Health Department Attempts to Prevent Disease of Democracy
by
William J. Appel
On March 20, the State Health Department held the third of three roundtable discussions on implementation of the Patient Health Information and Quality Improvement Act. The legislation, passed last year, grants consumers the right to access basic information about doctors, hospitals and health plans.
As with the roundtable discussions in New York and Albany, the one in Rochester was, for all intents and purposes, by invitation only.
The legislation provides for physician profiles, which include biographical information, practice limitations, malpractice history, and criminal convictions, hospital report cards, and health care plan quality assurance reports.
The Health Department was charged with holding discussions around the state in order to gather information on how to make the required information accessible. One would think that if the Health Department wanted to know how best to make the information accessible, they would welcome public participation. Instead, they opted for the opinions of experts: heads of professional associations of physicians and nurses and, representing consumers, Blair Horner of New York Public Interest Group.
Alerted to the discussion by colleagues in New York, I called the Health Department and asked to participate. They asked that I put my request in writing.
When I walked into the room where the discussion was taking place, the conversations immediately stopped. No one bothered to introduce themselves or to say hello. The skunk had arrived at the picnic.
I sat quietly through the discussion and found it very informative.
The representative from the nurse’s association made excellent points about what should be included in the hospital report cards.
The doctors seemed defensive about the malpractice reporting requirements, even though only 10% of their number have malpractice judgments or settlements against them. Further, the legislation only requires disclosure if there have been three malpractice judgments or settlements in a ten year period or if the Commissioner determines that the information would be relevant to patient decision-making.
Blair Horner knows this legislation inside and out and made an excellent case for disclosure of all relevant information in a manner that the public can easily access and digest.
I am far from an expert in this matter and do not mean to imply that I know more than any of the people who were invited on this subject. The point is that if the Health Department wants to know how best to get information to the public in a manner that is understandable, they should ask the public.
After the invited guest spoke, I raised my hand to make two points. One, that in posting malpractice judgment and settlement amounts, the Health Department should include the proviso that there is a big difference between upstate and downstate in this regard. This caveat is important so that people upstate do not make decisions about the egregiousness of a local physician’s conduct based on comparisons with judgments handed out downstate.
Second, I urged the Health Department to form a timeline for implementation so that there would be no unnecessary delays in making this information available to the public.
The skunk did not spoil the picnic after all. Maybe next time the Health Department holds a public hearing we will all be invited.