By Mariah Taylor

The National Practitioner Data Bank has three loopholes that make it possible for physicians to practice in multiple states even after being accused of patient safety issues and incentivize hospitals to not report concerns.

The National Practitioner Data Bank has been collecting data since 1990 and was designed to hold details about physician licenses, medical malpractice payment history, resignation or firing information, restrictions on clinical privileges and other information. Hospitals are legally required to report certain information and incidents to the data bank. However, roughly 45% of hospitals have never submitted a single clinical report involving adverse actions against a physician in the 33 years of the bank's operation, the Health Resource and Services Administration found.

The loopholes allow some physicians to keep practicing without closer scrutiny and for hospitals to not report patient safety concerns related to physicians performance. Of the roughly 250,000 physicians in the database, 17,000 lost or had their medical license suspended, and only half of those were disciplined in another state.

Texas recently passed legislation to close "Dr. Death loopholes" after a physician continued to practice despite harming or killing 30 patients across multiple states.

Here are three loopholes that lessen the power of the databank as an oversight tool:

1. Hospitals are required to report long-term restrictions on a physician's privileges, but only if they exceed 30 days. The limitation incentivizing hospitals to act within a time frame that allows them to avoid reporting.

2. Hospitals can often prevent malpractice lawsuits from being added to a physician's record by removing their names from settlement agreements, even if the physician is a named defendant.

3. Resignations have to be reported only if a hospital is officially investigating a physician when they resign or if a physician resigns to avoid an official investigation, which is difficult to prove. Voluntary resignations are not required to be reported. Hospitals are known to warn physicians to resign before an investigation is launched into their conduct to avoid being reported to the data bank.