03/25/2021    David Secord, DPM

RE: The National Practitioner Data Bank

I thought the article by Dr. Kobak was an
informative piece upon the National Practitioner
Data Bank. There is—as you might imagine—another
side to the coin of this organization. It is not
complimentary.

The National Practitioner Data Bank is run by
Health and Human Services and is audited on a
somewhat regular basis by the General Accounting
Office. To the best of my abilities, I’ve
gathered what appears to be the (so far) three
audits of the National Practitioner Data Bank by
the GAO. In all three of those audits, the GAO
concludes that 40% of the information contained
in the databank is wrong. As of this date, I’ve
seen no response from HHS or Congress on how an
organization which is filled with so much false
information could continue, unabated and without
revision, reorganization or dissolution.

One of the more puzzling aspects of the National
Practitioner Data Bank rules is that there is no
vetting of information submitted to the database.
Any reporting agency can file to a practitioner’s
report and it is there for life. The rules allow
a practitioner to file a response, but there is
no way to expunge false information—knowingly
false or not—once added to a profile. If a
hospital reported that you were responsible for
the Lindbergh kidnapping and murder, it would
appear in your report and the best you can do is
dispute the claim. The reporting agency then has
the opportunity to dispute your rebuttal. You do
not have the ability to dispute that entry in
answer to yours.

The lack of veracity in the National Practitioner
Data Bank and the sometimes pernicious nature of
hospital peer review committees in this Country
allows for punitive actions intended not to
inform the public (who cannot view entries) but
to destroy practitioner’s lives. Because of the
aegis surrounding hospital peer review committees
via the Healthcare Quality Improvement Act
(HCQIA) of 1986, they are allowed to act without
impunity and can—and do—use the National
Practitioner Databank to destroy lives. The entry
in Wikipedia is rather succinct: “Sham peer
review or malicious peer review is a name given
to the abuse of a medical peer review process to
attack a doctor for personal or other non-medical
reasons.[1]

The American Medical Association conducted an
investigation of medical peer review in 2007 and
concluded that while it is easy to allege
misconduct and 15% of surveyed physicians
indicated that they were aware of peer review
misuse or abuse, cases of malicious peer review
able to be proven through the legal system are
rare.[2]

Those who maintain that sham peer review is a
pervasive problem suggest that the Healthcare
Quality Improvement Act (HCQIA) of 1986 allows
sham reviews by granting significant immunity
from liability to doctors and others who
participate in peer reviews. This immunity
extends to investigative activities as well as to
any associated peer review hearing, whether or
not it leads to a disciplinary (or other) action.
That the AMA could conclude that abuses of the
“peer review process” are “rare” indicates that
they should have looked harder. The entry in
Wikipedia should include that the HCQIA
provisions make discovery impossible (making the
building of a lawsuit nearly impossible). Federal
and State “Whistleblower” statutes will not
override the protections of the HCQIA (which is
absurd).

Two organizations which exist to fight these
abuses have thousands and thousands of instances
documented (including mine). Between Semmelweis-
The International Association of Whistleblowers
and The Medical Justice organizations, there are
over ten thousand entries of medical
professionals who have seen their lives destroyed
by a “peer review committee” and a punitive entry
in the National Practitioner Data Bank. I can
only assume that their stories are akin to mine
and that both the impetus for the sham “peer
review” and the entry in the database was
intended, solely to destroy a life and
livelihood.

I’d love to see an honest examination of the
Database and an evaluation of what good it
achieves in light of the evil it perpetuates. As
long as even one person can have a hospital
invent offences, offer a dog and pony show via
it’s “peer review committee” and destroy you with
an equally invented entry to the National
Practitioner Data Bank, it should be reformed or
dissolved. I (obviously) favor the latter.

References
1. Federal Rules of Civil Procedure 30(b)(5),
also called FRCP
2. Edgar, Donald L. (1954). "Discovery of
Documents and Things: The Federal Rules and the
California Law". California Law Review. 42: 829.
Retrieved 21 January 2020.

David Secord, DPM, McAllen, TX

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