Investigative Summary:

A KXAN investigation found Texas patients aren’t getting all the information they need about some doctors’ histories. Our team searched through thousands of disciplinary records, spanning more than a dozen states, to discover some physicians are coming to Texas to leave their pasts behind. Patients wishing to research their doctors ahead of time will likely find incomplete, inaccurate and missing disciplinary actions — information that exists but kept secret from public view.

AUSTIN (KXAN) — Almost five years to the day after Dr. Christopher Duntsch was sentenced to life in prison, some involved in the infamous Texas case say patients are still being kept in the dark.

“Right now the public isn’t getting the information they need,” said Dr. Robert Henderson, who helped take down Duntsch.

Dallas attorney Kay Van Wey agrees. She represented more than a dozen victims of the man dubbed “Dr. Death” in the media.

“I remember how diligent those patients were in trying to research their doctor,” she said. “And were absolutely lambs led to the slaughter because there was no public information available about Dr. Duntsch.”

It turns out the information about doctors’ pasts does exist — just not for patients.

In 1986, President Ronald Reagan signed the Health Care Quality Improvement Act, which paved the way for the National Practitioner Data Bank. The NPDB is a confidential clearinghouse containing things a patient would want to know in order to make informed treatment decisions — such as whether a surgeon is banned from operating at a hospital and any medical malpractice settlements or disciplinary records.

State medical boards are required to report all that information to the NPDB. The system is designed to protect the public from doctors like Duntsch. However, the public will never get to see it. Only state medical boards and hospitals can access the data bank at a cost of $2.50 for every search.

Van Wey wants it opened up to everyone free of charge.

“Even in the instance if a patient was harmed and they hired a medical malpractice lawyer and a lawsuit was filed and we tried to subpoena that information, by law that is secret,” she said. “And that has got to be changed.”

“The patient has no power,” Van Wey said. “There’s no transparency in healthcare.”

The Federation of State Medical Boards is another resource states, like Texas, rely on to receive notifications about actions in other states. The non-profit proactively provides physician disciplinary records to all states where that person has ever held a license.

If the NPDB ever were to be opened up to the public, it would require an act of Congress. That, experts say, is unlikely to happen anytime soon.

Story continues below… The NPDB is a confidential clearinghouse containing things a patient would want to know in order to make informed treatment decisions — such as whether a surgeon is banned from operating at a hospital and any medical malpractice settlements or disciplinary records.
A diagram of how the NPDB works (Courtesy National Practitioner Data Bank)

Van Wey believes unsealing the Data Bank would help patients make more informed decisions when it comes to choosing a doctor or surgeon. It is especially true, she said, after a KXAN investigation found out-of-state disciplinary actions kept secret on the Texas Medical Board’s website.

“Lack of transparency is killing patients,” said Van Wey. “It’s not if another Dr. Duntsch is going to come along and hurt people. It’s when.”

Some physician groups, like the American Medical Association, oppose opening the Data Bank. Critics argue the information could be wrong, misleading or misinterpreted by the public in a way that needlessly damages a doctor’s reputation and violates their privacy.

The AMA pointed to a Government Accounting Office report from 22 years ago which, at the time, found “serious concerns about the integrity” of the NPDB due to duplicate entries and inaccurate or incomplete data. A better approach, the AMA argues, is to enhance the current state-run reporting systems already in place.

“There needs to be a much better system to get the information to the public,” said Dr. Robert Oshel, a former associate director for research and dispute resolution with the NPDB. He retired in 2008 after 15 years with the agency.

Oshel knows firsthand the information the Data Bank contains. He says the public should, too.

“At the Data Bank, it was very frustrating for me to tell people, ‘We can’t tell you that,'” he said, recalling the phone calls he would get from patients asking for information about their doctor. “We could not tell them. It’s frustrating.”

“If you can’t get full information about [a doctor’s] record,” Oshel added, “you can’t really protect yourself against the very few that are like Dr. Death.”

Digging through thousands of physician disciplinary records from more than a dozen states, a KXAN investigation found nearly 50 doctors who have been disciplined or had their medical licenses suspended or revoked in other states who are still practicing in Texas, or able to, with “clean” records. More than a dozen of them were issued Texas medical licenses after facing disciplinary actions elsewhere.

The TMB says it checks the Data Bank for all new medical license applicants in Texas and when it’s investigating a new doctor. The board also said it was aware of the “vast, vast majority” of cases KXAN identified and brought to its attention, which could suggest it was aware of potential red flags when licenses were issued. The board acknowledged as much, saying previous actions or convictions don’t automatically disqualify someone from getting a Texas medical license because “everything is looked at on a case-by-case basis.”

“As far as, does the [Texas] Medical Board go and review all, you know, 154,000 of our licensees to make sure that they’ve disclosed everything that’s come in?” said TMB Executive Director Stephen Carlton. “That’s something that’s a little more time intensive that the Medical Board has not, in the past, done.”

KXAN asked Carlton where the buck stops when it comes to protecting patients and catching potentially problematic physicians.

“That’s what we’re charged to do here at the Medical Board,” Carlton said. “To help protect the public and get that information out there.”

But Oshel says that information is not getting out to the public. He says patients are the ones who are suffering.

“There’s a lot of improvement that could be made,” he said. “And it’s not just Texas. It’s pretty much everywhere.”

Graphic Artist Rachel Gale, Director of Investigations & Innovation Josh Hinkle, Photojournalist Chris Nelson, Digital Special Projects Developer Robert Sims, Digital Director Kate Winkle and Graphic Artist Jeffrey Wright contributed to this report.