State medical boards responsible for disciplining physicians have failed to do so in more than half of cases where hospitals have revoked or restricted a physician’s privileges.
A study conducted by Public Citizen, a non-profit consumer advocacy group, found that 63% of the doctors whose hospital privileges were restricted or revoked were not disciplined by the state’s Board of Medicine, and 32 states didn’t even reprimand more than half of the offending physicians.
“Either state medical boards are receiving this disturbing information from hospitals but not acting upon it or, much less likely, they are not receiving the information at all,” says study overseer Dr. Sidney Wolfe, adding that either scenario is alarming.
The report was based on data from the National Practitioner Data Bank from 1990 to 2009. It examined the number of doctors whose hospitals barred – or put restrictions on – their practicing medicine there. Of the 10,672 U.S. physicians who faced hospital sanctions, 55 percent escaped any licensing action or discipline from their state medical board.
“In 20 years, only 10,000 doctors have ever been disciplined – which is an indictment of hospitals,” Wolfe says. “But once hospitals take action, it’s pretty serious. Of those, 5,800 were thrown off the staff of the hospital.”
Yet in many cases, the state medical board did not discipline the doctor any further, and as a result, many are still practicing medicine, he says.
“It’s a real indictment of medical boards,” Wolfe says, because these cases are the most egregious and already have been investigated by the hospital. “It’s like handing you a case on a silver platter. The investigation has been done.”
State medical boards and hospital peer review are considered two of the three “legs” of the three-legged stool of patient safety and doctor discipline. The third leg that holds doctors and hospitals accountable is the availability of medical malpractice lawsuits for injured patients.
But that leg is under continual threat from medical industry advocates who complain, without good evidence, that the industry could do a better job of policing itself if state laws could make it harder for advocates for injured patients — trial lawyers — to file lawsuits.
Other Public Citizen report highlights include:
Of the 5,887 physicians who the state medical boards failed to discipline – many of whom also had a history of medical malpractice payments – 1,119 were disciplined for incompetence, negligence or malpractice; 605 were disciplined for substandard care; and 220 were identified as an immediate threat to health or safety.
Other categories of serious deviations of physician behavior and/or performance that resulted in the loss of hospital privileges included sexual misconduct; inability to practice safely; fraud including insurance fraud, fraud obtaining a license and fraud against health care programs; and narcotics violations. A total of 2,071 physicians were disciplined by their hospital employers for one or more of these violations.
3,218 physicians in the study lost their clinical privileges permanently, and an additional 389 physicians lost privileges for more than one year.
Source: The Los Angeles Times
You can read the complete study here.