State medical boards took 5,721 disciplinary actions against physicians, an increase of 342 actions over 2008, according to the newly released Summary of Board Actions report from the Federation of State Medical Boards.
The report details the state-by-state disciplinary actions taken by its 70-member medical boards, along with information about the context in which each board operates, including standards of proof required when prosecuting cases and the healthcare professions regulated.
Lisa Robin, senior vice president of advocacy and member services at FSMB, says the growing number of disciplinary actions against physicians in 2009 reflects "a pretty stable trend over the past decade," as the effort to identify and discipline wayward physicians has improved with the pooling and sharing of information.
"The federation has a disciplinary alert service that has been very beneficial tool," Robin says. "When we receive an adverse action from a state board or entity that reports to us, within 24 hours we notify all boards where that physician holds a license. We know that more than 20% of physicians hold more than one license. So, as information sharing improves with those types of tools that can support boards, we will see increases."
Annual Summary of Board Actions reports since 1990 can be found in the Physician Data Center section of the federation's Web site.
Humayun J. Chaudhry, president/CEO of the FSMB, cautioned in the introduction to the Summary to resist the temptation to rank or compare state medical boards because they operate with vastly different financial resources, levels of autonomy, legal constraints, and staffing levels. Instead, Chaudhry said, the Summary is best used to track trends in physician discipline within each state over time.
To assist tracking, the report includes the FSMB-designed Composite Action Index (CAI), which is a weighted average of disciplinary actions taken against physicians practicing in a state, as well as all physicians licensed by that state. Actions affecting physicians' licenses, such as revocations and suspensions, are weighted more heavily in a state's CAI.
"The CAI is a barometer that can signal significant changes in a medical board's disciplinary activity level," Chaudhry said. "Changes in a board's funding, staffing levels, changes in state law, and many other factors can impact the number of actions taken by a board."
Even with the improved disciplinary actions, Robin says medical boards across the nation are facing budget crises that have impacted virtually every state.
"It's a huge issue and something we are very, very concerned about," she says, adding that some state budget cuts have led to employees being furloughed or laid off.
"Boards investigate complaints as they receive them, but they need a staff to do that. It is labor intensive. The regulatory side is very expensive for boards, and you have to have qualified people. Some boards have to share investigators with unrelated boards."
Even though most state medical boards are funded by dedicated revenues from licensing fees, desperate state legislatures are stripping their budgets, taking licensing fees, or swiping reserve funds, Robin says.
"The boards have a critical role in public protection and they have to be adequately funded to be able to do their jobs," she says.