Journal of Medicine - A federal health agency restored to its Web site a database of doctor disciplinary actions just months after pulling it off the Internet in response to a doctor’s complaints.

But the return of the information came with a catch. It has a new requirement that anyone who uses it must first promise not to link information in the database with publicly available information, like court files, to identify any doctor.

And that was exactly the way journalists for many news organizations had used the national data bank, which masked individual doctors’ names, to identify weaknesses in the oversight of doctors with dozens of malpractice cases.

Charles Ornstein, president of the Association of Health Care Journalists and a reporter for ProPublica.org, said, “It’s troubling that a federal agency is telling reporters what they can or can’t do, and how are they going to enforce this?”

The agency should post the data without restrictions, he said, and continue its policy of refusing to confirm or deny any particular doctor’s identity to the news media. The new requirement may amount to an unconstitutional restriction on freedom of the press, Mr. Ornstein said.

Mary K. Wakefield, administrator of the Health Resources and Services Administration of the Department of Health and Human Services, said in a statement that it had imposed “appropriate protections so that critically important research can continue” without violating legal requirements to keep identities confidential.

The data can be used for statistical analysis or reporting on unidentified doctors, Ms. Wakefield said in the statement. “We have taken steps to improve patient safety by making more information available to hospitals, health care entities, and State licensing boards than at any other time in the history of the Data Bank,” she added.

The National Practitioner Data Bank was created in 1986 to help hospitals, insurers and medical boards keep track of malpractice payments and disciplinary actions across state lines. Its Public Use File replaced each doctor’s name and address with a unique identification number, partly in response to objections by the American Medical Association.

But journalists and other researchers have linked specific amounts of malpractice payments in court cases with the specific amounts reported in the Public Use file to fairly easily crack the code, add up cases against doctors, and report on gaps in oversight.

The removal from the Web last fall was protested by dozens of academic researchers, consumer groups and journalism organizations, and by Senator Charles E. Grassley, Republican of Iowa, who said the file ““serves as the backbone in providing transparency for bad-acting health care professionals.”

Dr. Sidney M. Wolfe, director of health research at the Washington nonprofit group Public Citizen, said it was “obnoxious” and “unacceptable” for the administration to require journalists and researchers to attest they would not use the information in the very way they had been using to expose gaps in the system.

Dr. Wolfe, a member of an advisory group to the agency, testified before that group last week. He said Public Citizen research earlier this year found states took licensing actions against less than half of the 10,672 physicians listed as having clinical privileges revoked or restricted by hospitals from 1990 to 2009.

The Public Use File was withdrawn by Cynthia Grubbs, director of the division of practitioner data banks for the agency, after she was pressured by a doctor who was being investigated by The Kansas City Star, according to records released to Senator Grassley and to The New York Times under the Freedom of Information Act.

Dr. Robert T. Tenny, in an Aug. 24 fax to Ms. Grubb, wrote: “The settlements made in the cases listed were all CONFIDENTIAL. PLEASE HELP!” A month later, after the file was removed from the government Web site, he wrote, “Stay strong and keep up the good work!”

Ms. Grubbs also wrote the reporter to warn him he could be fined for using the information.

Dr. Tenny, a neurosurgeon, had at least 17 malpractice lawsuits against him, and about $3.7 million had been paid since the early 1990s to settle some of the suits, The Kansas City Star reported on Sept. 4. The article also found 21 other doctors with 10 or more malpractice settlements but no disciplinary action.

Dr. Tenny and his lawyer, Charles R. Hay of Topeka, Kans., did not immediately respond to e-mail and telephone requests for comment on Wednesday afternoon. They have not responded to questions in the past.

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