How to Find Out If Your Health Provider Is Dr. Jekyll or Specialist Hyde
This week's feature delves into a subject doctors don't like to talk about much — their mistakes. It focuses on the case of Ruth Farfan, a 68-year-old patient who died in 2012, shortly after what was supposed to be "routine" surgery at Denver's St. Anthony Central. Farfan's family has reached a confidential settlement with the surgeon who performed the operation, Dr. Nelson Mozia, but is now engaged in a legal battle with hospital officials over whether the hospital can be held liable for continuing to grant privileges to Mozia despite prior malpractice settlements and other concerns.
In Colorado, a great deal of information that hospitals have about doctors — stuff prospective patients might really need to know, such as whether a physician has been associated with an alarming rate of complications and medical errors — is kept confidential under the laws dealing with peer review and quality management processes. The idea is that internal evaluations and performance reviews would be less thorough if they weren't done in secret. So how do you give your doctor a check-up before he or she gives you one?
You can Google, Yelp, and Bing your physician, of course. But anonymous reviews, even bunches of them, don't prove much. As pointed out in my article, the now-retired Dr. Mozia received many glowing reviews in the course of his long career; he was even recognized as one of "Denver's Top Doctors" by 5280 a whopping sixteen times. During that same period, court records indicate, he was sued for malpractice or negligence eleven times. In at least five cases, the result was a confidential settlement with the plaintiff.
But Colorado does have a tool that offers more information about licensed providers than most states are willing to give up. It's the Healthcare Professions Profile Program, or HPPP, a searchable database found on the Department of Regulatory Agencies website. The database was established by the 2007 Michael Skolnik Medical Transparency Act, which has since been expanded since to include professionals from a wide range of health-care jobs, including RNs, LPNs and physician assistants. Enter a profession, type in the name of the provider, and you'll get a detailed profile that lists education and training, board certifications, hospital affiliations and employment contracts, disciplinary actions, malpractice settlements, any denial of coverage by insurance carriers (a key red flag), and more.
The database won't reveal malpractice litigation that is ongoing — or cases that were dismissed without any money changing hands. It doesn't list disciplinary actions in which final orders haven't been issues, a process that can take years. But the HPPP does provide a degree of disclosure that can help alert consumers to problems. You can also check out national search tools, such as this Surgeon Scorecard; it's part of a recent ProPublica series that examines the surgical complication rates of 17,000 physicians across the country. According to the series, 11 percent of the surgeons account for 25 percent of the reported complications — which suggests that picking the right doctor can be a life-or-death decision.