SECRECY ADDED TO LICENSING POOR POLICY

A plan to bring more secrecy to the licensing and regulation of Nebraska's
124,000 doctors, nurses, pharmacists and other health-care professionals
should raise concerns. It would conceal facts from the public about some
disciplinary actions.

The proposal is one of dozens of changes suggested by a committee that has
spent a year working on an overhaul of licensing regulations for
consideration by the State Health and Human Services System and the
Legislature. It would allow some health-care workers who abuse drugs or
alcohol to participate in a diversion program instead of having their
license suspended.

The diversion option would be available in cases where it could be
demonstrated that patients were not endangered or harmed. Diversion would
be for the person who snorted cocaine on weekends, apparently, if the
person could prove that he wasn't high when examining patients during the
week.

Upon completing successful treatment, the person could have the violation
removed from his or her record.

The purging of records is the troubling part. It amounts to rewriting
history. The licensing and regulation of heath-care professionals has long
been a public matter. Because of the special role of health-care
professionals, the public has a right to know if they have in some way
failed to meet professional standards.

Moreover, as James Smith of the Nebraska Attorney General's Office said,
determining whether a drunken doctor has actually endangered a patient
could be difficult at times. Often in health care there is no margin for
error. The fact that a person might be taking drugs "only" on weekends
doesn't mean that he or she can be trusted during the week. A patient
having surgery does not want a surgeon who is craving a drink while working
on her with a scalpel or laser.

Nebraska has made strides forward since 1993, when the Federation of State
Medical Boards of the United States ranked Nebraska ahead of only Puerto
Rico and the District of Columbia in taking action against problem doctors.
But the idea of limiting public scrutiny ought to be viewed skeptically. If
the substance-abuse practices or a doctor or nurse were kept secret, the
public might not be aware of people for whom treatment was a revolving-door
experience.

Proponents of the diversion program say the confidential process would
encourage people who need help to seek it and thereby help the state
maintain high professional standards.

Certainly professionalism is an appropriate goal. However, the question for
state government is whether more secrecy and more opportunities to avoid
punishment are the best ways to deal with doctors and nurses who become
addicted to alcohol or drugs. In our opinion, the leadership of the State
Health and Human Services System and the Legislature should exercise
extreme care when considering the changes.

Checked-by: Mike Gogulski