Description
The National Practitioner Data Bank (NPDB), or "the Data Bank," is a confidential information clearinghouse created by Congress with the primary goals of improving health care quality, protecting the public, and reducing health care fraud and abuse in the U.S.
Doctors and other individual healthcare providers are responsible for reporting most of their significant problems to NPDB. These include:
- Hospitals and other health care entities that follow a formal peer review process
- Medical malpractice payers (including hospitals and other health care entities that are self-insured)
- Professional societies that follow a formal peer review process
- State Licensing and Certification Authorities (including State Medical and Dental Boards)
- Private accreditation organizations
- Peer review organizations
- State law enforcement agencies
- State Medicaid Fraud Control Units
- State agencies administering or supervising the administration of a state health care program
- Federal government agencies (including the Drug Enforcement Administration and the HHS Office of Inspector General)
- Health plans
Those organizations are required to report the following actions into the NPDB:
- Medical Malpractice Payments
- Adverse Clinical Privilege actions
- State licensure and certification actions
- Federal licensure and certification actions
- Negative actions b a peer review organization
- Negative actions by a private accreditation organization
- Exclusions from participation in a federal or state healthcare plan
- Other adjudication actions taken by a government agency or health plan
- Health care-related civil judgements and criminal convictions in Federal or state court
- Criminal convictions
Essentially, this is the national database for doctors when they do something really wrong. It is intended to allow payers, hospitals and other providers to protect the public from the harm that bad providers might otherwise do, while giving doctors who make mistakes but who are "otherwise good doctors" a modicum of privacy and protection.
There is a Public Use File available for this dataset (which we link to below). However, the usage agreement for this data file now requires that you not link the data with other data sets. Essentially neutering the usefulness of the data set, and ensuring that even the de-identified version of the data, does not actually qualify as "open data". Previously, this data set had been open.
A reporter named Alan Bavley was doing a report on a doctor named Dr. Tenny, who had a huge number of issues in his NPDB file. As the result of Dr. Tenny's complaints, the PUF was briefly pulled and when it was restored it as behind the restrictive data use policy mentioned above. The details make a fascinating story, well documented in
How Complaints From a Single Doctor Caused the Gov’t to Take Down a Public Database by Marion Wang at Propublica. The issue is also well-covered by Pia Christiansen at AHCJ in
Secrecy around data bank protects 'Practitioner No. 222117'. Of course you should read Alan Bavely's comments on the matter too:
Secrecy protects doctors with long histories of problems
As a result of the controversial content and aim, as well as sometimes poorly justified policy stances like the one around the PUF, the NPDB is one of the most debated data sources in the United States.