A recent article published in Claims Journal described how “rogue” physicians are becoming an increasing problem. In the article, Linda E. Jones, a healthcare consultant from Baltimore, Maryland, defined a “rogue” physician as one “who may be having problems not doing things legally or ethically.” Ms. Jones further stated, “It’s really a behavioral problem.” The article’s author also quoted Ms. Jones as saying, “We do hear more and more issues of physicians [being involved in] illegal or unethical activity.”
Examples of rogue behavior may include patient complaints or grievances, disruptive behavior, sexual misconduct, Medicare or health insurance fraud, and committing criminal acts. For example, in late 2010, a Crestwood, Kentucky woman accused her primary care physician of sexually assaulting her while performing a physical examination. Of course, physicians and other healthcare providers should never commit these heinous acts. Unfortunately, however, when a doctor or other healthcare provider commits one of these despicable acts, the doctor’s medical malpractice insurance policy may not provide coverage. That could result in medical malpractice victims having little or no recourse against the physicians who injured them.
What’s even more troubling is that a public advocacy group, The Public Citizen, recently reviewed information contained in the National Practitioner Data Bank, and found that 55% of physicians who have had their practice privileges revoked never faced any state disciplinary or licensing actions for their improper conduct. The Claims Journal article quoted Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, as saying “One of two things is happening, and either is alarming. Either state medical boards are receiving this disturbing information from hospital but not acting upon it, or much less likely, they are not receiving the information at all. Something is broken and needs to be fixed.”
The aforementioned article discussed one way for medical malpractice victims to possibly recover for acts which may not be covered by malpractice insurance – bringing a negligent credentialing claim. A negligent credentialing claim may arise when a hospital or medical practice knows about a particular physician’s prior bad acts, but still elects to give him or her practice privileges, and the physician’s actions then injure a patient. Under this theory, a medical malpractice victim may be able to recover against a hospital or medical practice, even though he or she is unable to recover against the physician directly. Thankfully, just this past year, in Burton v. Trover Clinic, 2011 Ky. App. LEXIS 94 (June 10, 2011), the Kentucky Court of Appeals formally recognized that negligent credentialing is a viable cause of action in the Commonwealth.
If you believe that you or a loved one may be a medical malpractice victim, contact a medical malpractice attorney, Seth Gladstein. You may call Seth and Gladstein Law Firm at 502-855-4177. You may also email Seth – Seth@CommonwealthInjury.com.
Read more about this problem in the current issue of Claims Journal: http://www.claimsjournal.com/news/national/2011/12/06/196308.htm
You can also read the Kentucky Court of Appeals opinion in Burton v. Trover Clinic here: http://opinions.kycourts.net/coa/2009-CA-001595.pdf