When penalties were handed out for snooping in UCLA's medical records, it paid to have an M.D. after your name.
As a group, doctors at UCLA hospitals who wrongly peeked at the records of pop star Britney Spears got off lighter than other staffers, according to reports released Friday by state health inspectors.
The California Department of Public Health faulted the prestigious UCLA Medical Center in Westwood, its neuropsychiatric institute and a sister hospital in Santa Monica for two privacy breaches involving Spears: when she gave birth to her first son in 2005 and when she was hospitalized in the psychiatric unit earlier this year.
All told, at least 53 UCLA staffers -- including 14 physicians -- looked at Spears' medical records on the two occasions, even though they were not treating her, according to statistics from the state and UCLA officials. Eighteen non-doctors resigned, retired or were dismissed after their prying was discovered, according to data provided to The Times by UCLA. No physicians quit or were fired.
Asked about the discrepancy, Kathleen Billingsley, deputy director for the state health department's Center for Healthcare Quality, said: "I can't speculate as to why."
In the past, UCLA has explained that physicians are overseen by a group of their peers, while all other employees report to the human resources department. But on Friday, officials said all employees should be held to the same standards and should face similar discipline for similar wrongdoing.
"Historically, doctors have been treated in a way that may be more lenient than non-physicians, and we will address that," said Dr. David Feinberg, chief executive of the UCLA Hospital System.
"We will do everything possible in the future not to be accused of that."
After days of public disclosures about privacy breaches, UCLA officials announced the creation of a high-level committee to review privacy policies and ensure that discipline is meted out fairly. Chancellor Gene D. Block also said UCLA would improve computer systems to increase security for patient records.
"All of us are deeply committed to fixing whatever has to be fixed and making sure that patient confidentiality is protected," Block said, adding that UCLA wants its procedures to be a model.
Feinberg said the new committee would examine different types of privacy abuses and recommend appropriate discipline for each, including possible termination and referral to criminal authorities.
The three reports issued Friday on Spears' case indicated systemic weaknesses in privacy policies at UCLA's hospitals. One portrayed the staff of Santa Monica-UCLA Medical Center and Orthopaedic Hospital as a workforce hungry for tidbits on the pop star.
Employees, it said, were scurrying for their computers "within minutes" of Spears' arrival there in September 2005 to give birth to her first son, Sean Preston.
Even though Spears was assigned an alias to protect her privacy, five doctors and 19 non-physicians called up her records and those of her son "without authorization or justification" over a three-day period, the state said. Six staffers at the UCLA hospital in Westwood also looked at her records in 2005, even though she was not a patient there at the time.
Once again, non-physicians received lengthy suspensions or were terminated. The physicians received lesser discipline, including reprimands and fines.
The problem apparently was not ignorance of hospital policy. Inspectors noted that all of the employees had participated in patient privacy training and had signed confidentiality agreements promising to access patient information "only in the performance of assigned duties and where required by or permitted by law."
Inspectors, who began their investigation in response to a Times article, faulted UCLA for failing to report the Spears breaches to the state, as required. Feinberg pledged to report all patient confidentiality violations promptly in the future.
While cautioning that he was not defending what happened, Feinberg said the media attention on Spears, particularly earlier this year, was unprecedented. Helicopters hovered overhead throughout her weeklong stay in the psychiatric hospital, paparazzi crowded around every hospital entrance and some people went to the emergency room feigning mental illness so they could be near Spears.
"We've had high-profile people admitted before," Feinberg said. "I've never seen anything similar to this. I'm not trying to make an excuse. . . . However, this is particularly unusual."
Billingsley, the state regulator, said her agency's findings have been forwarded to city, county, state and federal authorities for possible prosecution and monetary penalties.
"We are taking this very, very seriously," she said.
Sherry Lansing, chair of the UC regents' health services committee, said the university is as well. "This is a very disturbing situation."
The state continues to investigate other privacy breaches at UCLA, particularly how a low-level administrative specialist was able to pry into the records of 61 patients, including actress Farrah Fawcett and California First Lady Maria Shriver, before she was caught last May.
The Times reported Friday that UCLA officials have known since at least 1995 that employees have peeked at the records of celebrities and even their own colleagues, but they have been unable to uproot the problem.
The newspaper also found instances in which physicians violated the privacy of employees who were also patients.
Dr. Alfred Pennisi improperly looked at the medical records of a subordinate several years ago while Pennisi was medical director of the UCLA Children's Health Center, according to an internal document. The physician remains on staff as interim division chief for general pediatrics. Through a UCLA spokeswoman, Pennisi has declined to comment.
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Peeking at a pop star's files
When pop star Britney Spears sought treatment at UCLA hospitals in 2005 and 2008, 53 UCLA employees inappropriately accessed her medical records. Here's a breakdown:
2005 (birth of her son, Sean Preston)
5 physicians, all disciplined and fined
25 other employees: 21 suspended, 4 fired
2008 (psychiatric unit admission)*
9 physicians, all suspended
14 other employees: All dismissed, resigned or retired
* Numbers subject to change because appeals processes are not complete.
Source: UCLA. Note: Includes figures from all UCLA medical centers.