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SPECIAL TREATMENT : Disciplining Doctors

Poor Performance Records Are Easily Outdistanced

By Cheryl W. Thompson
Washington Post Staff Writer
Tuesday, April 12, 2005; Page A01

Last of three articles

Gwyneth Vives was excited about becoming a mother for the first time at age 36. She shopped for baby outfits, attended birthing classes and painted moons and stars on the nursery ceiling for the infant she and her husband would name Alex.

But three hours after giving birth to a healthy boy in 2001, Vives, a scientist at Los Alamos National Laboratory in New Mexico, suffered a complication and bled to death. It was four days before Christmas.

Monia Thomas sued Pamela Johnson and Duke University Medical Center after her intestine was nicked during a tubal ligation. (Karen Tam For The Washington Post)

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Her husband, Ted, wouldn't learn until later that the doctor who tended to his wife that day at Los Alamos Medical Center had a troubled history.

Obstetrician and gynecologist Pamela L. Johnson had been forced to leave a previous job at Duke University Medical Center in North Carolina when questions arose about her surgical skills and her complication rate from medical procedures. Later, Johnson lied to get her New Mexico license, saying she had never lost hospital privileges, according to an order of the New Mexico Medical Board.

After Vives died, Johnson again lied about her past.

Claiming that she had never lost hospital privileges, Johnson was given a license to practice in Michigan, even before New Mexico could discipline her.

Hundreds of other doctors across the country have done the same: Facing problems in one state, they simply moved and restarted their careers. They were able to do so despite a federally imposed tracking system designed to prevent just that.

Among doctors licensed in the District, Maryland and Virginia, nearly two dozen got in trouble in one jurisdiction and then moved elsewhere to practice, according to a Washington Post analysis of medical board records between 1999 and 2004.

Nationally, 972 physicians during that period were disciplined in one state, then moved at least once more and were disciplined again for a separate infraction, according to federal statistics. Nineteen were disciplined in four or more states over five years.

Doctors who find themselves in trouble can move around because many are never reported to a national repository for doctor discipline records, known as the National Practitioner Data Bank. The aim of the data bank is to allow licensing boards and employers to check on doctors' records before they are hired and to prevent problem doctors from state-hopping.

But nearly 54 percent of all hospitals have never reported a disciplinary action to the data bank, according to the federal Department of Health and Human Services, which oversees the system. Even when hospitals or boards report problems, they don't always do it quickly, allowing doctors to move and get a new license before the paper trail catches up with them.

"It's only as good as the information reporters put in," said Cynthia Grubbs, a former acting deputy director and associate director for policy and analysis for the data bank.

Other weaknesses also plague the system:

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