Pubdate: 19 Dec 1998 Source: Omaha World-Herald (NE) Contact: http://www.omaha.com/ Forum: http://chat.omaha.com/ Copyright: 1998 Omaha World-Herald Company. 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