Smile, your name may be on line
Michael OReilly
CMAJ 1999;160:1353
© 1999 Michael OReilly
One of the Internet's strengths is its ability to break down barriers by providing ready access to information that used to be hard, even impossible, to obtain. It has already opened doors into government offices and lifted the covers off files relating to product performance. Now it is knocking on the vaults containing physicians' licensing and practice records.
Recently Ralph Nader's organization, Public Citizen's Health Research Group, published a book, 16,638 Questionable Doctors. The 4 volumes detail the disciplinary actions taken against physicians across the US and is available for sale over the Internet (www.citizen.org/).
"Patients have a right to know about their doctors — if they have been disciplined for sex offences, or substance abuse, or incompetence, or anything else," said Dr. Sidney Wolfe, author of the report.
Taking things a step further, a group called the Consumer Health Organization has published a Medical Malpractice Database online (http://members.aol.com/Doctorhlp/indexhold.html). By paying US$20 to $50, anyone can order a report about any doctor in the database. It is delivered electronically to the person's email address.
"Patients harmed as a result of medical malpractice need to warn other potential victims of the inherent risk associated with certain doctors," the Web site states. "Perhaps together we can fight back to raise the standards for medical care in this country."
This database contains disciplinary information on more than 17 000 American doctors that has been gathered from various medical organizations and consumers. It not only includes information on malpractice-related lawsuits and official complaints but also self-reported grievances that are awaiting investigation.
Because of the growing demand for licensing information, some state medical boards are getting in on the act. The Massachusetts Board of Registration in Medicine has recently opened its physician licensing records and made them available online (www.docboard.org/ma/ma_home.htm).
This allows anyone with Web access to search by name for a complete profile of any physician in the state. This not only includes name, address and office numbers but also lists physicians' educational and training credentials, their specialties and awards, and a list of professional publications. Finally, it provides a complete record of any disciplinary action brought against the doctor by a hospital, licensing board or the state that led to a conviction because of malpractice or a criminal act.
In Ohio, meanwhile, residents can pay an electronic visit to the state medical board (www.state.oh.us/med/). This system lets visitors search for a specific doctor's educational credentials, specialty training, amount of CME training logged and the status of the physician's licence. It also indicates whether any formal legal actions are under way and allows people to order complete reports.
At the Association of State Medical Board Executive Directors' DocFinder Web site (www.docboard.org/), patients can reach 13 other US state licensing agencies. The information here is not as detailed as that found at the Massachusetts or Ohio sites, but users can still find basic licensing information.
The American Medical Association is also in the game with its AMA Physician Select site, (www.ama-assn.org/aps/amahg.htm). The AMA provides an exhaustive list of American doctors but not much detail beyond address, telephone, medical school and practice specialty.
This level of disclosure is nothing new; the difference is simply ease of access and the speed at which patients can find basic information about their doctors.
Canadian licensing bodies have yet to open their complete records to Internet searchers. However, the College of Physicians and Surgeons of Ontario (www.cpso.on.ca/) recently unveiled a Find A Doctor system that does provide basic information about the province's 23 000 physicians.
This system lets users search for doctors by name or region, and provides the user with a detailed description of the physician's educational and CME credentials. It also states whether the doctor is accepting new patients.
The College of Physicians and Surgeons of Manitoba (www.umanitoba.ca/colleges/cps/) and the Alberta College of Physicians and Surgeons (www.cpsa.ab.ca/) both offer similar services. Users will find a complete list of registered doctors, including basic addressing information, specialties and registration number.
Although the Canadian systems are not yet as advanced as their American counterparts, the direction is clear: we are going to see more openness and increased access to physician licensing records.
Canadians, more and more, are digging into their own pockets for medical care. This increased commercialization and "consumerization" of the health care system will be accompanied by the inevitable scrutiny of people providing the care — something the Internet is pushing along quickly.
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