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Public spanking
How to avoid the worst doctors and lawyers in Pennsylvania and New Jersey.

Even the worst doctor has patients lined up in the waiting room, sad but true, so the joke goes.

The same can be said of the worst lawyers and their clients.

But thanks to the Internet, New Jersey and Pennsylvania residents no longer need be the punchline.

Both states' consumers now can research the licenses of lawyers and doctors before they hire them or use their services.

The system of databases and portable document files (PDFs) both states have placed online in recent years is far from perfect. But it marks a major first step in what some officials said will be a continuing effort to make public records truly public for the first time.

The reason is simple: The high cost consumers and other professionals must pay because of what they say is a small number of bad practitioners.

An analysis of federal data by Ralph Nader's consumer group, Public Citizen, found last year that "just 5 percent of American doctors are responsible for half (of) the malpractice in the United States."

KEEPING IT QUIET

Until recently, Pennsylvania professionals largely didn't weed out their own bad apples in public.

Almost half of the hospitals in the state have not reported any violations by doctors that affected patient care, Gov. Ed Rendell's malpractice reform task force has found.

Hospitals may give their bad doctors short, non-reportable suspensions or ask them to quit - allowing them to practice some place, any place else - rather than take disciplinary action against the doctor's license, which is a public process, a national expert said.

Rendell's proposed malpractice reforms now include investigating those hospitals that don't report violations.

Since 1972, some Pennsylvania lawyers have faced disbarment and license suspensions from a disciplinary board connected to the state Supreme Court. However, their names were always left out of the public case files, a state official said

Any client curious about an attorney's license history either had to ask the lawyer directly or call the board.

Not anymore.

An online database listing the license history of every lawyer in Pennsylvania dating back to 1972 was tapped more than 64,000 times on June 25, its first day, said Ed Frownfelter, a disciplinary counsel for the state Disciplinary Board and the head of www.padisciplinaryboard.org/.

"In the past, the system was accused of being much too concerned with secrecy and confidentiality," Frownfelter said, adding that a change in board leadership and "increasing public criticism" led to the creation of the Web site.

MAKING PUBLIC INFO PUBLIC

Elaine Bixler, the board's executive director and secretary, said although the information it provides always has been public knowledge, "nobody knew where to go to get it. Now, it's just in a form that people can check themselves."

The system's a work in progress, Bixler and Frownfelter said. For example, while users can find out when an attorney was disciplined by the board and the case file number, there is no hyperlink to take them to the Administrative Office of Pennsylvania Courts' Web site (www.aopc.org/), where the records of disciplinary cases are posted online in PDF format.

That will be done from now on, Frownfelter said. His agency has enough money budgeted to add links to cases as far back as Jan. 1, 2000, he said. "The important thing is to give access to the most recent decisions."

Users who want older information can visit the nearest law library for "Pennsylvania District and County Reports," a quarterly legal journal that lists the details of disciplinary actions.

New Jersey simply posts PDF files containing names of disciplined and disbarred lawyers and the basic reasons why on a Web page at www.judiciary.state.nj.us/oae/discipline.htm, even though a record number of lawyers was disciplined by the state Supreme Court last year for ethics violations.

Pennsylvania.'s lawyer database also marks an improvement over the Department of State's professional licensure verification system - www.licensepa.state.pa.us/default.asp - which tracks doctors as well as most other licensed professionals in the state. (From dentists and nurses, to real estate agents and used car dealers.)

That site, online for more than two years, simply states the current status of a doctor's license and whether or not any disciplinary history exists. If it does, the user is prompted to call the department prothonotary's office in Harrisburg at 717-772-2686 for more information.

The office charges 10 cents per page to have case files mailed out. "There are talks right now about posting that information onto the site," said Brian McDonald, the department's deputy press secretary. At this point, though, there is no money budgeted for that.

The department does post regular press releases on its parent Web site - http://www.dos.state.pa.us/ - whenever a professional is disciplined listing the name and the basic reason. Those Web pages can be accessed using the site's search engine.

New Jersey offers several online licensee directories for various medical professions on its Division of Consumer Affairs Web site (www.state.nj.us/lps/ca/medical.htm), to find out the current status of their licenses only.

NATIONAL GAPS

Pennsylvania and New Jersey officials share information whenever a doctor or lawyer is disciplined, in case that person tries to practice in the neighboring state, officials said.

But if a disciplined physician moves across the country, the only way to check his or her previous license status is to use the National Practitioner Data Bank's online database (www.npdb-hipdb.com/).

The database also contains information on malpractice awards - including out-of-court and sealed settlements - as well as hospital disciplinary actions taken against every physician in the country.

Every hospital administrator in the nation is required by federal law to use the database before hiring a doctor. It's available for use by state boards of medical examiners to help decide whether a doctor should be granted a license.

However, the same federal law that created the data bank in 1986 also prohibits the public from accessing it.

"It was a political compromise," said Robert Oshel, associate director of the Health Resources and Services Administration's division of practitioner databanks. The data bank was founded with tax money, but now survives solely on fees paid by its users.

While Congress has some bills pending to open the database for public use, the American Medical Association has argued against it, fearing consumers would misconstrue its information, Oshel said.

Despite its limited use, Oshel said the data bank "improves health care because before, practitioners were able to move from state to state, and didn't tell their new hospital boards about their problems in the past. The Pennsylvania board wouldn't know that another state revoked their licenses.

"The idea of you resigning and going away and we won't take any action, shouldn't happen in the dark any more," he added. "Now if somebody resigns while an investigation is under way, under the law it's reportable to the data bank."

However, when the consumer's group Public Citizen examined anonymous records from the data bank, it found there were numerous questionable doctors who have inflicted repeated injuries on patients, yet they have never been disciplined.

Among these doctors, who were identified only by randomly generated numbers:

• Physician Number 94358, licensed in New Jersey, settled or lost 33 medical malpractice suits involving improper diagnosis or treatment between 1988 and 1993, inflicting more than $400,000 in disability costs to his patients. This doctor has not been disciplined by authorities in New Jersey.
  
  
• Physician Number 64625, licensed in Pennsylvania, paid 24 medical malpractice claims involving improper performance of surgery between 1989 and 2001. Damages to this doctor's patients exceeded $370,000. This doctor has never been disciplined by Pennsylvania authorities.

When Pennsylvania's malpractice reform task force looked at the data bank information, it found "in the 11 years of operation of the data bank, only 131 of Pennsylvania's 258 hospitals (50.8%) have ever made a report about one of their physicians. ... Only 15 states have a lower rate of actions by their state medical boards per 1,000 physicians than does Pennsylvania."

Oshel countered, "That doesn't mean they flouted the law. It probably means they've never taken a reportable action."

For a report to be required, a doctor must have his or her hospital privileges suspended for more than 30 days for "conduct and competence that affects patient care," Oshel said. "It's up to the hospital what affects patient care and what doesn't."

"There's a tendency not to want to take reportable action for fear of legal action by a doctor," he added.

The American Bar Association, a private nonprofit group that voluntarily credentials lawyers, runs the National Lawyer Regulatory Data Bank. It is only available online for use by attorney disciplinary authorities, said ABA spokeswoman Nancy Slonim. There is no link to it on the public portion of the ABA Web site.

The public can call the ABA (312-988-5321) and ask questions about a specific lawyer for a $10 fee, she said. Its information, which is provided by each state, is basically the name of the lawyer and the fact that the person was disciplined and for how long, but not the underlying cause.

"We advise that they confirm the information with the individual states," Slonim said.

Dave Ralis' Pave The Grass column appears on Mondays. You can send him an e-mail at  or call him at 215-269-5051. To read his previous columns, click here.