When Dirty Doctors Can’t Be Identified

As promised in yesterday’s post, I’m reporting today on a frustration among those of us who work in patient safety.

That frustration is once again sparked in this report from the Hartford Courant. Fifteen year old Mark Tsvok, injured in an auto accident in 2004, died from his injuries as a result of the misdeeds of Dr. Daniel H. Hechtman who made one misstep after the next in his treatment (or lack thereof) of the teenager.

After a series of investigations and hearings, Dr. Hechtman lost his license to practice anywhere in the state of Connecticut.

So what did he do?

He moved on down the road — to New York — where he is now a pediatric surgeon at Maimonides Medical Center in Brooklyn, N.Y.

From the Hartford Courant: “For years, the 47-year-old Hechtman held two licenses – one in Connecticut and another in New York – and the action of regulators in Hartford appears to have done little or nothing to inhibit him from treating patients in a neighboring state.

There is no record of what happened in Connecticut on Hechtman’s physician profile in New York, a state-sponsored service designed to flag doctors who have run into disciplinary trouble.

Hechtman’s profile says he has had no New York-based disciplinary actions against his license. Under a heading for out-of-state actions, it says “none reported.”

….. Even though Connecticut reported the settlement to the National Practitioner Data Bank and the Federation of State Medical Examining Boards – two national services designed to spread information about medical misconduct by individual doctors – it is virtually impossible for members of the public to find information about his track record.

Hechtman shows a clean bill of professional health not only on the New York site but on commercial doctor report card sites, such as Health Grades. “

Thus — the crux of the problem. As the reporter stated, “It is virtually impossible for members of the public to find information about his track record.”

So What Can Patients Do?

Empowered patients know to look for information about specific doctors before undergoing any type of difficult or invasive treatment — but — if that information isn’t truly available, how can they do so?

I did a little investigation on my own. I checked in with the State Board in Connecticut — Dr. Hechtman is still listed there, although it says his license expired. There is a way to get to disciplinary information — although it took some real doing to get there. Here’s a link to the basics:

http://www.physicians.dph.state.ct.us/web_public/web_public.show#47505

I could find nothing at all on New York State’s disciplinary listings. And HealthGrades made it impossible to even find a listing, much less have the right information.

Here’s my suggestion. If you know you will need surgery, or any kind of invasive testing or treatment, find out how long your doctor has been practicing in your location. If the doctor has been in your location for, say, 10 years, and you look him/her up online and find out there is no disciplinary action or lawsuit, then there is a good chance (although — who knows?) that doctor will do the job for you. The 10 years shows a track record over time. Even if that doctor had problems before 10 years ago, s/he clearly did not lose his/her license as a result — in your location. That’s not to say s/he didn’t lose it in another state more than 10 years ago, however.

You might have to consider the age of the doctor. This doctor looks to be in his 40s, so 10 years would not be out of the question. If the doctor is only in his/her 30s, you might need to make an adjustment of your expectations.

If the doctor has been located where you are for fewer than 10 years — or if you find out your doctor practiced in another located, too (as in Dr. Hechtman’s case) — then begin looking specifically in other states, perhaps starting with nearby states (New York is right next to Connecticut. One could also look in Massachusetts and Rhode Island).

The bottom line is that it isn’t easy to find this information, and in some ways, you may need to trust your intuition. And of course, an emergency situation will make much of this a moot point.

Better communications via the internet will begin to remove these dirty doctors from practice — but it will take diligence, and a website that is truly willing to step up to the plate to expose them — before it’s particularly useful for patients.

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