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The problem is that most people don't realize that its relatively easy to for a patient (or their lawyer) to formally notify the state medical board of a complaint. Even billing issues are sometimes investigated by the state board.

For smaller claims, the doctor may settle the case for less than the threshold for listing in the public provider record. The National Practitioner Data Bank [0] is more strict in what gets recorded and doctors can't cover it up as easily.

Doctors and hospitals might try and deny the issue but in some states, if the complaint is substantiated (but the doctor is not formally reprimanded) it still gets noted in the National Practitioner Data Bank. This will be checked by any prospective employers in the future.

In aviation, there is a philosophy that its better to admit a mistake, and learn from it. This is known as the "Asoh Defense" [1]. Doctors could learn a lot from Capt. Asoh. The NASA Aviation Safety Reporting System [2] is for aviators to self-report a safety issue without fear of being violated by the FAA for their admission. There is even an immunity policy for non-deliberate pilot errors.

[0] https://en.wikipedia.org/wiki/National_Practitioner_Data_Ban...

[1] https://en.wikipedia.org/wiki/Japan_Airlines_Flight_2#The_.2...

[2] https://en.wikipedia.org/wiki/Aviation_Safety_Reporting_Syst...




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