Doctor discipline by state boards increasing

State medical board disciplinary actions against physicians increased 6.3% from 2008 to 2009, according to an annual report from the Federation of State Medical Boards.

There were 5,721 disciplinary actions in 2009, the highest level since 2005, when 6,213 actions were taken by the 70 boards that discipline allopathic and osteopathic physicians. In 2004, there were 6,265 actions, the highest one-year total in two decades.

There are about 735,000 actively licensed physicians in the U.S., federation data show.

Humayun Chaudhry, DO, president and CEO of the federation, said the report, released in April, shows a mostly steady climb in discipline during the past decade. "We don't see small fluctuations up or down as being significant."

But Dr. Chaudhry cautioned against comparing state boards' actions year to year, because significant variability among board resources, staffing and statutes affect the number of actions taken.

Still, it's important to point out differences among state boards, said Sidney Wolfe, MD, director of Public Citizen's Health Research Group.

Medical boards are not doing enough to protect the public from doctors who are practicing substandard medicine, Dr. Wolfe said, also citing the impact of limited funding and inadequate staffing.

Public Citizen, a consumer advocacy group, uses the federation's data to annually rank boards by rates of serious disciplinary actions, defined as license revocations, surrenders, suspensions and probation/restrictions.

The group said boards across the country took 3.05 serious actions per 1,000 physicians in 2009. Although that's an improvement from the previous year, Dr. Wolfe said it's still lower than the 3.72 rate in 2004.

"This is not an indictment of most doctors. It's an indictment of most medical boards for not even doing the minimum and proper amount of disciplining," Dr. Wolfe said. He added that Public Citizen's intention is to raise awareness about which boards need better funding and staffing.

Board reactions

California is one trouble spot, Dr. Wolfe said. Public Citizen ranks it 41st for disciplinary actions among all states.

Russ Heimerich, a spokesman for the state's Dept. of Consumer Affairs, which oversees the medical board, agrees California needs to do a "much better job" of disciplining physicians and other health care professionals. But he said Public Citizen's rankings raise "some concerns about the implication that serious disciplinary actions are the sole indicator of whether a board is doing a good job."

This California board, which licenses and disciplines MDs only, took 559 disciplinary actions in 2009, up 8.9% from 2008. However, that is still 10.4% below the 624 actions taken in 2005. Heimerich said state officials are examining the disparity. (Osteopathic physicians have a separate licensing board in California and some other states.)

A regulation starting June 27 will require California MDs to send notices to patients or post signs in offices stating they are licensed by the medical board. The notices must include the board's contact information.

In Florida, officials say the Florida Board of Medicine's performance improved in 2009, in part because attorneys were hired to fill four vacancies in the board's prosecution unit. The board, which licenses and disciplines MDs only, also established a triage team to handle priority cases.

Following the new hires, the board took 272 actions against physicians in 2009, up 8.3% from 2008.

On April 9, the board began posting online administrative complaints filed against physicians and other health professionals in an attempt to improve transparency, said Eulinda Smith, a spokeswoman for the Florida Dept. of Health. These complaints previously were available by request.