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The American Medical Association, dedicated to keeping the "bad apples" out of the barrel of health care providers, is strengthening a national clearinghouse to prevent unqualified physicians from moving from state to state.

"It's part of the AMA's longtime goal to ensure that physicians providing services are qualified, competent and ethical," said Dr. Alan R. Nelson, a Salt Lake internist and chairman of the AMA's Board of Trustees.It has also been a longtime goal of Nelson, who is running unopposed for the position of AMA president-elect. He was a consultant to the National Center for Health Services Research, organized a statewide peer review program for the Utah Medical Association and was on the study committee on Quality of Care for the Institute of Medicine, National Academy of Sciences.

While state and county medical societies have medical ethic and grievance committees, Nelson said it's in the AMA where the ethical standards are set - and met.

Two years ago the AMA received a government contract to establish a clearinghouse for all physicians. Included in this so-called master file is demographic information - the physician's age, location, where he trained and licensed, and whether he is board certified.

Being added to the master file is whether the physician has had any disciplinary action from his hospital or state licensing board. Also included are professional liability claims for which a payment has been made. If a physician has been sued 20 times and the suits resulted in a payment, it would be noted on his master file.

"We make this information available on request about 250,000 times a year," Nelson said. It's available to all military and Veterans Administration hospitals, as well as civilian health care facilities (clinics and hospitals).

"About half of the hospitals in the country currently request the information when a physician applies for privileges," the executive said. "The person inquiring would be told there's a red flag on this physician and he should contact the state board of medical examiners for more information.

"It stops the physician who has lost his license in one state from going to another to get privileges."

Nelson said the clearinghouse will also provide information about impaired physicians who have not been able to continue with a treatment program.

"The other part of the law which is notable and useful provides immunity for good faith peer review activity," the AMA executive said. Physicians previously have been fearful of censuring a colleague because of the risk of the accused physician coming back and suing them.

The establishment of the master file has helped alleviate that fear, especially considering the file information is available only to health care entities and licensing boards.

"Specifically excluded are attorneys who are just going on a fishing expedition," Nelson said.