In Florida, 63% of the 571 physicians with one or more adverse clinical privilege actions, or 361, had no action taken against them by the Florida licensing agency.
In Delaware, Hawaii, Indiana, New Mexico, Nevada, Pennsylvania, South Dakota and Tennessee, more than 70% of physicians with one or more clinical privileges escaped any state license action. Of large states, in California, 54% of physicians had no licensure actions, Texas, 60%; Ohio 57%, New York 50% and in Illinois, 66%.
Of the 5,887 doctors whose hospitals reported their clinical privilege limitations to the NPDB, 350 had three such reports, 231 had more than three, and of those, 23 had seven or more, without any state action.
Public Citizen's report explains that federal officials apparently believe they don't have the authority to investigate state medical boards. However "during the 1980s and 1990s, the OIG acknowledged the importance of effective medical board oversight; during this time period they conducted 16 evaluations of state health professional licensing boards including nine specifically addressing inadequate medical boards performance.
"Because of highly questionable legal constraints imposed by OIG lawyers, the last OIG review of state medical boards was 18 years ago."
Wolfe's report said that the group's analysis "raises serious questions about whether state medical boards are responding adequately to hospital peer review determinations of substandard care or conduct, and, secondarily, whether state boards are getting copies of hospital reports to the NPDB. Given the value of hospital disciplinary reports, such reports must be received and properly utilized by medical boards to assure patient safety."