Report: State Medical Boards Might Be Under-Disciplining Physicians

The number of serious disciplinary actions against physicians slightly increased in 2009 but the rate remains 18% lower than five years ago, according to Public Citizen's seventh annual ranking of state medical boards, HealthLeaders Media reports.

The findings might mean that many boards are under-disciplining physicians, according to Sidney Wolfe, the director of Public Citizen's Health Research Group.

The rankings were based on three years of Federation of State Medical Boards data that outline serious disciplinary actions against physicians between 2007 and 2009. The report found that physicians are more than 3.6 times as likely to be disciplined in the top five states as in the bottom five.

Specifically, it showed that the weighted average rate of disciplinary action in the top five states -- Alaska, Arizona, Kentucky, North Dakota and Ohio -- was 5.45 actions for every 1,000 physicians. The bottom five states -- Connecticut, Minnesota, New Hampshire, South Carolina and Wisconsin -- had a weighted average rate of 1.5 actions per 1,000 physicians.

California placed 41st in the ranking, with a weighted average rate of 2.36 disciplinary actions per 1,000 physicians (Public Citizen report table, 4/5).

Recommendations

The report suggests that state medical boards would more effectively discipline physicians if they have solid leadership and are independent, proactive and well-staffed and -funded.

The report also recommends that boards implement a legal framework for physician discipline. For example, states could use "preponderance of the evidence," instead of "beyond a reasonable doubt," when considering allegations against physicians, the report said.

Previous Report

Public Citizen's report comes one week after FSMB issued a separate report finding that state medical boards took 5,721 disciplinary actions against physicians in 2009, up 6% over the previous year (Commins, HealthLeaders Media, 4/6).