

Complaints From a Single Doctor Caused Government to Take Down a Public Database - knowtheory
http://www.propublica.org/article/how-complaints-from-a-doctor-caused-the-govt-to-take-down-a-public-database

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scott_s
Arvind Narayanan (who is also on HN as randomwalker) has published papers and
given many talks about this fundamental concept: "the level of anonymity that
consumers expect—and companies claim to provide—in published or outsourced
databases is fundamentally unrealizable."

It sounds like this is an example of that principle. It's not feasible for the
public database to be both useful _and_ preserve complete anonymity of the
doctors. You can check out much more from his two websites:
<http://randomwalker.info/> and <http://33bits.org/>

~~~
randomwalker
Thanks for the mention.

Unfortunately, all too often regulators and Government agencies take the wrong
lessons from de-anonymization -- remove data altogether, try to ban de-
anonymization, etc. [1] I'm actually visiting D.C. right now with my policy
hat on.

In this case, I think we should be having a conversation about whether
doctors' right to privacy is more important than public interest and patient
safety. Ironically, a major reason why medical practitioners are often against
public data release/reviews etc is apparently because they cannot publicly
refute allegations or bad reviews, which is in turn because of patient
privacy. Sometimes it feels like a morass of bad laws with unintended
consequences.

[1] Recent proposed changes to HIPAA do exactly that, without even an
exception for research.

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pavel_lishin
The headline is technically true, but not very accurate; the database has
since been brought up, but as the article states:

> Nov. 9 - HRSA restored public access to the database, but as many reports
> have noted, it comes with a major caveat. According to the website, users of
> the new database are no longer allowed to combine information gleaned from
> the public database with any other publicly available information in a way
> that would identify doctors. Or in other words, the government is now trying
> to tell the public -- including the press -- what it’s allowed to do with
> publicly available information.

~~~
tantalor
Looks like the NPDB people have added an EULA you must agree to before
accessing the database.

> In order to access the [Public Use Data File], users will now be asked to
> review and agree to a Data Use Agreement (DUA) that spells out specifics of
> how the data provided in the PUF may be used in accordance with the law.

[http://www.npdb-
hipdb.hrsa.gov/resources/publicDataStatement...](http://www.npdb-
hipdb.hrsa.gov/resources/publicDataStatement.jsp)

Users may copy the data, but they can't distribute it.

> Not repost the dataset and only report, disclose or post data from the
> dataset in connection with statistical reporting or analysis that does not
> identify any individual or entity.

<http://www.npdb-hipdb.hrsa.gov/resources/publicData.jsp>

~~~
rsingel
As a reporter, I can only say that EULA makes me want to start digging in that
database.

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nickand
I got a nose job and now I can't breath as well. Of course there was a risk,
but if I would have known it would be this bad I never would have done it. The
doctor did everything he could to reassure this wouldn't happen before the
operation. Now I am having a very difficult time figuring out what if anything
I can do medically and legally. My life is very different.

Doctors should not get anonymity. Their job is too crucial. I'm not dead, but
my life will never be the same. Anything that could have changed that would
have made a huge difference in my life.

Also, if you're wondering the doctor was in Beverly Hills and fairly famous.
This was no back alley procedure. At the moment I really feel like my whole
world collapsed and with the way we treat doctors I feel like no one is on my
side.

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sanderson1
A can see both sides of this story. I do want to make one thing clear. I think
any public information is just that—public. There shouldn't be restrictions on
how it is used other than in purposely misleading ways, which is probably how
this doctor viewed the release of the information related to his medical
background. I think the reporter was completely justified in what he did. I
don't believe he was on some kind of witch hunt, out to destroy this doctor's
career. From the sounds of it, he's doing a pretty good job of that himself.

On the flip-side, just because a doctor is sued for malpractice doesn't mean
he's guilty of malpractice. I'm not familiar with the database, but if it
doesn't list the outcomes of malpractice suits, it should. Simply saying a
doctor has been sued 16 time for malpractice doesn't tell the full story. But
in this case, him settling almost half of those cases, in my mind, does admit
some level of guilt.

Do I think the doctor is right in wanted the use of this information
restricted? No. Do I think he deserved discipline from the Medical Board?
Probably. Do I see how inaccurately presenting information can hurt innocent
people? Absolutely.

I'll go back to what I started with. Public is public. Just tell the full
story. (which, by the way, I think was done fairly well in the article)

~~~
mazelife
Agreed. The reporter's story is well-written, tries to be fair, but definitely
takes a point of view. And that's OK; I think it's a good piece of public-
interest journalism.

Sadly, the malpractice thing isn't as clear cut as you'd hope. The choice to
settle a claim is usually made by the insurance provider, regardless of the
wishes of the physician, so a settlement doesn't mean anything per-se: the
insurance provider decides whether to settle by weighing a lot of factors,
including many that have nothing to do with the actual facts of the case. A
court of law—particularly in a jury trial—may not be the fairest way to
adjudicate these issues, but the AMA routinely attempts to block any other
proposals for holding doctors accountable (see the story: they supported the
removal of the database as well) so malpractice suits and the occasional
newspaper story are what we're left with in policing these docs.

~~~
sanderson1
Thanks for the clarification. I didn't realized the role insurance companies
played in malpractice settlements. I agree with knowtheory above, fight facts
with facts and tell the whole story. It makes it really hard when people are
actively trying to hide information that could be of interest to the public.

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radtad
As an aside: HealthGrades, a health care ratings site, seems to think a
certain Dr. Robert T. Tenny, MD from Kansas is clean as a whistle:
[http://www.healthgrades.com/physician/dr-robert-tenny-
xt5b4/...](http://www.healthgrades.com/physician/dr-robert-tenny-
xt5b4/background-check)

~~~
mkopinsky
Has anyone ever found value in these sites? I have tried to use them to look
for a doctor or the like and have invariably found them to be total junk.

