Aug. 9, 2011 - WASHINGTON, D.C. - The state of California has become delinquent in disciplining doctors with documented poor records, Public Citizen said in a letter sent today to California Gov. Jerry Brown urging him to take the necessary steps to correct the dangerous shortcomings of the state medical board.
California's state medical board has failed to take disciplinary action against 710 physicians in the state, all of whom were disciplined for wrongdoing between September 1990 and the end of 2009 by California hospitals, health maintenance organizations, ambulatory surgical centers and other health care organizations. What's more, 102 of those doctors were designated by peer reviewers as an "immediate threat to health or safety" of patients.
Some of the other violations include delivering substandard care, wrongly diagnosing surgical patients, improperly leaving surgical equipment in a patient, alcohol or other substance abuse, and physical illness or impairment.
"Unless the California Medical Board significantly improves its record of failing to discipline those California physicians previously found by their hospitals or other places they practice to present an immediate threat to health or safety, tens of thousands of California patients are at risk of being injured or killed by these doctors," said Dr. Sidney Wolfe, director of Public Citizen's Health Research Group.
In Public Citizen's annual ranking of state medical boards, California used to place among the top half of states when it came to disciplining doctors. But since 2006, the rate at which doctors were disciplined has consistently dropped. In Public Citizen's 2011 analysis, California ranked 35th in the nation, 41st in 2010.
In fact, had the state board acted against faulty physicians at the rate it had in 1997, when it ranked 18th in the country for rate of serious disciplinary actions, 164 more physicians would have been seriously disciplined in 2010 than were disciplined.
The 710 doctors represent about half of the doctors disciplined by California health care organizations in the time period Public Citizen studied. A full 35 percent of the 710 were repeat offenders.
To obtain the information sent to Brown, Public Citizen analyzed 19 years of data from the National Practitioner Data Bank, which tracks state disciplinary actions, medical malpractice payments and clinical privilege actions taken against physicians. A state-by-state analysis of doctors disciplined by hospitals and other health care organizations - but never disciplined by state medical boards - is available at http://www.citizen.org/hrg1937.
Nationally, 220 physicians were designated by peer reviewers as an "immediate threat to health or safety" of patients - California physicians comprising nearly half of them. For all of these physicians, hospitals or other health care entities have suspended, limited or revoked their clinical privileges.
Public Citizen sent a letter on March 14, 2011, to California's medical board asking it to work with the Health Resources and Services Administration of the U.S. Department of Health and Human Services to identify the faulty physicians. The medical board responded in April, noting that understaffing and lack of resources may affect its ability to follow up on the 710 physicians Public Citizen identified as having escaped punishment.
California's poor performance in disciplining bad doctors is nothing new. A 2005 report by the California Medical Board Enforcement Program Monitor analyzed the state medical board's performance; nearly six years later, some of the most significant recommendations from the report have yet to be implemented, Wolfe said. These suggestions, which Public Citizen endorses, include transferring medical board investigators to the California Department of Justice, where they could work more seamlessly with prosecutors of the Health Quality Enforcement Section, and raising licensing fees to increase the medical board's budget. (Although fees were raised, there has been no commensurate increase in board enforcement staff.)