Last week was a busy week for New York’s Governor David A. Paterson on issues often written about in this blog – medical malpractice, dangerous drugs, defective toys and sexual predators using the internet. Some bills were signed, others introduced. The most ambitious of these was on the medical malpractice front, Governor Paterson proposed legislation that offers more transparency for patients and tougher professional discipline for physicians; enhanced infection control requirements will facilitate the prevention of and response to infectious disease transmissions. Part 1 will discuss this legislation, Part 2 the others. The information herein is set forth in press releases issued by the governor’s office.
The Governors Program Bill will boost the physician disciplinary system and increase the authority of the Department of Health (DOH) in epidemiological investigations while also giving consumers access to more information about physicians, particularly those charged with misconduct.
Under the current system of professional discipline, the State Board for Professional Medical Conduct (Board), located within the DOH, investigates allegations of misconduct by physicians, physician assistants and specialist assistants through the Office for Professional Medical Conduct (OPMC).
If OPMC recommends that charges be filed, licensees may request a hearing, and substantiated charges may result in penalties, including the revocation or suspension of a license. This bill will enhance the existing system of professional discipline as follows:
- Identify potential misconduct by requiring OPMC to continuously review information about medical malpractice claims and payouts.
- Increase referrals to OPMC by requiring health plans and managed care organizations to report the termination of a physician contract premised on impairment or misconduct and require courts to report sentences imposed against physicians for criminal activity.
- Require the Board to make charges public when they are served upon a physician and make professional discipline hearing determinations public when issued. A statement advising that the charges or determinations are subject to challenge by the physician will accompany the charges.
- Require physicians to more regularly update their physician profiles which contain information such as educational background, practice area, and legal actions (which are available to the public at www.nydoctorprofile.com ) by making these updates a condition of re-registration. Information about licensure actions is available through a link to the OPMC web site. The bill will require physicians to post in their offices an official OPMC poster containing information on how to access physician profiles and OPMC disciplinary actions.
- Require physicians who have lost their right to practice medicine to take steps to safeguard and make accessible the medical records of their former patients.
- Allow OPMC in certain circumstances to more easily obtain a physicians own personal medical records if there is reason to believe that he or she may be impaired by alcohol, drugs, physical disability or mental disability.
- Authorize the Board to require an objective, impartial evaluation of a physicians competency when called into question.
The bill also addresses public health issues concerning communicable diseases and infection control by increasing the States ability to disseminate information, enhance enforcement and training. The bill will:
- Authorize DOH to disclose information to the public as needed regarding public health threats that come to light in the course of an OMPC investigation, notwithstanding otherwise applicable confidentiality provisions.
- Authorize DOH to direct a physician to cease any activity uncovered during a communicable disease investigation that constitutes an imminent danger to health.
- Facilitate communicable disease investigations by providing that a failure to respond to communications, or provide records requested by the State or local health department in conjunction with such investigation, constitutes professional medical misconduct.
- Require physicians who practice in certain office-based surgery settings to report the transmission of health care disease upon learning of the transmission.
- Provide that course work or training in infection control practices, already required for physicians, physician assistants and specialist assistants, must also be completed by every medical student, medical resident and physician assistant student. The bill would also require that documentation of such training, which must be provided to DOH under current law, also attests to the practitioners competence in the course content.
- Require DOH to conduct a study and issue a report by January 1, 2009 as to whether restricting the use of multi-dose vials for the packaging of medications and requiring the use of disposable medical equipment engineered for single use is viable.
The issues of multi-dose vials and relaxation of privacy restrictions to permit the dissemination to the public of health threats received much publicity when it was revealed that the DOH had been investigating Dr. Harvey Finkelstein for three years before it disclosed that Dr. Finkelstein had caused two of his patients to become infected with hepatitis C and sent letters to 628 of his patients that they were at risk for transmittal of hepatitis B and C and HIV and should be tested.