Illinois Not Checking Doctors' Credentials; May Hurt Patient Safety

July 13, 2012

Many patients trust their doctors. Some patients take the time to do research before choosing providers and others may simply trust that hospitals hire competent staff. Regardless of the process used to choose a doctor, most patients trust that they are receiving quality care when they make appointments.

Unfortunately, a recent article by the Chicago Tribune may make patients question their doctors' competence. The article reports that Illinois is slowly falling in its national ranking "among the states for its rate of serious disciplinary actions taken against physicians."

What does this mean for patients?

For one patient, it meant a major permanent injury was suffered after a physician was granted the ability to practice medicine in Illinois even after settling six medical malpractice cases over a 10-year period and being denied medical licenses in other states.

For another patient's family, it meant the wrongful death of a loved one after a physician who received reprimands for providing inadequate care and suspended privileges when deemed an "immediate threat to the health or safety of patients" delayed necessary medical interventions necessary to save the patient's life.

Although most physicians in the state provide compassionate and competent care, some fail to meet this standard and are not even allowed to practice medicine in other states. Blame for the presence of these substandard physicians in Illinois is being placed at the feet of state officials, who are being called out for not properly reviewing practicing physicians' records in the National Practitioner Data Bank before issuing licenses to practice in the state.

National Practitioner Data Bank: A Tool to Weed Out Bad Doctors

The National Practitioner Data Bank, or NPDB, is a "confidential information clearing house created by Congress to improve health care quality, protect the public and reduce health care fraud and abuse in the U.S." This tool is available online and allows hospitals, state agencies and licensing authorities to look into a physician's professional background.

Federal law requires that all medical malpractice liability payments be reported to this authority, as well as certain adverse actions taken against physicians. As a result, the site provides a wide array of information on each physician, including:
- Medical malpractice payments
- Revocations, suspensions, probations or loss of licenses in other states
- Negative actions filed by licensing authorities or peer review organizations

The database was intended to prevent offending doctors from traveling state to state to practice. In order to practice medicine, physicians must apply for and receive licenses in the states in which they wish to work. Congress began this database because some doctors would have their licenses revoked in one state for providing care that was dangerous to patients, only to apply and receive licenses in other states.

To combat this practice, the NPDB was created. The NPDB allows state officials to look into a physician's professional background before issuing a license to practice medicine within their state.

Unfortunately, it appears Illinois is not using this system as often as other states. Because of this lapse, physicians with questionable or even dangerous backgrounds may be practicing medicine within the state.

Illinois' Methods for Overseeing Licensed Doctors

Illinois regulates its medical licensing through the Department of Financial and Professional Regulation and the Medical Licensing Board. There are three ways to receive a license to practice medicine in Illinois: through a test, by acceptance of examination in another state or by endorsement.

After a medical resident passes a series of national tests he or she could apply to receive a medical license in the state of Illinois. If a physician is currently licensed in another state he or she can apply to receive a license in Illinois, a process referred to as endorsement.

In order to receive a license by endorsement, a candidate must be of "good moral character" according to the Illinois Department of Financial and Professional Regulation's licensure requirements. Applicants are also required to provide certified copies of court records and detailed explanations for any disciplinary actions. However, officials must use tools to verify answers in case an applicant is not completely honest.

State officials claim that the NPDB is too expensive to use on a regular basis. Yet, the endorsement licensure application notes that physicians will be required to pay extra fees in order to receive a license in Illinois, including fees associated with access to reports. It seems state officials could easily include the cost for reviewing a physician's background in the NPDB as part of the application fee.

Although the NPDB is not used, the state does utilize a national nonprofit's service through the Federation Credentials Verification Service, or FCVS. This process verifies the physician's history, including identity and medical education. However, it appears physicians can opt out of this system by submitting official transcripts from the physician's medical school.

If a physician is not forthright and a hospital or official is negligent in looking into the doctor's background before hiring or issuing a medical license to practice in the state, and an injury to a patient results, liability may apply. Victims of these hiring or licensing practices -- patients who receive inadequate care and are injured -- may be able to receive compensation to cover medical and rehabilitative expenses incurred as a consequence.

Every situation is unique. Contact an experienced medical malpractice lawyer to protect your legal rights and discuss potential remedies.

Article provided by Lloyd Law Group
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