What Residents Should Know About the NPDB

Team of surgeons at workWhile you are likely aware of the National Practitioner Data Bank (NPDB) in a broad sense, it is not something that would typically apply to you while you are in training. However, though residents and trainees are rarely named in a report, certain harmful clinical actions that take place outside of the scope of a formal graduate educational program (e.g., moonlighting in the intensive care unit) must be reported by law by the entity.

Here, we share useful, timely information for you and your fellow residents about the NPDB, the confidential information clearinghouse created by Congress in 1986; obtaining an NPDB self-query, reviewing and responding to a report; and more.

What is the NPDB?

As stated on its website, the NPDB was founded to improve healthcare quality, protect the public, and reduce healthcare fraud and abuse in the United States. It is a federal web-based repository of reports that contain information on adverse actions associated with physicians and other healthcare practitioners, medical malpractice payments, and healthcare-related judgments or convictions. As of May 2017, the NPDB houses 1.3 million reports.

“Running a report provides a way for hospitals and other healthcare organizations to see if a clinician has any negative feedback or ‘dings’ on his or her license(s),” says Maureen Locke, director of credentialing, state license, and travel at Medicus Healthcare Solutions (Medicus). “If, for instance, a provider was terminated from a facility, has malpractice problems, or has issues from a licensing standpoint, this information will appear on that report.”

Owing to the NPDB, practitioners who have been named in a report by, say, a healthcare entity or state agency are unable to move to different states to practice without disclosure or discovery of previous damaging performance. Practitioners and organizations identified in a report are granted access to their own information, which is not available to the public.

How can I find out if I have been named in a report?

You can place a self-query order, which is a search of your information in the NPDB database. The cost of a self-query is $4 as of this writing in July 2018. After completing the required steps on the NPDB website and agreeing to the terms in the Rules of Behavior and Subscriber Agreement, those who order a self-query receive their results in both an online response and a sealed letter via regular mail.

“Every practitioner has a report, even right out of residency, though it may not contain anything detrimental,” says Locke. “Medical staffing offices (MSOs) and other entities query for reports on practitioners during their licensing, credentialing, and hiring processes. I think it is a great idea for residents to obtain theirs before they complete training as it would probably be helpful for them just to see what a report looks like.”

According to the NPDB website, practitioners will receive a notification letter when an entity submits a report about them. It will contain the report number as well as a password, which is required to view the report.

How often should I do a self-query?

Although you will be notified when a reporting organization names you in a report, you may want to place a self-query order every so often to ensure you are recognized in good standing professionally, particularly as the cost to conduct one is quite reasonable.

Whether you are planning to look for a permanent position or work locum tenens, it would be prudent to ensure your information in the NPDB is accurate.

“It is useful to have the report ahead of time in either case,” Locke conveys. “If you are looking for a permanent opportunity at a facility, its MSO is going to run one, so you’ll want to make sure it correctly reflects your experience. And if you plan to take locum tenens jobs, you need to know if an entity has named you in a report. Medicus and other healthcare staffing companies are not sanctioned to run NPDB searches on providers. But it is invaluable for us to have that information before we present you for assignments.”

Can I dispute a report?

Yes. In fact, as stated by the NPDB, there are a few things you can do if you are not in agreement with information provided in a report:

  • Get in touch with the entity that filed it. While a report can be edited only by the organization that submitted it, you can contact them in hopes of resolving your dispute and having any misinformation corrected or modified.
  • Give your perspective by adding a subject statement. At any time, you can write a statement providing additional information. It will be sent to all entities that received the report and included with all future queries.
  • Visit the NPDB site to place the report into Dispute Status. It will become part of the report, and the reporting entity and any queriers from the past three years will be notified.
  • Elevate to Dispute Resolution. You can do this if 60 days have passed from the time you placed the report into Dispute Status and contacted the reporting entity. Dispute Resolution will address only the factual accuracy of the report or whether it was presented in keeping with NPDB regulations.

Call Medicus Healthcare Solutions at 855.301.0563 to explore locum tenens opportunities with an experienced recruiter, and read our blog for tips, the latest news and trends, and other helpful information.

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