Report: Physician disciplinary action rates drop off in last decade

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The Public Citizen’s Health Research Group has released a report calculating the rate of serious disciplinary actions per 1,000 doctors in each state, finding that the rate of serious actions per 1,000 physicians in 2009 was slightly higher than the rate in 2008, though it continues to be significantly lower than the peak for the past ten years.

According to the April report, written by Sidney M. Wolfe, MD, and colleagues, the rate in 2009—3.05 serious actions taken by state medical boards per 1,000 physicians—remains 18 percent lower than the peak rate in 2004 of 3.72 serious actions per 1,000 physicians.

The disciplinary actions, including revocations, surrenders, suspensions and probation/restrictions, were accounted for through the utilization of newly-released state-by-state data from the Federation of State Medical Boards (FSMB) for 2009, wrote the authors. These data were combined with previous FSMB reports in 2007 and 2008, they wrote.   

The Washington, D.C.-based group found that the most recent three-year average state disciplinary rates ranged from 1.07 serious actions per 1,000 physicians in Minnesota, to 7.89 actions per 1,000 physicians in Alaska.

According to the findings, from 2007-2009, the states with the lowest serious disciplinary action rates included:

  • Minnesota (1.07 actions per 1,000 physicians);
  • South Carolina (1.09);
  • Wisconsin (1.59);
  • New Hampshire (1.65);
  • Connecticut (1.80);
  • Massachusetts (1.93);
  • Mississippi (2.17);
  • Florida (2.25);
  • Maryland (2.30); and
  • Vermont (2.34).

In addition, the report found that the states with the highest three-year rates of serious disciplinary actions for 2007-2009 included:

  • Alaska (7.89 serious actions per 1,000 physicians);
  • North Dakota (6.01);
  • Kentucky (5.67);
  • Ohio (5.43);
  • Arizona (5.20);
  • Oklahoma (5.01);
  • Colorado (4.99);
  • Louisiana (4.76);
  • New Mexico (4.13); and
  • Hawaii (4.03).

The authors wrote that these data demonstrate “a remarkable variability in the rates of serious disciplinary actions taken by the state boards,” and that there is “considerable evidence” that most boards are under-disciplining physicians.

Noting potential reasoning for the variance among state boards, Wolfe and colleagues said that boards are likely to discipline physicians if funding, staffing, leadership, independence from state medical societies and proactive investigations, rather than only reacting to complaints, is achieved.

“Most states are not living up to their obligations to protect patients from doctors who are practicing medicine in a substandard manner,” said the report. “Action must then be taken, legislatively and through pressure on the medical boards themselves, to increase the amount of discipline and, thus, the amount of patient protection. Without adequate legislative oversight, many medical boards will continue to perform poorly.”