State Medical Boards Often Fail to Protect Patients from Bad Care: Report

A new report by the consumer advocacy group Public Citizen suggests that many state medical boards are not protecting patients from doctors practicing substandard medicine, potentially exposing consumers to a risk of medical mistakes by failing to take serious disciplinary actions against bad doctors.

The group released its annual ranking of state medical boards last week, looking at the number of serious disciplinary actions each state took against doctors from 2007 through 2009. Researchers said they found considerable evidence that most state medical boards are not disciplining doctors enough.

Public Citizen’s Health Research Group used recently released data from the Federation of State Medical Boards (FSMB) to calculate the number of severe disciplinary actions taken per 1,000 physicians in each state. To eliminate the large variability in states with fewer doctors, the researchers looked at data from a three-year period.

Researchers determined that on average only 3.05 serious disciplinary actions were taken for every 1,000 doctors. Minnesota ranked the lowest, with only 1.07 actions per 1,000 physicians. The state most likely to discipline doctors was Alaska, with 7.89 serious actions per 1,000 physicians.

“There is considerable evidence that most boards are under-disciplining physicians,” according to Dr. Sidney Wolf, director of Public Citizen’s Health Research Group. “Most states are not living up to their obligations to protect patients from doctors who are practicing medicine in a substandard manner.”

Public Citizen researchers say that information from previous years show that the number of disciplinary actions reflects a failing on the part of state boards to appropriately penalize doctors. In 2006, the organization published a report on doctors penalized for criminal activity and found that in 67 percent of all insurance fraud convictions and 37 percent of all inappropriate drug use convictions, state medical boards only took non-severe disciplinary action.

The report details not only which states are the best and worst performers, but also which states have improved over time and which have fallen to lower levels of discipline. Public Citizen said one of the more disturbing trends is that the most populated states tend to rank low as far as disciplinary action. Florida is consistently in the bottom 10, and California ranked 11th worst this year. The only state among the 15 most populous states in the country to rank in the top 10 was Ohio, with 5.43 actions per 1,000 physicians.