A new report from Public Citizen has concluded that state medical boards that should have disciplined problem doctors have failed to do so, and the failure stretches back over the past two decades. The failure to mete out discipline raises the question of how many of these doctors have become repeat offenders when it comes to failing to maintain the proper duty of care to patients. Is the failure to address disciplinary issues leading to otherwise preventable incidents of medical malpractice?

The study examined state-board discipline rates for doctors who had had their privileges revoked or restricted by a hospital. Florida had the worst rates, with 63 percent of doctors with restricted or revoked privileges going undisciplined by the state Board of Medicine.

The report found that in thirty-two states, the state medical boards had taken disciplinary action on less than half of the doctors in the revoked-or-restricted-privileges class. (Pennsylvania medical malpractice attorneys noted that Pennsylvania was among those thirty-two states.)

As one observer put it, either the state boards are not getting information about hospitals’ disciplinary actions, or they are getting the information and not acting on it. Either way, something is wrong with the disciplinary system.

What is disturbing is that the restriction or revocation of privileges by a hospital is almost certain to be the result of serious misconduct or a serious medical failure by a doctor. The hospital would have already conducted an investigation, so the state medical boards are essentially receiving disciplinary cases delivered on a silver platter.

The report indicates that the hospitals’ actions are not related to trivial matters. Out of the 5,887 physicians that had privileges revoked or restricted but who were not disciplined at the state level, 1,119 of them were disciplined for incompetence, negligence or malpractice. Another 605 were disciplined for substandard care, and 220 were identified as an immediate threat to health or safety.

There were 2,071 physicians disciplined for one or more of the following: sexual misconduct, inability to practice safely, fraud including insurance fraud, fraud obtaining a license and fraud against health care programs, and narcotics violations.

It may be that some conduct that warranted discipline by the hospitals did not warrant discipline at the state level. It may be that some of the conduct that led to discipline by a hospital was unrelated to treatment of patients. What the study found, though, was that even if there were situations where state-board-level discipline was not warranted, there were still hundreds and even thousands of cases where state-level discipline should have been administered, but was not.

State medical boards, including Pennsylvania’s, need to do more to prevent medical malpractice. They could start by holding doctors accountable for their actions.

Source: Los Angeles Times “Report: States fail to discipline rogue doctors” 3/15/2011