The News & Observer was quick to note in a July 18 editorial that the N.C. Medical Board's vote to post all medical malpractice payments greater than $25,000 was a retreat from the board's initial proposal to publish all payments.

Let's not miss the larger point. Today patients have no reliable way to know whether medical providers have made malpractice payments. When the board's expanded practitioner profiles go live, North Carolinians will have access to about 90 percent of all such payments -- even with the $25,000 threshold. This is a vast improvement in public access.

The board's existing physician profiles, available at www.ncmedboard.org, already publish licensees' full disciplinary histories in North Carolina. Soon the board's site will report criminal histories and disciplinary actions taken by other state medical boards or regulatory bodies, as well as suspensions and revocations of hospital privileges.

These changes will make the board's Web profiles among the nation's more comprehensive, even with a $25,000 threshold for reporting of malpractice payments. Many boards that post such payments report only physicians with multiple payments, and some limit disclosure to payments exceeding $100,000. The N.C. Medical Board chose not to take this approach in the face of considerable pressure from its licensees and others.

If further compromise occurs, it won't come from the board. Those who oppose the board's plans for malpractice reporting will ultimately have to convince state lawmakers that concealing this information is in the best interest of their constituents. That will be a tough sell.

R. David Henderson

Executive director, N.C. Medical Board, Raleigh