State Medical Boards’ Enforcement Against Doctor Misconduct Appears ‘Dangerously Lax’

October 1, 2024

State Medical Boards' Enforcement Against Doctor Misconduct Appears 'Dangerously Lax'

WASHINGTON D.C. - Many state medical boards across the U.S. appear 'dangerously lax' in disciplining physicians responsible for negligent medical care, according to a new Public Citizen report.

The latest (2021-2023) Public Citizen "Ranking of the Rate of State Medical Boards' Serious Disciplinary Actions,*, authored by Robert Oshel, Ph.D. an advisor to Public Citizen's Health Research Group, and Robert Steinbrook, M.D., director of the Health Research Group,examines the rates of serious disciplinary actions state-by-state. The low rates of disciplinary actions in many states, they argue, suggest these states' licensing boards are not "adequately taking actions to discipline physicians responsible for negligent medical care or whose behavior is unacceptably dangerous to patients."

"The results of our latest analysis are profoundly disturbing," said Oshel, former Associate Director for Research at the National Practitioner Data Bank. "There is extreme variation from state to state on the extent to which the licensing boards take disciplinary action against incompetent or miscreant physicians, which does a disservice to the public."

According to the latest rankings, the state medical boards most effectively disciplining doctor misconduct are, in order, Ohio, the Michigan osteopathic board, Wisconsin, and North Dakota.

The state medical boards most lax on doctor discipline are Indiana, Georgia, the Pennsylvania allopathic board, Delaware, and South Carolina.

(The report calculates the rate of serious disciplinary actions taken against physicians between 2021-2023, a calculation that accounts for both the number of actions and the number of doctors in a state. Since there is no reason to believe that the rate of physician misconduct varies by state, states with a higher number of disciplinary actions are presumed to be doing a better job of holding negligent doctors accountable.)

"Patients deserve for their physicians to be held to firm and transparent standards when it comes to their care, no matter which state they're in," said Steinbrook. "Medical licensing boards need to step up to enforce crucial standards for the doctors they oversee and protect patients from doctors who are unable or unwilling to do their jobs properly."

Nationally, the total number of serious disciplinary actions did not change overall, as compared to 2019-2021, which was covered inthe previous report. Unlike previous reports the 2021-2023 report includes both allopathic and osteopathic state medical boards in its rankings.

Public Citizen's experts have long advocated for medical board reforms such as appointing nonconflicted board members, expanding oversight by state legislatures, increasing the use of the National Practitioner Data Bank (NPDB) by medical boards and improving reporting of disciplinary actions. The report also calls for federal legislation requiring state medical boards to use the data in the NPDB when licensing all physicians and renewing their licenses and opening the physician-specific data in the NPDB to the public.

*The Ranking of the Rate of State Medical Boards' Serious Disciplinary Actions report is based on recent state-level information from the National Practitioner Data Bank (NPDB), a national flagging system that also includes information on hospital actions and medical malpractice payments.

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