Hospitals enjoy substantial protection when reporting physicians to the National Practitioner Data Bank (NPDB) in many situations, with laws protecting against retaliatory lawsuits as long as the hospital was required to report and followed appropriate protocols. However, there are situations in which reporting to the NPDB is not required but might still be the right thing to do when leaders are concerned about a clinician’s threat to patient safety. In those circumstances, the protection against liability is not ironclad.