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Poor Performance Records Are Easily Outdistanced

But the sanctions in the law and enforcement are "probably not strong enough," Croft said. "To say we were even aware of 10 percent of the possible violations [by doctors] is probably an exaggeration."

Dale G. Breaden, a spokesman for the North Carolina Medical Board, said hospitals help doctors by limiting discipline to less than 30 days because longer sanctions must be reported.


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)

SUNDAY: Doctors with substance abuse problems are allowed to keep practicing, often despite relapses, and medical boards rarely revoke licenses.
Physicians Practice Despite Abuse
Some Doctors Sent to Rehab

MONDAY: A physician in Maryland or Virginia is twice as likely to be punished as a doctor in the District, where the medical board's record of serious disciplinary action has been among the lowest in the country.
D.C. Board Rarely Punishes Doctors
Despite Deaths, D.C. License Upheld
Graphic: Medical Discipline

TUESDAY: Doctors who are disciplined often restart their careers by moving to a another state, despite a federal system meant to prevent physicians from hiding troubled pasts.
Track Record of Lies, Job Dismissals
Red Flags About Md. Man Ignored
Multiple Licenses to Conceal History

_____Graphic_____
The Movements of Pamela L. Johnson

_____Related Document_____
Jewel Quinn

_____Transcript_____
The Medical Community: Arthur Caplan, PhD, of the University of Pennsylvania discussed bioethics.


_____Resources_____
Many state medical boards allow you to search for your doctors' standing and medical compliance history.



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"Suddenly, everybody was taking action that didn't extend beyond 29 days," Breaden said.

The American Medical Association and other organizations have fought to keep the names of doctors private, arguing that opening the data bank to the public would violate physicians' privacy.

Wyden said he would like to allow the public to get information about "the most flagrant violations." Although that would certainly trigger opposition from the medical community, he said, "I think it's time to end the days when the consumers are the last to know."

High Complication Rate

Pamela Johnson had a promising career when she arrived as a 30-year-old resident at Duke University Medical Center in 1989. Records show that she joined the faculty four years later and was named an assistant professor in 1995.

But in 1997, Charles Hammond, head of OB-GYN, wrote to Johnson that she would have to leave Duke if she didn't "make significant progress," Johnson said in a court deposition. Later, Hammond asked her to stop performing surgery, according to the deposition.

In the deposition, Johnson said Hammond told her that her problems included a "high surgical complication rate" and the "worst QA [quality assurance] file of anyone at Duke." There was pressure from the hospital's risk management office to fire her to avoid paying a higher malpractice premium for the department, she said in the deposition. In June 2000, Johnson's Duke hospital privileges were terminated, according to a New Mexico Medical Board record.

In the interview, Johnson said she was a "fairly good" surgeon but acknowledged that she had "a few little" problems at Duke.

Former Duke employee Monia Thomas was one of three patients in North Carolina to file claims against Johnson for malpractice, accusing her of nicking her intestine during a 1997 tubal ligation. Thomas said in an interview and in her complaint that she ended up in the emergency room, which turned into a 10-day hospital stay. Doctors had to perform a colostomy, which was later reversed, Thomas said in the interview.

Thomas, now 45, said she was unable to work for a year. "I had to wrap my side in towels so that no one sitting next to me in church would hear the noise from the [colostomy] bag," she said. "I was just going in to get a tubal ligation. She told me in a couple of days I would be ready to go back to work."

Thomas sued Duke as well as Johnson. In 2000, the case was settled with Duke for an undisclosed amount, she said.

Johnson said in the interview that she didn't remember Thomas or the operation.

Even though Johnson was forced to leave, Duke gave her something that would help her get hospital privileges in three other states: letters of recommendation.


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