Do your research about your doctor or hospital

Doing research before you get healthcare is important.  Why?  Because the quality of care that you receive can differ based on the doctor or hospital that you choose.  According to a 2016 study by Johns Hopkins, medical error is the third leading cause of death in the United States. It accounts for 10% of all deaths nationwide.

 How do you research your Georgia Physician?

LOOK THEM UP

You can “Look Up a Licensee” on the Georgia Composite Medical Board’s website

  • You can search by provider type and city, last name, or license number.
  • For active licenses, physicians’ profiles will show you:
    • When they were licensed in Georgia
    • How long they practiced in their current location
    • Whether they accept Medicaid patients
    • Where they went to medical school
    • Hospitals where they have admitting privileges
    • Disciplinary actions taken by licensing boards and hospitals (includes loss of hospital privileges); only covers action taken after April 11, 2001
    • Felony convictions
    • Medical malpractice information, including arbitration awards and lawsuit settlements
    • Awards they have won
    • Foreign languages they speak
  • Some information in the physician’s profile (including criminal charges and malpractice claims) is provided by the physician.

COMPARE THE PHYSICIAN’S SERVICES WITH YOUR NEEDS

  • Websites like healthgrades.com, allow you to see how patients have graded doctors and hospitals in your area.
    • You can search by specialties or procedures.
      • For example, if you search for “family medicine” or “gastric bypass surgery,” you will get a list of doctors who practice near the zip code you entered.
      • You can further narrow your search by insurance, distance, and gender.
    • You can also search for specific physicians.
      • Physicians’ pages will show you much of the same information found on the Medical Board’s website, such as education and malpractice claims.
      • It will also give you a summary of patient ratings of the physician’s:
        • Trustworthiness
        • Helpfulness, and
        • Staff
      • It also allows you to compare doctors with similar experience in the area.
  • Medicare.gov also offers a physician comparison tool:
    • This tool allows consumers to “search another way,” by selecting your gender, problem area, condition, specialty, and location to find a physician.
  • Pro Publica’s Surgeon Scorecard gives you comprehensive information about specific types of surgeries in a location (zip code, city, state), including how many hospitals perform that type of surgery and how many have at least one surgeon that has a high rate of complications.
    • It also has information on specific physicians, including what procedures they perform, how many times they’ve done them, and their rate of complication.
    • Information on specific hospitals includes overall data on complications by procedure and specific information on the surgeons in that hospital.

HOW TO FIND THE RIGHT FACILITY/HOSPITAL FOR TREATMENT

There are online resources available to help you choose the best facility for the care that you need.

  • Hospital Quality and Safety: The Leapfrog Group
    • The Leapfrog Group is a national nonprofit started by employers and other purchasers of healthcare to evaluate quality and safety in U.S. hospitals.
    • Georgia Watch is the Leapfrog Group Regional Roll-Out Organization for 21 hospitals in the metro Atlanta area.
    • You can go on the Hospital Safety Score website to find hospital safety scores for many hospitals in your area.
    • You can also compare hospitals on this website  and find information from self-reported responses to an annual hospital survey.
      • There you can see very detailed information about hospital safety broken down:
        • C section rates
        • Mortality rates for high risk surgeries
        • Nurse staffing
        • Policies that are in place to prevent errors, such as medication errors
        • Information how well the hospital prevents infections (for example, handwashing policies).
  • US News and World Report allows you to find information on specific hospitals and also has a “Best Hospitals” national ranking.  A hospital’s page shows:
    • Patient recommendations
      • Includes breakdown of factors like communication and attentiveness
    • Awards it has won
    • Ratings of complications and mortality in various specialties
      • Also compares these ratings to national average
    • Patient risk ratings
      • Says whether they are (1) better than expected, (2) as expected, or (3) worse than expected based on the national average.
    • List of the physicians at the hospital that you can filter by specialty

 WHAT TO DO IF SOMETHING BAD HAPPENED WITH YOUR CARE? HOW/WHERE DO YOU REPORT IT?

  1. First, tell the physician or hospital/facility.
    • Contact the provider or hospital/facility responsible for the questionable care. Contact information is generally available on the hospital’s or physician group’s website. Relay your concerns to the provider or members of the hospital’s administration.  They may not be aware of your situation and may take steps to resolve your concerns.
  2. File a complaint.  Complaints about your doctor or hospital for improper care, or unsafe conditions can be filed with your state licensing board or department of health services. For more information on where to submit your complaint, please visit this website.

Filing a Complaint in Georgia about a licensed professional

The State of Georgia has established various boards whose purpose is to oversee the health professions and to set and enforce standards for licensure.  All complaints must be sent to the appropriate board for review. The Georgia Secretary of State’s website lists all of Georgia’s Professional Licensing Boards and gives information on how to contact them.

  • If you believe a doctor, physician assistant, physician resident in training, acupuncturist, auricular detoxification specialist, perfusionist or respiratory care professional, orthotists or prosthetists licensed by the Composite Medical Board has violated provisions of the Medical Practice Act, has acted in a manner that is considered “unprofessional conduct,” or has provided a level of care that would fall below the minimum standard of care, then you may have the basis for a complaint. You may file complaints online or by mail. Please visit this website for more information.
  • A nurse’s practice and behavior is expected to be safe, competent, ethical and in compliance with the Georgia Nurse Practice Act, Board rules and other applicable laws.  If you believe that there is a problem with a nurse, you may file a complaint with the Georgia Board of Nursing. Please visit this website for more information.

Filing a Complaint about a Hospital in Georgia

  • If you believe you received poor quality care from the licensed facility or program, you have the option of filing a complaint online against a facility or program licensed through the Division of Healthcare Facility Regulation at this website, but the online portal is unavailable at this time. To file a complaint about a licensed health care facility or service provider, you can call 1-800-878-6422.

What you can report to Medicare?

  • If you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan, you can file an appeal at this website.

Sentinel Event Reporting

  • The Joint Commission, a hospital accreditation organization, implemented a policy in 1996 requiring careful investigation and analysis of Patient Safety Events (events not primarily related to the natural course of the patient’s illness or underlying condition), as well as evaluation of corrective actions, to reduce risk and prevent patient harm. If you believe you have experienced a “sentinel event” as defined on their website during the course of your care, and the event was not reported, you may contact a Joint Commission representative at this website.

If you believe that you experienced serious negligent harm from a provider, you may also want to consult with a medical malpractice attorney.

Georgia Watch does not give legal advice or representation to individuals or organizations.  If you need legal advice specific to your situation, you should consult with a licensed attorney.