Serious disciplinary actions against physicians grew by 1.5% last year. At the same time the total number of licensed doctors increased by more than 6%, a new national report reveals.
The Federation of State Medical Boards, the umbrella group for state agencies that oversee the licensing of doctors, said 4,662 disciplinary actions of all types were taken in 2001 against U.S. physicians, 45 more than in the previous year.
Of those actions, 4,015 were punitive, including license revocations, suspensions, probation and other types of restrictions or modifications to a physician's license, according to the Euless, Texas-based organization. While the number of punitive actions against doctors edged up, the number of licensed practicing doctors increased to nearly 718,200 from about 676,500, the report said, triggering renewed criticism from some consumer advocates.
"They're getting slightly worse, not better," Sidney Wolfe, M.D., director of the Washington-based Public Citizen's Health Research Group, said of the overall national policing effort by state medical boards.
Despite concerns from consumer advocates like Wolfe, top officials of the federation said they believe that state boards continue to protect the public from incompetent doctors.
"Medical boards are doing more and more, year by year, to be proactive about educating licensees about how to stay out of trouble," said Dale Austin, the organization's chief operating officer. "There are proactive efforts to get individuals help and keep them out of trouble so they never become a statistic. Those things, coupled with the fact that actions have been virtually level over the past few years, say that the boards are doing their jobs and doing their jobs better and better all the time."
On the same day last week that the FSMB released its annual compilation of state disciplinary actions, Wolfe's advocacy group published its own yearly summary of state-by-state rates of discipline using slightly different information that shows even fewer disciplinary actions against physicians.
Public Citizen takes into account only the most serious actions against doctors-including revocations, suspensions and other restrictions of medical licenses. These most serious measures account for about 2,800 of the federation's 4,015 punitive actions. Public Citizen also uses American Medical Association statistics for the total number of nonfederal doctors, which at 792,149 is higher than the FSMB's figure of nearly 718,200 licensed doctors.
Based on that formula, Wolfe said, the rate of serious disciplinary actions across the nation decreased to 3.36 actions per 1,000 physicians in 2001 from 3.49 actions per 1,000 physicians in 2000. The lowest disciplinary rates were in the District of Columbia, which reported 0.73 actions per 1,000 physicians, and Hawaii, which had 0.80 per 1,000. The highest rates were in Arizona (10.52) and Oklahoma (8.66).
"The state boards should hold physicians to the highest standards, and if they're not, patients are vulnerable to doctors who are practicing bad medicine and endangering lives," Wolfe said. "Such wide differences in discipline rates mean that some states could be doing a whole lot more to protect patients."
But FSMB officials said state overseers are doing a good job despite being hampered at times by a lack of financial resources.
"There is always criticism, probably always will be," Austin said. "Medical boards have limited resources; there are just so many cases they can investigate. But medical boards are doing . . . better and better all the time. Is it ever done? No."
Public Citizen released a companion report that rated the information available on state medical boards' Web sites. It found that only Arizona, Maryland, North Carolina, New York, Ohio, South Carolina and Virginia provided complete information about sanctions against doctors.