State medical boards displayed their toughest oversight ever on America's physicians in 2004, meting out a record 5,502 "prejudicial actions," or revocations, suspensions and reprimands.
That number is up almost 20% from the previous year, when state boards imposed strict sanctions on 4,590 physicians, according to an annual compilation by the Federation of State Medical Boards to be released today.
It's the sharpest increase since 1994, when the number rose by almost 16%.
"Quite frankly, it's surprising to see the numbers up as much as they are this year," said Dale Austin, the federation's chief operating officer. "Several states have shown an increase in activity. We don't know if that's just a one-year phenomenon when things come to closure more quickly than usual."
The Dallas-based federation, which represents state medical boards in the U.S. and its territories, said its members took 2,116 actions in 2004 that involved the loss of a physician's license, a nearly 19% increase from the previous year. The leading causes of the harshest form of punishment were substance abuse, unprofessional conduct and controlled-substance violations. Since 2000, when 1,724 physicians lost their licenses, the number of doctors forced from practice has increased nearly 23%, the federation said.
Critics have questioned the significance of the percentage increases, saying they do not take into account annual increases in the number of physicians. In 2003, for instance, the number of prejudicial actions represented 5.6 sanctions per 1,000 doctors, based on a total of about 815,000 nonfederal practicing physicians. In 2004, despite the seemingly large jump in the percentage of strict sanctions, the number represented 6.5 actions per 1,000 doctors, based on a total of approximately 849,000 nonfederal physicians.
"From the standpoint of calculating the whole of the physician population, as imprecise as that number can be, it's a small increase in overall percentage," Austin said.
In all, state medical boards took a total of 6,265 disciplinary actions against physicians last year-5,502 serious sanctions; and 763 "nonprejudicial" actions, which don't affect licenses but require board staff time and resources, including license reinstatement after probation. The total of all board actions has increased by almost 36% over the last five years, according to the federation.
The federation's complete 2004 Annual Summary of Board Actions is available at fsmb.org. Consumers can conduct a national search on physicians and their disciplinary histories at docinfo.org, which is the federation's Physician Data Center. It includes more than 135,000 actions against approximately 46,000 physicians. The fee per report is $9.95.