‘Trivial’ reprimands

States’ actions against docs don’t sway citizens group

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.