Green explains that the problems he's discovered raise questions about the veracity of research projects that used NHAMCS to draw conclusions that large numbers of physicians don't deliver appropriate emergency care.
"For example, you might look at study that used the NHAMCS to see what percentage of patients with a broken bone got narcotics to treat their pain. They found numbers that look lower than what any of us would [expect, prompting] people to say ‘Whoa, that's lower than it should be,' and conclude that the doctors are doing a bad job of treating patients' pain."
Likewise, another study using NHAMCS data showed that physicians weren't always checking for pregnancy when teenage girls came to the emergency department complaining of abdominal pain.
"You'd see a low number and think there must be a lot of bad doctors, yet the alternative explanation that's suggested by the study that I've done is to say, wait a minute. Maybe there's a problem with the underlying data."