How states handle discipline of physicians varies widely

There's a great variation in the rate that state medical boards choose to hand out discipline to physicians, a new study has found.

When it comes to disciplinary action, including the revocation, suspension or surrender of a medical license, a lot may depend on where the physician practices, researchers at the University of Michigan Medical School found.

The percentage of doctors who are disciplined or pay a malpractice claim is four times less in some states than in others, according to the study published in BMJ Quality and Safety. And since there isn't such a wide difference in the actual behavior of doctors, the reason lies in the wide variation between states in their regulations, procedures, and resources for disciplining doctors, according to a university announcement about the study.

States with the highest number of disciplinary actions were Delaware, Kentucky and Ohio. States with the lowest rates included Massachusetts, New York, Connecticut and Pennsylvania.

"We don't know what the 'right' rate of physician disciplinary action is, but no state should want to be in the extremes," John A. Harris, M.D., one of the study authors, said in the announcement. "Patients assume oversight of doctors is well-regulated in all states, that all doctors are held to the same ethical standards and disciplined appropriately when needed. But there's no central governing body, and there's significant variation."

Researchers analyzed information from the U.S. National Practitioner Data Bank from 2010 to 2014 and found that each year about 4 out of 1,000 U.S. physicians will face disciplinary action. State medical boards reported 21,647 disciplinary actions, of which 5,137 involved the revocation, suspension or surrender of a license. States ranged from a rate of 2.13 to 7.93 disciplinary actions per 1,000 physicians.

State medical boards are self-governing bodies and can decide what kind of discipline is merited in different cases. "In one state the punishment for a particular violation could be a fine, while in another state you could lose your license for doing the same thing," said Elena Byhoff, M.D., who co-authored the study. Unlike many other countries, the U.S. has no national system for overseeing and disciplining physicians.

While doctors worry about malpractice suits, a complaint filed with a medical board can actually have more serious and long-lasting implications, as FiercePracticeManagement previously reported. Actions by medical boards are almost four times greater than the number of malpractice payouts reported.

To learn more:
- read the study
- check out the announcement