Most Medical Boards 'Terrible' at Discipline
Wolfe says that Public Citizen has sent letters to state medical boards, urging them to investigate physicians who were disciplined by hospitals for various reasons, but not by the boards themselves.
Of the 5,887 physicians who were disciplined by hospitals between 1990 and 2009:
- 1,119 were cited for incompetence, negligence or malpractice.
- 605 had carried out substandard care.
- 220 were disciplined because they were an "immediate threat to health or safety."
In addition, many of the doctors had a history of medical malpractice payments. A physician in New Mexico had 26 malpractice cases, while a physician in Indiana had 20. Fourteen states had a physician with at least one clinical privilege report, no state licensure action, and at least 10 medical malpractice payments.
The data "demonstrate a remarkable variability in the rates of serious disciplinary actions taken by the state boards. Only one of the nation's 15 most populous states, Ohio, is represented among those 10 states with highest disciplinary rates," according to Public Citizen.
The California state medical board was sharply criticized for failing to act promptly following Michael Jackson's death on June 25, 2009. A judge eventually suspended Murray's license to practice medicine and ordered the state to notify other states where he was licensed about the suspension. Other states where Murray had a medical license, among them Nevada, Hawaii, and Texas, were slow to discipline him too, according to a USC Annenberg School of Communication and Journalism report.
Murray was charged, tried, and convicted of involuntary manslaughter and sentenced to four years in prison before California filed a petition to remove his license.
California officials have defended their actions, saying they were always in touch with prosecutors, and the safety of the public was never at stake.
"We were able to move along at the pace we needed to," says medical board spokesman Wood, referring to the proposed discipline of Murray.
The pace of the states' medical board work involving physician discipline hasn't been good for years. According to Public Citizen "most states are not living up to their obligations to protect patients from doctors who are practicing medicine in a substandard manner." Without legislative oversight, it says, "many medical boards will continue to perform poorly."
The situation is not without hope, however. State boards can turn their behaviors around, says Wolfe. Most need adequate funding and staffing. They should also have independence from state medical societies, and what they need most of all, says Wolfe, is "excellent leadership" and a board willing to do the right thing.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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