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Bernard S. Goffen, MD
Veterans Affairs Medical Center Salem, Va

JAMA. 1992;268(24):3429.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The Special Communication on the National Practitioner Data Bank (NPDB)¹ reflects remarkable variability in the reporting of adverse actions involving practitioners' licensure, privileging, and malpractice by the 53 localities providing the raw data accepted for inclusion. For example, the authors speculate on, but provide no good explanation for, the difference by a factor of 10 between the adverse action rates for New York State and Mississippi. Similarly, the clinical privilege action rate varies by a factor of five between Illinois (0.7) and Washington (3.2), Colorado (3.6), or Arizona (3.6).

Considering the lack of uniformity in the laws regulating medical practice in the reporting localities, the variability noted should be expected. At the same time, without evaluating individually each action to eliminate those that fall outside the norm for the United States, the value of the project is compromised.

The following examples of physician censure by the . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Bruce B. Dan, MD, Senior Editor.

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