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Profiles of doctors sparking disputes

Ever wondered whether your doctor has been sued for malpractice?

Ray McEachern wishes he had known some things about his wife's physician five years ago _ before she went in for an angiogram. An artery was punctured, and now she is partly paralyzed.

"If we had had his record, we never would have used him," said McEachern, of Tampa. "He had three closed claims."

McEachern heads a grass-roots group, the Association for Responsible Medicine, and he supports a proposed law to make doctors' malpractice histories easier for consumers to obtain.

The measure, sponsored by state Sen. Ginny Brown-Waite, R-Spring Hill, was approved last week by the Senate Health Care Committee. It has one more committee stop before reaching the floor. The same proposal is pending in the House.

It is facing heavy criticism from some of the state's most powerful doctors, who worry that too much information will mislead the public and damage reputations.

"I don't want to sound elitist, but we're not talking about whether a plumber has put the pipes together wrong," said Plantation physician Mathis Becker, vice president of the Florida Medical Association. "We're talking about some tough issues here on whether a person's professional career can go on the line with this information."

Comments like that frustrate Brown-Waite, who is chairwoman of the Senate Health Care Committee and accuses the medical association of nitpicking at problems to derail her proposal.

"We need to be in protect-the-patient mode and not protect-the-physician mode," she said. "For too long, the Legislature has protected the physician."

Doctors want to limit the information listed in the profiles, but patient advocates say the profiles should include everything, including lawsuits that did not result in malpractice payments.

"If a doctor has been sued four or five times, even if he's won, to me that should be a red flag to a patient (that) this doctor has a problem but has a way of winning (in court)," McEachern said.

Brown-Waite's proposal falls somewhere between what the medical association wants and what McEachern wants.

The profiles would include the doctor's name, professional and educational history, criminal history and closed malpractice settlements, along with any disciplinary action taken by the Board of Medicine in the past 10 years.

Doctors would be required to submit fingerprints for both state and federal criminal background checks.

The proposed profile information already is public record, but consumers must go to several state or local government offices to obtain it. Beginning in 1999, Brown-Waite's proposal would make it all available in one place, the Internet.

The Agency for Health Care Administration is compiling a consumer book that would contain some of the information Brown-Waite wants to put in the profiles. But it would list only doctors who had paid three or more malpractice settlements in the past five years.

Agency officials hope to publish the book next month.

"It's our belief that one or two malpractice claims does not mean necessarily you're not a good doctor," said agency spokeswoman Nina Bottcher. "Three or more (settlements)? We want to leave that up to the public to decide."

Physician advocates are uncomfortable with legislation that proposes to go much further than that. If the state must pass a law, they suggest using the same plan approved last year in Massachusetts. In that state, consumers can call a toll-free number and request a physician's profile.

The document contains professional and educational history, in addition to lists of awards and publications. It also shows malpractice payments, hospital disciplines and criminal histories _ but only for the past 10 years.

It also lists a half-page of caveats about how a malpractice claim does not necessarily indicate a doctor is bad, and it tells patients how a doctor's amount of claims compares with the average.

Much like the Florida version, the Massachusetts law faced controversy. "What has happened here is that the profile simply does not tell you the ability of the physician and whether they take on high-risk patients," said Dr. Barbara Rockett, a past president of the Massachusetts Medical Society. She has traveled the country in recent months opposing moves by states, including Florida, to follow Massachusetts' lead in creating the profiles.

Opposing Rockett is the current society president, Dr. Joseph Heyman. He appeared recently with her in Orlando to debate the issue before the Florida Medical Association and says he believes the Massachusetts model has been a success.

"The way we did it, we felt that we were giving information to patients that they wanted," Heyman said. "But on the other hand, it was fair and it put things in perspective, and it was understandable to the patient."

The Florida association wants the state's proposal to include only settlements paid in the most recent five or 10 years and says only settlements resulting in discipline should be listed.

In some cases, insurance companies decide to settle a claim without the doctors' permission, the association argues.

"That casts a great cloud over somebody if the insurance carrier makes an economic decision to settle a case," said Becker, the medical association vice president, who paid two settlements in the early 1980s. One was settled by the insurance company without his opinion. "That reporting of information implies the physician is guilty of something. We have a problem with that."

Becker said the medical association "supports the concept" of Brown-Waite's proposal.

The senator says she thinks the association is trying to "nickel and dime" it to death.

"If they had their druthers, the bill would go away," she said. "But it's not going to go away."

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