Q&A with Alan Bavley: Finding Gold in the National Practitioner Data Bank
Here's the second part of my conversation with Kansas City Star health care reporter Alan Bavley, also known as the reporter who kicked the doctor's nest. The first part ran on Wednesday and caught a lot of attention on Twitter this week, thanks to help from folks at the Association of Health Care Journalists, ProPublica, Embargo Watch, Open Missouri, and Consumers Union, among others. The second part is below.
Q: When did you first hear from the Department of Health and Human Services?
A: Aug. 26.
Q: This was with the letter they sent you. What did you do when you saw that threat about the fine?
A: If you read the letter from the Department of Health and Human Services very carefully, it really isn't a direct threat. But it certainly put me on notice. And my first reading of the letter, after scanning it to the "could be subject to a civil monetary penalty," wasn't all that careful. The letter came as a complete surprise. I've been a reporter for many, many years and had never encountered anything like it before – a government official who knew details of my unpublished story and citing federal regulations that might apply to it. I shared the letter with several people internally and externally in order to gain some (calming) perspective and confidence that I should proceed with the story as written.
Q: I have read the letter, and I think, at a minimum, it is an attempt at prior restraint. The agency is using the $11,000 fine as a threat of something that you could incur should you use the NPDB to expose any doctors contained in the database. Maybe I'm not being generous enough. What other purpose might the department have had in sending you that letter?
A: I can see how the letter can be interpreted as an attempt at prior restraint, and we did have that discussion in the newsroom. I can only speculate as to what other reasons the NPDB may have had to send me the letter, but the fact that it was copied to Robert Tenny might offer a clue. Perhaps they were trying to placate Tenny by offering him evidence that they were playing hardball with me. Just a theory.
Q: It's always tough, as a newspaper reporter, to put yourself into the story. It feels uncomfortable. What made you decide that you had to become part of the story?
A: I take issue with the premise of your question. I never decided to be part of this or any other story. I'm an old-school newspaper reporter. You report on others, not yourself. I was thrust into this. That was inevitable, I suppose. It was I who triggered a series of events that became newsworthy. But I would not want to become the focus of this imbroglio. Yes, I did receive an inappropriate and basically weird letter from a federal official. But what is most important is that a federal agency is now denying the public access to important information concerning patient safety. We should not lose sight of that.
Q: Now that IRE has made the old Public Use File available for reporters, what would be your tips for reporters hoping to pursue stories similar to yours?
A: First of all, you should have serious data base skills, or team up with someone who does. The public use file is massive and unwieldy and unfriendly to novices. Second, have hypotheses you want to test. (In my case it was doctors with multiple malpractice payouts go undisciplined in Kansas and Missouri.) You can go fishing in the data base, but you may waste a lot of time that way. And if you want to identify doctors in the data, you'll need enough outside information, mainly court records, to triangulate.
Q: What great stories do you think are still left untold in the NPDB?
A: The story I wrote could probably be done in many other states. There may be stories to be done on how hospitals do or don't take away staff privileges. There may be stories on how much is actually paid out in different states on malpractice claims compared to the cost of malpractice insurance premiums, particularly relevant if local doctors are complaining about rate increases. I'm just throwing out ideas. I'm sure other reporters can find more creative uses for the data.
Q: How does it feel to be the poster boy of the moment for free speech?
A: Uncomfortable. As I said before, I never wanted to be a focal point of this situation. Yes, I did feel a few moments of anxiety and the Star burned some extra work time and billable hours with our attorney dealing with this. But we haven't been penalized. We haven't suffered in any way making government information public. Others have. If you're going to have posters, make them your subject.
Related Posts:
Q&A with Journalist Alan Bavley: Keeping Track of Medical Malpractice Frequent Fliers
We Are All Alan Bavley: How to Get HRSA's Attention on Doctor Database
The Reporter Who Kicked the Doctor's Nest
Secret History: Five Tips from the Kansas City Star's Malpractice Investigation