When doctors get in trouble for repeatedly malpracticing on patients, what do they do? Many mosey down the road and practice elsewhere. That’s because the professional licensing system is a state-by-state patchwork, with a lax and unworkable national reporting system.

The Milwaukee Journal-Sentinel and MedPage Today deserve credit for digging into medical boards across the country to find at least 500 hop-scotching and problematic practitioners including:

• A Colorado doctor, whose care of a multiple sclerosis patient causes four other MDs to complain to the state medical board when the patient died in 2011. The board and the doctor agreed he was “permanently inactivating” his license in 2014, meaning he can’t ever get it back. But the doctor also practices in Florida, where he works with no restrictions, despite malpractice lawsuits from seven other patients in two states, all accusing him of MS misdiagnoses.
• A New York plastic surgeon who had sex with a patient, had his license suspended for three years, and is permanently ordered to have a chaperone present whenever treating any female patients in the Empire State. But he operates free of medical restrictions in Wisconsin, where he was appointed to an endowed chair at the University of Wisconsin-Madison, funded in part by billionaire Diane Hendricks, a patient and major political contributor to Gov. Scott Walker.
• A Missouri hospice doctor, who shows on state regulators’ sites without disciplinary history, nor red flags. But in Illinois, where a medical board official once called him an “imminent danger to the public,” families of three dead patients remain haunted by his “therapies.” He’s still in practice, despite prescribing massive amounts of pre-surgery laxatives to infants and failing to act in the case of an older woman with a blood infection.

The news organizations, stepping back to see common issues among the more than 500 troubling doctors it identified, reported that the single biggest reason that boards took action against these practitioners was for “medical errors or oversights. One fifth of the cases were a result of putting patients in harm’s way. All have slipped through a system that makes it difficult for patients, employers and even regulators in other states to find out about their troubling pasts.”

The National Practitioner Data Bank, a creaky and 30-year-old system (whose home page is shown in photo, above), is supposed to help inform hospitals and state boards about problem doctors, the investigation found, adding:

But it has never been available to the public, provides only portions of troubled medical backgrounds and even state medical boards rarely turn to it. Some officials weren’t aware of the misconduct of doctors licensed in their state until it was brought to their attention by reporters. In an age of transparency and big data, consumers can tap into a wealth of information online to make choices about everything from choosing a restaurant to hiring a painter.  But patients will have a difficult time finding out how many times their doctor has been sued for malpractice, slapped with a disciplinary action or hit with the loss of hospital privileges. They may not even be able to find out if their doctor has been charged with a crime.

It’s also not a good thing when, as the investigation shows, states’ oversight of doctors itself is a hash, a mish-mash that leaves geography a bigger determinant of patients’ protection over common sense. Why do neighboring states like Georgia and North Carolina have such disparities in not only what they demand of doctors and their practices but also how they police them and inform the public of problem practitioners? “Imbalances” in quality controls are greatest in these two states among the 50, say the Journal Sentinel and MedPage Today.

In my practice, I see the major harms that patients suffer while seeking medical services, and it is unacceptable that doctors and hospitals don’t act to rid their profession of its dangerous practitioners.

The doctors’ shift-and-shaft incidences, sadly, are a recurring bane, which flares up not just nationwide, but also regionally and even in a metro area, where a bad doctor can move from hospital to hospital harming patients. It’s also no secret, and a long time unresolved woe, the weak regulation by state medical boards of bad MDs.

Doctors may beef a lot about medical malpractice lawyers like me, and accuse the civil justice system, wrongly and without evidence, of helping to hike health care costs, for example, by forcing higher malpractice insurance prices. They might better spend their time protecting patients and curtailing malpractice costs by busting their bad peers out of their ranks. Physician, heal thyself.