‘Triv­ial’ rep­ri­mands

States’ ac­tions against docs don’t sway cit­i­zens group

Modern Healthcare - - THE WEEK IN HEALTHCARE - An­dis Robeznieks

Thanks in part to in­creased ac­tiv­ity in two large states, the num­ber of dis­ci­plinary ac­tions taken by state med­i­cal boards in­creased 6.8% in 2011, but the Public Cit­i­zen Health Re­search Group is not that im­pressed and notes that “se­ri­ous” ac­tions were not up by much.

Ac­cord­ing to the Fed­er­a­tion of State Med­i­cal Boards’ an­nual sum­mary of board ac­tions, the num­ber of to­tal dis­ci­plinary ac­tions rose to 6,034 from 5,652 in 2010. These in­clude re­vo­ca­tion of med­i­cal li­censes and li­cense priv­i­leges, pro­ba­tion, and li­cense lim­its or re­stric­tions, while other ac­tions such as fines or rep­ri­mands are more ad­min­is­tra­tive in na­ture.

Us­ing FSMB data, Public Cit­i­zen counts up a three-year av­er­age of re­vo­ca­tions, sus­pen­sions, pro­ba­tions and re­stric­tions to cal­cu­late a “se­ri­ous ac­tion by per 1,000 physi­cians” met­ric, and Dr. Sid­ney Wolfe, di­rec­tor of its Health Re­search Group, noted that most of the in­crease re­flects an rise in mi­nor ac­tions. “I looked at this in­crease and 70% is not for se­ri­ous ac­tions,” he said, char­ac­ter­iz­ing many of the board ac­tions as “un­jus­ti­fi­ably triv­ial.”

Ac­cord­ing to Public Cit­i­zen, taken to­gether the na­tion’s boards took 3.06 se­ri­ous ac­tions per 1,000 physi­cians last year, com­pared with 2.97 in 2010. The his­tor­i­cal high is the 3.72 fig­ure recorded in 2004.

In Florida, a state whose board typ­i­cally is rated as one of the worst in the na­tion by Public Cit­i­zen, the num­ber of ac­tions rose sig­nif­i­cantly last year. Ac­tions in­creased 54.4% to 332 from 215, while li­cense re­vo­ca­tions in­creased 51.6% to 144 from 95.

Ac­cord­ing to Jes­sica Ham­monds, a spokes­woman for the Florida Depart­ment of Health, the state be­gan im­ple­ment­ing im­prove­ment mea­sures in 2009 and has filled four at­tor­ney va­can­cies in its pros­e­cu­tion unit, es­tab­lished a triage team to han­dle pri­or­ity cases, and “es­tab­lished a more ro­bust qual­ity re­view of all set­tle­ment agree­ments to en­sure con­sis­tency with board guide­lines.”

The Med­i­cal Board of Cal­i­for­nia also in­creased its to­tal dis­ci­plinary ac­tions by 18.9% to 648 from 545, while its num­ber of li­cense re­vo­ca­tions rose to 209 from 184 in 2010.

Other large in­creases oc­curred in Ohio, the only large state to con­sis­tently score high in the Public Cit­i­zen rank­ings, which in­creased its num­ber of ac­tions by 13.5% to 295 from 260 in 2010; and in Texas, where the num­ber of ac­tions rose 9.1% to 707 from 648.

The states with the high­est se­ri­ous ac­tions per 1,000 physi­cians, ac­cord­ing to Public Cit­i­zen, were Wy­oming, with 6.79 av­er­aged over the past three years; Louisiana, with 5.58; and Ohio, with 5.52. The boards with the least se­ri­ous ac­tions per 1,000 physi­cians over the past three years are South Carolina, with 1.33; Dis­trict of Columbia, 1.47; and Min­nesota, 1.49.

A lack of dis­ci­plinary ac­tiv­ity of­ten is a sign of a lack of board fund­ing, Wolfe said.

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