U.S. District Judge Gerhard A. Gesell ruled yesterday that detailed information compiled by medical groups about doctors and hospitals participating in federally funded programs such as Medicaid and Medicare must be made public.
Under Gesell's ruling, for example, information such as the names of those doctors who admit at government expense the most patients for certain operations -- such as hysterectomies -- would be disclosed.
The material is compiled by federally designated medical monitoring groups known as professional standards review organizations that in the past have strenously opposed attempts to make the information public. Their attorneys said yesterday they will seek to appeal Gesell's ruling.
The standards review organizations were set up to determine whether doctors and hospitals meet appropriate professional standards in providing health care at federal expense, and whether the medical services are necessary in the first place.
Gesell's ruling came in a suit filed under the Freedom of Information Act by the Public Citizen Health Research Group in which the nonprofit organization sought certain medical data compiled by the Washington, D.C., review organization, which is known as the National Capital Medical Foundation.
Public Citizen sought documents in four categories: number of admissions and average length of stay of patients in Washington hospitals; physician profiles for the five doctors who admit the most Medicaid and Medicare patients to area hospitals; hospital profiles for the five hospitals that admit most patients; and evaluation studies of care compiled by the review organization.
Public Citizen did not ask for information that would allow individual patients to be identified, Gesell noted.
Attorneys for the standards review organizations, both nationally and locally, argued that physicians who participated in the program did not know their names would be made public and said the raw data sought by Public Citizen would be subject to misinterpretation.
They argued, for example, that physicians might be the subject of "misleading publicity, possibly unwarranted professional and public criticism, and damage to professional reputation," Gesell said.
On the other hand, Gesell noted in ordering the material released, the plaintiffs in the case said disclosure of the material will enable "the consuming public to make more fully informed choices among individual physicians and hospitals rendering, Medicaid and Medicare services."
He also discounted claims that physicians might not participate in the review organization program or Medicaid or Medicare programs in the future if their names are disclosed.
"The conceivable adverse effect on overall physician participation does not outweigh a clear public interest in increased knowledge concerning the quality of government-funded medical services," Gesell said.
The review organization attorneys have 30 days to appeal the ruling.