The U.S. Gave Troubled Doctors a Second Chance. Patients Paid the Price.

Indian Health Service hired dozens of physicians with trails of medical mistakes and regulatory sanctions—sometimes to disastrous effect

By Christopher Weaver, Dan Frosch and Lisa Schwartz of The WSJ. Excerpts:

"The federal agency, which provides health care to 2.6 million Native Americans, has given second chances to dozens of doctors with trails of medical mistakes and regulatory sanctions—sometimes to disastrous effect, a Wall Street Journal investigation found."

"The Journal examined 163 malpractice claims against the IHS that the government settled or lost since 2006. One out of four doctors involved in those cases worked for the IHS despite a history that should have raised red flags by the agency’s own standards, the Journal found. At least 66 of the patients died as a result of the alleged malpractice, the analysis found.

Insurance actuaries say U.S. doctors typically have one malpractice claim every 20 years or so. Surgeons and other high-risk specialists have twice that rate. The IHS was willing to hire doctors with many more lawsuits in their past, in some cases more than 10 in less than a decade."

"The Journal found that IHS managers didn’t always make basic inquiries about physicians’ work histories."

"IHS officials hired doctors whom state regulators had punished for transgressions such as drug addiction or sexual misconduct."

"The agency for decades has been criticized by Native Americans and government watchdogs for lax and dangerous care, including by the main U.S. hospital regulator."

"To examine how the IHS screened doctors, the Journal reviewed data from a Treasury Department fund that pays claims against the U.S. government. The Journal then matched those records to federal lawsuits that named 171 doctors—both full-time employees and certain contractors—who plaintiffs alleged were involved in negligent care at the IHS.

At least 44 of those doctors had histories that should have caused concern based on the IHS’s own guidelines, according to medical-board documents, court filings and other records. The guidelines urge managers to screen doctors for multiple past malpractices cases, medical-board sanctions and criminal convictions."

"Because the U.S. government covers malpractice claims, IHS doctors don’t need to carry their own coverage—nor will they pay any settlements out of their own pockets, in most cases. That can make the agency an attractive destination for physicians with past claims."