Public Citizen ranks Michigan near top of states with most aggressive physician discipline

There are at least a couple of ways to view state medical boards that don’t issue many serious disciplinary actions for physicians. One way is to assume that because the rate of serious disciplinary actions per 1,000 licensed physicians in the state is low, nearly all of the doctors in the state are less likely to be professionally inadequate or engaged in criminal activities than physicians in other states.

That isn’t how the consumer advocacy group Public Citizen views things, however. The nonprofit organization says many state medical boards “are doing a dangerously lax job” of protecting the public.

Public Citizen recently issued a report ranking states by their rates of serious disciplinary actions per 1,000 licensed doctors in each state from 2017 to 2019.

Michigan is near the top

Michigan ranks as the fourth most aggressive with 1.70 serious actions per 1,000 physicians, trailing only Kentucky (2.29), Arizona (1.81) and Pennsylvania (1.78).

The most lenient were Georgia, New Hampshire and the District of Columbia, with 0.32, 0.32 and 0.29 serious actions per 1,000 doctors, respectively.

Public Citizen uses disciplinary actions by medical boards as a measure of how well each state protects patients. “There is no reason to believe that physicians in any one state are more or less likely to be incompetent or miscreant than the physicians in any other state,” the organization stated in its report.

Defining ‘serious’

According to a news report, Public Citizen considers decisions against a doctor’s medical license to be serious if they involve “license revocation, suspension, summary restriction, summary suspension, voluntary surrender while under investigation, voluntary limitations while under investigation, limitations or restrictions, denials of renewal and voluntary agreements to refrain or suspend pending completion of an investigation.”

The report was co-authored by Sidney Wolfe, MD, who told MedPage Today that many states with low rates of serious disciplinary actions – meaning their boards fail to discipline physicians with documented serious issues – do so because the boards lack funding.

He cited Georgia as an example: the medical board there sent to the state $7 million collected in licensing fees but received only $2.5 million back in appropriations.

Wolfe and co-author Robert E. Oshel, Ph.D., also told MedPage Today that medical boards could also measure competence with physicians’ medical malpractice payouts, but that boards rarely do. The Public Citizen report states that three-quarters of the 8,633 doctors with five or more malpractice payments “have never had a medical board licensure action of any kind, serious or nonserious.”