MEDICAL incompetence is a twofold problem for this nation's citizens. It subjects patients to unwarranted risks and poor outcomes, and it contributes to higher payments for health care owing to increased liability awards and premiums with the consequent practice of "defensive" medicine.1-3 In addition, it interferes with the availability of necessary medical services.4-6 Currently, these issues are being discussed as part of the debate surrounding reform of the health care system in the United States.
The Health Care Quality Improvement Act (HCQIA) of 1986, however, established a legal base and a national reporting system intended to improve the ability of the health professions to police themselves.7 The act's principal program, the National Practitioner Data Bank (NPDB), is designed to collect comprehensive data on adverse actions taken against and malpractice payments made on behalf of practitioners and make them available to credentialing authorities. The NPDB opened on September
Mullan F, Politzer RM, Lewis CT, Bastacky S, Rodak J, Harmon RG. The National Practitioner Data BankReport From the First Year. JAMA. 1992;268(1):73-79. doi:10.1001/jama.1992.03490010075033