Every Massachusetts patient has the right to assume that every doctor practicing in this state is in good standing with the state Board of Registration in Medicine, the division of the Massachusetts Health and Human Services department responsible for doctor licensing and discipline. Being in good standing with the Board, however, does not mean the physician has never been the subject of a medical malpractice complaint — or even multiple claims — but there is no basis for the Board to respond.

As a recent investigation by WBZ-TV Boston found, many doctors in Massachusetts who have been accused of extremely grave malpractice, such as failure to diagnose a serious illness, or obstetrical malpractice resulting in birth injuries, are still eligible to practice medicine in the state because they settled their cases out of court.

“A malpractice suit is not proof of substandard care, it’s an allegation,” pointed out the Board’s executive director. “And since most of those are settled – 96 percent of them are settled – that doesn’t give any determination if there was wrongdoing or not.”

When doctors and hospitals settle medical malpractice cases out of court, they generally do not face any disciplinary action by the Board of Registration in Medicine. In some cases, that could mean that a physician who has committed a serious medical error that significantly injured a patient could legally continue practicing medicine.

This is because a legal settlement is basically a private matter. The Board can only act upon the basis of complaints, and when most medical malpractice claims are settled, the doctor or hospital involved does not admit to any wrongdoing.

Here are some interesting statistics from the WBZ-TV report:

Of more than 16,000 doctors whose records were reviewed by WBZ-TV, 654 had settled one or more malpractice claims out of court in the past 10 years.

Of those 654 doctors, only 6 — less than 1 percent — faced any discipline from the Board.

The reporters found 14 doctors who had settled three or more malpractice claims in the last 10 years. None of them had faced disciplinary action.

The Board of medicine has disciplined 51 doctors, on average each year, since 2006.

Whether or not you believe the Board should be allowed to initiate discipline based on medical malpractice settlements that result in no admission of wrongdoing, far too many patients are suffering the tragic consequences of doctors’, hospitals’ and other health care professionals’ negligence.

WBZ-TV, for example, profiled the case of a baby boy who lost access to oxygen while in his mother’s birth canal. When the baby was finally freed by a vacuum extractor, he was not breathing. The parents of this infant claimed that their doctor committed medical malpractice by failing to immediately order a cesarean section in response to this medical emergency. He waited, and the infant’s organs began to fail before he could be extracted.

That doctor has settled the resulting birth injury claim, along with two other malpractice claims. He has never been disciplined by the Board of Registration in Medicine.

Perhaps a pattern of settled claims should be a red flag that tells the Board to take action? Should Massachusetts change the rules of how medical malpractice settlements are taken into account in physician discipline?

Source: CBS Boston, “I-Team: Medical Malpractice Overlooked in Massachusetts?” Kathy Curran, Feb. 23, 2012