care and unnecessary care.
We could take a big bite out of our national medical bill by eliminating our 2% from practice.
* * *
# # #