Physicians Should Run a Self-Query in the National Practitioner Data Bank—Here’s Why

The National Practitioner Data Bank (NPDB) is a federal repository of information detailing specific actions against healthcare providers.

It includes settlements and judgments paid by an insurance carrier in your name (you being the defendant).

It includes disciplinary actions by state licensing boards, including public letters of reprimand, probation, suspension, and revocations.

It includes adverse actions against you at hospitals, such as restriction of privileges lasting over 30 days.

And there’s more.

Anyway, for the vast majority of doctors, if you are in the NPDB, you’ll know it. There should be no mystery.

Further, the NPDB is required to notify you of a report.

If you received a notification letter from the NPDB, you are the subject of a report submitted to the NPDB. When a report has been submitted to the NPDB, the NPDB is required to notify the subject. You should review your report to ensure the information is accurate.

This assumes that the NPDB knows how to find you.

Knowing if you are in the NPDB is important so you can answer questions honestly and accurately on new and renewal applications for state licensure, hospital privileges, in-network status with insurance carriers, and more. These organizations have access to your NPDB information. They have an army of credentialing personnel to make sure your answers match up with what is in the NPDB.

If there’s a disconnect between your answer and the NPDB report, your application will likely be delayed or denied.

Here are real world examples of doctors who believed they answered renewal application questions honestly.

“Has a settlement or judgment of a medical malpractice case been paid in your name?”

If you worked for a federal institution, such as the VA, the military, or Indian Health Service, you are a federal employee. If you cared for a patient and they sued you, they were not really suing “you.” They were suing the federal government under the Federal Tort Claims Act. The federal government was the defendant. (By the way, if an active duty serviceman is making a claim, he has a tough road to climb, given the immunity offered to the military – but, assume that it’s a spouse of an active duty serviceman.) You may never know that a suit was even filed. The government can settle the case as it sees fit. These cases often take years to meander through the system. Once settled, the institution will review whether you breached a standard of care. If they conclude you did, they’ll allocate a percentage of that settlement to you (and that allocation can be 100%). While they should notify you of this, you may never learn of this outcome. You may never know that a settlement was paid in your name and reported to the NPDB. While you may have answered your license renewal question honestly (viewed by a subjective lens), you would not have answered accurately (viewed by an objective lens).

Next, you may have been employed by an organization constrained by an employment agreement which allows the employer to settle a medical malpractice case without your consent. You may be long gone by the time such a case is filed. Or settled. And you may never know the outcome. Or you just assumed it’s been 5 years, it likely was dropped. Or no news is good news.

That might all be true.

Or not.

You just don’t know. If such a case was settled in your name and payment made to the plaintiff, a report to the NPDB was almost certainly submitted.

So, I’m making the case to periodically do a self-query of the NPDB.

Here’s the link. https://www.npdb.hrsa.gov/ext/selfquery/SQHome.jsp (Click on “Start a new order.”) It takes minutes and costs under $10.

If there’s an unpleasant surprise, at least you’ll be aware of it. You can dispute an inaccurate report. You can post a subject response to explain “what happened.” At the very least, you’ll be able to avoid an unpleasant surprise when you apply for or renew your license, hospital privileges, or in-network status with payors.

What do you think?