Altman, Lawrence K. "Communicable Diseases Masked Behind Doctors' Erratic Reporting,"


Altman, Lawrence K. "Communicable Diseases Masked Behind Doctors' Erratic Reporting,"
New York Times, 10 July 1990, p. C3.

Here is a complaint from the Center for Disease Control: physicians in private practice do not
report communicable diseases to the proper authorities and, as a result, the statistics needed to
detect outbreaks of communicable disease are available. The trouble is that physicians are not
taught in medical schools the value of reporting such data and they are not punished for not
reporting. Passing a law about reportable disease does not mean that the disease gets reported.

"Not surprisingly, many doctors pay more attention to reporting cases in a medical journal than
to a health department. Doctors who fail to report cases are rarely disciplined."

Surveys found that significant numbers of physicians were unaware of the legal requirement to
report communicable disease. Studies have shown that reporting for many common notifiable
diseases was from 6 to 90 per cent. In one study, reporting rates were 35 percent overall, from 11
percent for viral hepatitis to 63 percent for tuberculosis.

"Many doctors have explained the lapses in reporting by saying they assumed that laboratories
and hospital administrators had reported the case. ... Some doctors said they were overburdened
with paper work, while others excused not making reports by claiming they would be violating
laws and regulations on patient confidentiality."

Few experts doubt that for every outbreak of disease that is recognized others go unrecognized.

There is, surprisingly, no mention here of the social pressures on the physician not to report