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When we go to the doctor, we assume he knows what he's doing. The white coat, the diplomas on the wall, all give us the sense that he's skilled and trustworthy. But sometimes that's not the case. A physician may be incompetent, even dangerous, and patients not know it, because disciplinary records on doctors are typically off limits to the public. Andrew Holtz reports on the deadly fallout from that secrecy and how some in Congress are trying to change the system.

ANDREW HOLTZ: Michael Swango was a popular doctor who had a way with people. He also may have had a way with murder. He's suspected of giving perhaps dozens of hospital patients lethal injections.

JAMES STEWART, AUTHOR, "BLIND EYE": He is a psychopathic serial killer. He also happens to be a medical doctor who repeatedly found employment in hospitals.

ANDREW HOLTZ: Journalist James Stewart followed Swango's career path and a trail of suspicious deaths across Ohio, Illinois, Virginia, South Dakota, New York and even Africa. In his book: "Blind Eye: How the Medical Establishment Let a Doctor Get Away With Murder" Stewart writes that warning signs, and even Swango's conviction for injuring co-workers by slipping poison into their tea, all were swept under the rug.

JAMES STEWART: That's what really stunned me, was how could this happen, and I think the answer lies, as that subtitle suggests, in the way that the medical establishment polices its own ranks, or in this case, failed to police its own ranks.

ANDREW HOLTZ: Many doctors refused to believe the worst allegations against Dr. Swango, Stewart says, and when concerns arose they couldn't ignore, they quietly helped him go on to other hospitals.

JAMES STEWART: They wanted to get Dr. Swango out of their hospital, they didn't want their patients to be at risk, but they didn't want to call any attention to it, and they didn't want to be sued.

ANDREW HOLTZ: Swango's case is extreme. But other dangerous doctors have recently made headlines and gotten the attention of Congress.

One patient says her surgeon carved his initials into her abdomen after a C-section. The surgeon was suspended but then went right on working at another clinic.

SEN. RON WYDEN (D) OREGON: Very often, when you have one of these small number of incompetent people, that they are extraordinarily slippery and evade the disciplinary authorities.

ANDREW HOLTZ: Democratic Senator Ron Wyden told Congress that legislation he helped draft a dozen years ago was supposed to pin down problem physicians by putting them into a national data bank.

Anytime a doctor is severely punished by a hospital, professional group or licensing board, or has to pay a malpractice judgment, a report is supposed to go into the national practitioner data bank. Then hospitals are required to check the data bank for information on their staff or any new hires. But don't try looking for a report on your physician, because the national data bank is closed to patients.

REP. THOMAS BLILEY (R) VIRGINIA: As we all know, knowledge is power. When consumers have accurate information, they are able to make sound health care choices.

ANDREW HOLTZ: Now influential Republicans are joining Wyden in pushing to make the files public.

SEN. RON WYDEN (D) OREGON: There is no logical argument for keeping information about proven flagrant cases of professional misconduct from the public.

ANDREW HOLTZ: But doctors worry the reforms could go too far.

ROGER ROSENBLATT, MD, UNIV. OF WASHINGTON SCHOOL OF MEDICINE: I think it would have a disastrous effect.

ANDREW HOLTZ: Dr. Roger Rosenblatt has studied the data bank. He found many hospitals may not be reporting problem doctors and he predicts that greater public scrutiny would cause them to cover up even more.

ROGER ROSENBLATT, MD: Backfire is a very good word. It is a well-intentioned program, but the side effect, like with a medicine, can be so bad that you don't want to use the medicine.

ANDREW HOLTZ: Rosenblatt worries that data bank reports could become ammunition for eager malpractice lawyers and that good doctors might be unfairly blamed for unavoidable problems. So instead, he wants to see a reporting system like the airlines use.

ROGER ROSENBLATT, MD: It isn't necessarily the pilot that's at fault. It may be the radar, it may be the instruments, it may be the weather reporting system. We need that analog in medicine, and we need it badly.

ANDREW HOLTZ: James Stewart thinks the data bank could work, but it needs to be overhauled.

JAMES STEWART: If it was comprehensive, if it covered all doctors and if there were provisions, sanctions which required hospitals to comply with it, I think it could in fact protect us from the Swangos of the future.

ANDREW HOLTZ: Michael Swango is in prison now, but only for lying on a job application. He hasn't been charged with any of the suspected murders. If he isn't charged, he'll soon go free.

JAMES STEWART: I think it's safe to say that there's a high probability, if he's released from prison, the death toll will resume again.

SHARYL ATTKISSON: Pretty frightening. So, how do you go about checking out your doctor? To find out if a company is legitimate, you can call the Better Business Bureau. And if you have questions about a lawyer's record, the American Bar Association can help. But getting information on a doctor can be a lot trickier. In most states, the medical board can tell you if the doctor is licensed to practice and not much else. But as our Bob Bates found, more information is available if you know where to look.

BOB BATES: Nancy Achin Sullivan heads up the Massachusetts Medical Board. She came to the job with an impressive resume. She's been a state senator and a successful businesswoman. But she says what prepared her most was her experience as a cancer patient - three times.

NANCY ACHIN SULLIVAN, MASSACHUSETTS MEDICAL BOARD: I am here because I have had great medical care, but I have also seen what happens when people don't have the information they need to make good decisions and they aren't getting the help and support they need from the medical community.

BOB BATES: Sullivan's agency offers that help on the Web, through a site that provides information about all Massachusetts doctors.

NANCY ACHIN SULLIVAN: This is a way for the right doctor and the right patient to find each other again.

BOB BATES: Patients looking for the right doctor can log on and find out everything from where she went to school to whether he's been disciplined by a hospital. Information you can use to interview the doctor.

NANCY ACHIN SULLIVAN: Take this document and say, "Gee doctor, I see you went to this medical school and you trained here - what did you learn there? Tell me what you learned there that is meaningful to my diagnosis."

BOB BATES: The site even tells you whether a doctor has had to pay out for malpractice and if the amount is above or below average for his specialty. Some argue that malpractice information can be misleading, but Sullivan says it can be helpful, if used the right way.

NANCY ACHIN SULLIVAN: I think it is fair to say, "Dr. Smith I see that you have a malpractice payment. Talk to me about what could go wrong, what you've learned from this and how can I make sure nothing goes wrong with me."

BOB BATES: The consumer advocacy group, Public Citizen, which publishes the book "Questionable Doctors" says more states need to put on line what they know about their doctors.

SIDNEY WOLFE, MD, PUBLIC CITIZEN: This is a fairly simple way. It's really inexcusable that all the states don't have this information up.

BOB BATES: A recent survey by Wolfe's organization found that of the 41 states providing doctor data on the Web, all but a few leave out what he considers to be essential information.

SIDNEY WOLFE, MD: Information such as malpractice pay outs against doctors, hospitals throwing doctors off the staff or disciplining them because of poor medical care. There are only a couple of states that have that kind of information up.

BOB BATES: And none of these sites give consumers information on physicians from other states - or those who move from state to state. Now several commercial sites are trying to fill that void. You pay a fee - they do the check. One such company is For ten dollars it will scour a physician's record for problems he or she might have had with hospitals or medical boards anywhere in the country.

Charles Inlander of the People's Medical Society thought the service valuable enough to endorse it.

DR. CHARLES INLANDER, THE PEOPLE'S MEDICAL SOCIETY: It's not the only thing health care consumers should do in terms of researching a doctor, but it's a one-stop place to find out the vast majority of the information you'd like to know about a doctor before you use them or before you continue using them.

BOB BATES: Whether it's through a commercial site or the one she runs in Massachusetts, Nancy Sullivan says the information makes a difference: "Since you are a cancer survivor, have you heard from people who have used the web site and have succeeded in finding a good doctor?"

NANCY ACHIN SULLIVAN: "Oh, hundreds and hundreds."

BOB BATES: For Sullivan, who also lost a sister to cancer, it's not about weeding out bad doctors. It's using the information to find a doctor who's right for you.

NANCY ACHIN SULLIVAN: Part of it makes me sad that that information wasn't there when I got sick or when my sister got sick. Did we do everything we could have done? And nobody should face life-threatening diseases with doubts.

SHARYL ATTKISSON: Michael Swango has been in prison, but only for lying on a job application. He was recently charged in several patient deaths, and is awaiting trial. He insists he's innocent.

For more on checking out your doctor or any other HealthWeek story, you can call our toll-free number, which we will give to you at the end of the program.

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