For the first time in eight years, the number of serious disciplinary actions taken against doctors dropped in 2005, the Federation of State Medical Boards has found.
Even while the population of nonfederal physicians grew by about 4% from 2003-05, serious disciplinary actions against doctors dropped by 1.6%, falling from 5,502 in 2004 to 5,412 in 2005, the Dallas-based association reported in its annual survey.
Those 5,412 so-called "prejudicial actions" include revocations, suspensions, surrenders or mandatory retirements of a medical license, as well as probation or other limitations on the practice of medicine. The category also includes less-serious actions such as penalties or reprimands. The annual report also found that medical boards took 801 minor, or nonprejudicial actions, against doctors, bringing the total in 2005 to 6,213 -- slightly less than the total of 6,265 in 2004.
Officials with the federation said medical boards are doing a good job protecting the public from incompetent, impaired or unethical doctors even as they compete with other state agencies for the annual funding needed to carry out their work in policing the estimated 850,000 nonfederal physicians in the nation. The federation represents 70 state medical boards in the U.S. and its territories.
James Thompson, M.D., who is president and CEO of the federation, said the decrease in disciplinary actions is a slight "blip" that doesn't demonstrate a lax attitude toward enforcement.
"We can expect some fluctuation," he said. "I don't think we can assume there's a steady or increasing level of bad practice of medicine. I don't see this as a trend."
But the Public Citizen's Health Research Group, a not-for-profit consumer advocacy group, voiced continuing concerns about whether medical boards, usually overseen by volunteer doctors who must pass judgment on their peers, are doing an adequate job policing the profession.
In its own annual report on this topic, the Health Research Group, using selected statistics from the federation's annual survey, found that state medical boards took just 3,255 "serious" disciplinary actions against doctors in 2005. This definition focuses specifically on revocations, surrenders, suspensions or probation/restrictions, and does not include the comparatively minor penalties or reprimands that the federation considers serious enough to be included in the category of "prejudicial" sanctions.
That number is down 1.2% from 2004, when medical boards took 3,296 of the most serious disciplinary actions against doctors. In some states, such as Mississippi, the rate of disciplinary actions against doctors was just 1.6 per 1,000 over a three-year period from 2003-05. The state with the highest percentage of disciplinary actions over that same period was Kentucky, where the ratio was about nine serious actions per 1,000 physicians.
Sidney Wolfe, director of the HRG, said the number of serious disciplinary actions against doctors would jump by at least 4,000 or 5,000 annually if "all states did as good a job" as those at the top of the list.
Thompson acknowledges some problems with state medical boards, saying that many are understaffed, overworked and poorly funded. Some are compromised, he said, by their close connections to state medical societies. "It's a system that's really in need of repair," he said. "I think everyone would agree that there is room for improvement and opportunity to do things better."