Doctor profiles veiled in secrecy

Claims histories are closely guarded in Maryland, protected by laws that keep information from patients

By Fred Schulte | Sun reporter

December 19, 2005

Second of three parts

Maryland's official Web site on physicians shows no malpractice claims history for Dr. Willie C. Blair, a Greenbelt surgeon.

But that picture is incomplete.

An Internet site run by the medical board in Virginia, where Blair also is licensed, reveals what Maryland's does not - that he has settled five malpractice claims over six years. All were Maryland cases. In four of them, patients died.

Blair is one of hundreds of doctors in the state on whose behalf insurers have paid about $290 million over the past six years to resolve malpractice claims. But Marylanders are unlikely to find out from their state's Internet site, or any other public records, who the doctors are and how much was paid to patients who alleged that they were injured, an investigation by The Sun has found.

The formula for deciding which malpractice settlements are made public is so restrictive that few doctors qualify. Lawmakers adopted that formula in 2003 as part of a broad, but ultimately flawed, effort to reform the state's oversight of the medical profession.

"The criteria have to be changed. It's crazy. It doesn't do consumers any good right now," said C. Irving Pinder Jr., executive director of the state Board of Physicians, adding that the disclosure requirement should be overhauled or even abolished because it is ineffective.

Dr. J. Ramsay Farah, one of 21 members of the oversight panel, acknowledged that the standards for posting settlements might be too restrictive.

"It may be worth revisiting to [determine] the circumstances of those cases that are not posted," said Farah, a Hagerstown specialist in treating addictions. "Are we missing something here?"

Malpractice claims by themselves do not prove substandard care. Doctors in specialties with relatively high risk, such as emergency care and obstetrics, tend to draw claims.

Blair, a general surgeon, said in an interview that while he's been sued "a lot," the claims against him arose from "complex and unusual" cases.

"I have a habit of taking anybody who comes in. They are all high-risk," said Blair, who has been on call at the Prince George's Hospital Center where he is president of the medical staff. "If I don't take care of them, nobody else will."

In an investigation of how the state oversees physicians and protects the public, The Sun found that it is unusual for doctors to have more than one or two malpractice claims filed against them in a decade. About 200 physicians, in a state where 17,000 practice, were the subject of three or more claims from 2000 through 2004. Regulators in several states said a pattern of malpractice claims should prompt scrutiny, but the Maryland Board of Physicians pays little attention to doctors' claims histories.

Protected secrets

Claims histories are virtual state secrets in Maryland, protected by laws and rules that make it harder for patients to make informed choices and for hospitals and other employers to screen doctors.

Secrecy has prevailed largely because doctors, lawyers, legislators and state officials have, for different reasons, found it advantageous to shield most details of medical negligence cases.

The Sun identified several ways in which the public is denied information:

Doctors and lawyers settle the vast majority of claims out of court, avoiding the time, expense and public record of a trial. Typically, both sides sign confidentiality agreements that conceal the amounts paid to patients and their families.

Insurers must report to the board all malpractice payments made on behalf of doctors. But the board says state law prohibits disclosure of most of the doctors' names.

Any discussion of doctors' performance that occurs during the board's disciplinary proceedings is closed to the public. By contrast, such hearings are open in 19 of 22 states surveyed by Maryland legislative auditors.