Discussion of the databank is part of a larger debate over medical errors and the quality of care. Many H.M.O.'s have adopted clinical guidelines to ensure that doctors follow the best practices for diagnosing or treating specific conditions. H.M.O's assume that hospitals and physician groups will evaluate the quality of care and report incompetent doctors, but that assumption is often unjustified, the report said. H.M.O.'s and hospitals cannot be sued for errors they investigate and properly report. But if they fail to report discipline involving those errors, the government may remove the legal protections, a penalty that is rarely invoked.
Doctors evaluate colleagues in a peer review process.
Senator Wyden said consumers ought to have access to information in the databank about flagrant misconduct by doctors. But doctors and hospitals say such disclosures would make it impossible to discuss errors and misconduct candidly in the rigorous peer review process because of the fears of lawsuits. State medical boards license and discipline doctors, but they differ in how aggressively they investigate questionable doctors and in how much information they make available to the public or the databank.