The Privacy That Doctors Are Afforded Comes at a Deadly Cost

-- By JessieChao - 15 Apr 2021

The problem with choosing a good doctor

In a study by Airtasker more than 91% of people polled reported that they trusted doctors. The inherent trust and reverence that most Americans have towards doctors is problematic. People are often impressed with doctors as theoretically they can save a life and help people. Patients often want to trust doctors as many doctors promise to relieve pain and offer hope. This reverence is damaging because it allows dangerous doctors to receive good reviews as people are snowed by their perception of doctors. For instance, if a patient has a surgical complication the patient might still leave a good review or no review at all. Shockingly one of the most horrific doctors, doctor Christopher Duntsch who will be discussed later, received outstanding patient reviews.

Even if you review a surgeon how do you really know if the surgeon did a good job? I have had over 13 surgeries on my left arm and the only thing I could report on is the doctor’s bedside manner. There is no way for me to know if the doctor was efficient/capable during surgery, how many times the doctor had to replace the pin, or any number of things because I am sedated and without a medical degree. These factors make choosing a doctor based on reviews incredibly difficult.

The story of former doctor, Christopher Duntsch

Duntsch was a neurosurgeon who earned an M.D. and a Ph.D. from a top spinal surgery program. He had only 4 and 5 star reviews on Healthgrades and glowing reviews on Facebook and Best Docs Network. There was no way the perspective patients could know from any of the publicly available information that they would be in life-threatening danger. Neurosurgeons are required to complete 1,000 surgeries to graduate residency; however, Duntsch completed less than 100 surgeries. Here privacy and lack of good medical safeguards/accountability creates the perfect storm. Out of the 37 patients he operated on, 33 of them had been injured with unheard of complications. Two of his patients died, including a 55 year old who went in for a routine and simple surgery. His last patient made it his mission to bring the case to the District Attorney so Duntsch would pay. Duntsch was the first doctor to be sentenced to life in prison for his injuries to patients. Even though there are supposed to be defenses to keep dangerous doctors away from patients these safeguards are often private, bureaucratic, and slow. The medical community system has a major problem.

What usually happens if a doctor is negligent

Unfortunately, the custom and practice in the medical world is to first protect the hospital, then the doctor, and pass the problem to someone else. Whenever a hospital (all except one) discovered that Duntsch was severely injuring patients the hospital would let him resign and he would go on to get surgical privileges at another hospital. This cycle is maddening and can be explained in part by the hospital’s fear that Duntsch might sue if the hospital inhibits Duntsch from getting employment at another hospital. In fact, 6 months passed before Duntsch was even reported to the state medical board and another year for the board to investigate. Duntsch operated during that time.

Data is private

Despite the flurry of media coverage and Duntsch’s trial nothing has changed to make sure that the public has access to more reliable information concerning the doctors who we are supposed to put our lives in their hands. The public is still limited to the research they can do on a doctor. The National Practitioner Data Bank (NPDB) is a ‘web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers. Established by Congress in 1986, it is a workforce tool that prevents practitioners from moving state to state without disclosure or discovery of previous damaging performance. Federal regulations authorize eligible entities to report to and/or query the NPDB. Individuals and organizations who are subjects of these reports have access to their own information. The reports are confidential, and not available to the public. The NPDB assists in promoting quality health care and deterring fraud and abuse within health care delivery systems.’ Neither other doctors nor the public can access the NPDB, and half of the hospitals in the country have never reported a doctor. Many hospitals do not report due to fear of being sued. Hospital administrators are allowed to use this database; however, even after Duntsch was reported to this database he was still hired by another hospital. The medical system as it stands now cannot be trusted and thus this information should be public.

Solution

In order to prevent these doctors from essentially having a license to kill, we at the very least, must allow the public to have access to the private databases that track if a doctor has an unusual complication, lawsuit, history of negligence etc. This will help the public make more educated decisions. I understand complications are a part of surgery; however, it is unreasonable to protect doctors who have a long history of severely injuring and killing patients needlessly. This will also help displace doctors as perfect infallible people. Hospitals also need to have a stricter practice of reporting and hiring medical professionals who have a history of making fatal errors. Doctors have to go through medical training, pass a plethora of tests, and complete residency. There should be safeguards at every step of the way to make sure a person who holds a life in his/her hands is competent. We live in the age of technology yet information about a doctors competency is withheld from those who need the information the most because of the hospitals’ fear and greed.

This is an excellent draft. I think there are two related routes to improvement. You can tighten the existing discussion. Look at the sentence level for ideas that are being repeated or can be merged.

The space retrieved can be used to think more deeply in two directions. The secrecy aspect of medical performance information can be addressed by disclosure. But the problem of obtaining, analyzing and presenting that information in useful and authoritative ways is more complex than disclosure. The forms of pattern recognition that are falsely described as "machine learning" and even more misleadingly described as "artificial intelligence" these days, can be very helpful in finding patterns in clinical data that will lead to identification of physician malpractice, among other failure modes, some of which take shocking numbers of lives.

Therefore we can argue strongly that health care delivery should be among the most comprehensively surveilled of all social activities. But the importance of privacy for patients, whose other privacies cannot be safely maintained if their bodily privacy is comprehensively broken, makes the architecture of such surveillance acutely sensitive. Here all the conflicts that technology, law and politics must mediate are at their least tractable. You need a few sentences to explain those issues at your chosen level of generality in order to make the essay most effective in educating its readers.

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