WASHINGTON - April 14 - Using information from the Federation of State Medical Boards, Public Citizen has ranked the performance of the 50 state medical boards and the District of Columbia based on the rate of serious disciplinary actions taken against doctors in 2003.
The 10 worst-performing boards were Rhode Island (the lowest rate), Wisconsin, Minnesota, Delaware, Michigan, Mississippi, Pennsylvania, Hawaii, Arkansas and Maryland. The 10 best-performing boards were Kentucky (the highest rate), Wyoming, North Dakota, Arizona, Oklahoma, Vermont, Montana, Alaska, West Virginia and Ohio.
Nationally, state boards took 2,992 serious actions against doctors, including license revocations, surrenders, suspensions and probations/restrictions. Physicians are typically disciplined for offenses such as negligence, incompetence, sexual misconduct and breaking criminal laws. Public Citizen calculated each state boards disciplinary rate per 1,000 physicians; the national rate was 3.55 actions per 1,000 physicians, compared to 3.56 in 2002. The disciplinary rate for the top state was 7.9 times that of the lowest state.
Because some small states do not have many doctors, an increase or decrease of one or two serious actions in a year can have a much greater effect on the rate of discipline than in larger states. So Public Citizen calculated the three-year disciplinary average for the states and ranked these, to better illustrate long-term trends. The three-year ranking for 2003, then, reflects an average of rates in 2001, 2002 and 2003; the three-year ranking for 2002 reflects the average of rates in 2000, 2001 and 2002, and so forth.
An analysis of these rankings shows that five of the states that ranked in the bottom 15 states in both the 2003 single-year and three-year analyses have consistently been in the bottom 15 states for nine of the past three-year average periods. These states are Wisconsin, Minnesota, Tennessee, Delaware and Hawaii.
"The data raise serious questions about whether patients in low-ranking states are being adequately protected because they are exposed to doctors who might be put on probation or have their licenses revoked in states that take doctor discipline more seriously," said Sidney Wolfe, M.D., director of Public Citizens Health Research Group. "Patients are more likely to be injured in states with poor doctor disciplinary records than in states that do a better job."
Boards are more likely to do a better job of disciplining doctors if they have adequate funding and staffing, good leadership, independence from state medical societies, and the power to undertake significant investigations, Wolfe said. For a copy of the report, click here.