Medical boards vary widely in punishing physicians
Medical boards vary widely in punishing physicians
Whether or not disciplinary action is ever taken against you or a physician you know may well depend on where you live, according to a new study conducted by Public Citizen, Ralph Nader’s advocacy group in Washington, DC.
The report, based on data compiled by the Euless, TX-based Federation of State Medical Boards, shows huge variations among states when it comes to taking serious actions against physicians, including revoking and suspending licenses, placing physicians on probation, or asking physicians to surrender credentials. Meanwhile, the number of disciplinary actions being taken nationwide has fallen consistently since 1994.
"If you don’t have adequate staff or budget, it isn’t even possible that you’re going to do a good job," says Sidney M. Wolfe, MD, a Washington, DC-based internist who wrote Public Citizen’s report on the study.
Wolfe notes that in the District of Columbia, where 4,000 physicians practice medicine, the licensing board has only "three-fourths of a director and three-tenths of a lawyer. There’s no way they’re going to be able to do anything in the way of disciplining doctors."
According to Wolfe, other reasons some state medical boards have a poor record of policing physician activity include:
only following up complaints, rather than conducting proactive investigations; failing to use all available data from sources such as Medicare, Medicaid, and hospital sanctions; being too dependent on state medical societies; lacking a reasonable statutory framework for disciplining doctors.Wolfe’s particularly concerned about the wide variation that exists among state boards when it comes to standards of evidence. "The standard for most disciplinary action should be simply a preponderance of the evidence,’" he says. "But in 25 to 30 states, the standard is clear and convincing evidence.’ In my view, that’s too high a standard to have to achieve to get a doctor, who’s doing a huge amount of damage to patients, on probation or out of practice." Wolfe notes that a couple of state boards even have to meet a criminal standard — "beyond a reasonable doubt" — before taking any action.
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