Doctor discipline: State fails to offer full disclosure

The brain aneurysm was small, but George "Wes" Bidwell Jr. wanted it repaired before it got any bigger.

So with the 33-year-old warehouse supervisor from St. Paul prepped and ready for surgery that morning in August 2001, Dr. Arturo Camacho grabbed a surgical saw and made his first cut -- to the wrong side of Bidwell's head.

Two hours into the surgery, someone caught the mistake. Camacho switched to the correct side of Bidwell's head and the repair was done. A year later, Bidwell sued Camacho for malpractice, claiming the wrong-side surgery led to memory problems, seizures and changes to his personality. In 2004, a jury awarded Bidwell $850,000.

Such malpractice findings are increasingly easy to find on websites maintained by medical boards in 19 states, but not in Minnesota, where regulators have resisted efforts to make more information available to people who want to check into the backgrounds of their doctors.

The Minnesota Board of Medical Practice also doesn't disclose whether doctors have been disciplined by regulators in other states or lost their privileges to work in hospitals and other facilities for surgical mistakes and other problems -- information provided in 13 other states.

"This is information that consumers need to know," said former Minnesota board member Kris Sanda, who led an unsuccessful effort to add more adverse actions to the state's website. "The more knowledge we have about all of these doctors, the better off we are."

The Minnesota board does provide complete disciplinary reports on doctors going back to the 1970s. It also provides information on criminal convictions provided by the doctors themselves, but it does not verify that information.

Robert Leach, the board's executive director, agrees that people have a right to know about their doctors. But he said the board would need legislative approval to offer more information than it currently provides. Under state law, any information obtained by the board as part of a complaint investigation is confidential.

Picking doctors with 'eyes open'

In 1997, Massachusetts became the first state to use its website to publicly post board and hospital disciplinary actions, malpractice settlements and criminal convictions. The action was mandated by state lawmakers.

Each year, about 600,000 individual users visit the website to gather information on physicians, said Russell Aims, a spokesman for the Massachusetts Board of Registration in Medicine.

"We wanted to make sure the profiles were clear," Aims said. "That was the whole idea -- you can go to one place and you can pretty much find out anything on given physicians."

In 2009, the Federation of State Medical Boards, a national nonprofit organization that helps state medical boards in their role of protecting the public, recommended that all state websites include information on previous criminal convictions, malpractice histories and disciplinary actions against doctors by state boards and hospitals.

That year, regulators in North Carolina upgraded the state's website after seeking approval from state lawmakers.

"People want this information, they expect this information and the board said we better do something about it," said Jean Brinkley, public affairs director for the North Carolina board.

Today, in addition to posting information on a physician's education and training, North Carolina's website also displays information on whether a physician has been disciplined by a hospital or medical board, been convicted of a misdemeanor or felony or paid out on a malpractice claim.

Brinkley said the information is not "a guide to good and bad doctors."

"It makes people aware of issues, so they can go into care with their eyes open," Brinkley said.

More info in other states

Minnesotans can sometimes learn more about their doctor by visiting websites maintained by regulators in other states. Many physicians are licensed in multiple states because they work in more than one place.

For example, Minnesotans can go to the Florida website and see that the insurer for Dr. Mark H. Montgomery, a physician and surgeon who once practiced in Minnesota, paid more than $1 million in a malpractice case. A jury found Montgomery acted negligently during a tonsillectomy in a Minnesota hospital that resulted in the death of a 3-year-old boy. Minnesota's website makes no reference to the malpractice case or jury award.

Consumers can visit the New York website and find out that Dr. Tracy E. Napp, a radiologist from Clear Lake, Minn., was fined twice and reprimanded once in the past decade by the New York board for "professional misconduct" after drunken driving arrests in Minnesota. There is no record of board action against her in Minnesota, nor is there a mention of New York's reprimand on the Minnesota website.

By checking out-of-state websites, Minnesotans can discover that Dr. Naiyer Imam, who received his Minnesota license in 2005, was denied a license in Alabama because he submitted false or misleading information in his application. The moves prompted five other states to take action, and in 2009, North Carolina issued a "letter of concern" to Imam after he misread a CT scan. None of those adverse actions are included in Imam's profile on Minnesota's website.

"I can go on the Internet and find out more information about a siding company than I can about a doctor who is going to perform surgery on my 10-year-old daughter," said Chris Messerly, a medical malpractice attorney in Minneapolis.

Changes blocked in Minnesota

Ten years ago, Sanda led a board task force that recommended adding biographical information, criminal convictions and copies of board discipline and corrective actions to the Minnesota website.

Putting malpractice awards on the website was strongly opposed by the medical community, though it did not object to the other additions, Sanda said. As a compromise, the task force recommended the board collect malpractice data for three years and then study the issue again.

The board was supposed to revisit the malpractice issue, but Leach said it lacked sufficient data to make a decision.

To the Minnesota Medical Association, which represents 10,000 physicians in the state, providing the public with details of every adverse action carries the risk of unfairly harming a doctor's reputation. "I hope that it doesn't happen here," said Dr. David Thorson, chairman of the Minnesota Medical Association's board of trustees.

The group favors public disclosure only of disciplinary actions by Minnesota regulators.

"The board's obligation is to evaluate physicians for licensure in a manner that protects the safety of the public," Thorson said. "We have to assume that the board is doing that."

Leach said consumers would be confused if the board posted malpractice cases without providing additional data that would help people understand whether a doctor's malpractice history was above or below state norms.

"If we are going to put this information out to the public we want to do it in the best way possible and we don't think that just sheer numbers is the best way possible," he said.

richm@startribune.com • (612) 673-4425 howatt@startribune.com • (612) 673-7192

MINNESOTA BOARD OF MEDICAL PRACTICE

The board oversees physicians, acupuncturists, physician assistants, respiratory therapists and traditional midwives.

Board: 16 volunteers appointed by the governor, of whom 11 are physicians

Number of licensed physicians: 20,036

Employees: 23

2011 fee revenues: $5.4 million

2011 expenditures: $3.9 million

2011 complaints against doctors: 728

PART 1

Dozens of Minnesota doctors have escaped punishment for mistakes and misconduct. Read the complete story at startribune.com/doctors