Access to Enforcement and Disciplinary Data: Information Practices of State Health Professional Regulatory Boards of Dentistry, Medicine and Nursing
Strong, Denise E., Journal of Health and Human Services Administration
This article reports on a study of public access to enforcement and disciplinary information on the websites of health professional regulatory boards. The major purpose of the study was to determine the extent to which enforcement and disciplinary information is available and accessible to the public. A secondary purpose was to determine the extent to which available information can be readily analyzed for policy research and evaluation. The study examined the websites of boards of dentistry, medicine and nursing to determine the types of disciplinary data that could be accessed and analyzed by the public. The findings confirm the trend toward transparency among the boards of dentistry, medicine and nursing. Nevertheless, these boards could significantly increase transparency by providing more detailed information about disciplinary matters.
The study grew out of an unsuccessful effort to obtain current disciplinary data from Virginia's Department of Health Professions, the administrative home of health professional boards, as a first step in conducting a longitudinal study of disciplinary decisions, updating earlier studies. In 1990 and in 1997 the Department of Health Professions conducted studies of its enforcement and discipline activities (Virginia Department of Health Professions, June 1990, January 1997). At that time, Strong was able to obtain and analyze a broad range of disciplinary data, stripped of all identifiers such name, address and license number (Strong, 2005). It was decided to conduct a similar 20-year longitudinal analysis of disciplinary decisions through 2008.
BACKGROUND AND NEED
In attempting to obtain a data set on disciplinary decisions from the Virginia Department of Health Professions, the researcher learned of two developments that, on the surface, apparently resulted in contradictory outcomes: disciplinary data has become simultaneously, more available to the public and less available. The first development is that the Virginia Department of Health Profession has moved in the direction of greater transparency. The amount of information and the ease of accessing that information increased exponentially since the 1980s. The Department's website makes considerable data available that can be easily downloaded in an Excel spreadsheet. This information includes details such as whether a complaint was substantiated, the number and types of violations sanctioned, the types of sanctions imposed, and compliance with department complaint processing performance standards. The quarterly reports contain summary data and date back five years.
At the same time, state policy changes placed new limitations on access to certain types of enforcement and disciplinary data (Communication with Department of Health Professions' staff, Richmond, Virginia, November 13, 2009; Boodman, 2001). Under the new policy, the Department does not release information such as severity of an offense, or source of a complaint (e.g. consumer, law enforcement, practitioners, inspection, etc.).
Given that Virginia has been a leader in strengthening the enforcement and disciplinary functions of regulatory boards, the researcher began to wonder about trends in other states. Where are health professional boards in 2009 with respect to making information available to the public? What has transpired over the last twenty years with state health professional regulatory boards, given the broad trends in public administration and management (such as reinventing government, expansion of citizen participation mandates, and performance management)?
These questions are rooted not only in the developments in Virginia, but also in the literature and practical needs of several constituencies. A frequent criticism of state regulatory boards has been the lack of transparency, accountability and responsiveness to patients and the broader public (Public Citizen Health Research Group, 1993, 2002; Yeon, 2006). …