Transparent medical boards still failing in Public Citizen’s medical board rankings
May 30, 2011
Second guessing is crucial in science and in health writing.
Last year, Antidote reviewed records from medical boards from coast to coast and found that the boards were "inconsistent, inefficient and ill equipped to monitor the hundreds of thousands of doctors licensed under their watch." (The cases can be found at this Google map, too.)
When Public Citizen released its latest list of medical boards ranked by the seriousness of their discipline against doctors, I read the report with an eye toward my own findings.
According to Public Citizen, which performed a much more comprehensive but also more rigid assessment of state boards, the worst states for discipline are these, from worst to slightly better:
Minnesota
South Carolina
Wisconsin
Connecticut
Massachusetts
Rhode Island
Florida
New Hampshire
Utah
Vermont
Most of these states were called out for criticism in one of my Doctors Behaving Badly posts, but only one of them – Utah – was in my bottom seven for the worst at providing consumers information. I said that Alaska, Illinois, Maine, Mississippi, Nevada, New Jersey and Utah suffered from clunky sites, scant information and the awful tendency to force people to pay for records.
I also found nine that "provide consumers with websites that are intuitive, easy to use and full of good details about physician histories, often going back many decades." Those would be: California, Georgia, Iowa, Maryland, North Carolina, Ohio, Oregon, Texas and Wisconsin.
So Wisconsin, a terrible board as far as Public Citizen is concerned, was actually pretty good by my assessment.
Every time Public Citizen does one of these rankings, some medical board official will say that it is an unfair assessment because state boards all work differently.
This is partly true, and it is also part of the problem. Antidote reviewed 128 disciplinary actions. As I wrote at the time, the actions ranged "from assurances of compliance, which have about as much effect on dangerous doctors as love letters, to full-on license revocations, which work as long as the board follows up to make sure the doctor is not still practicing without a license."
I also wrote that for the same offense "one state will revoke a doctor's license while another will write a letter and file it in a drawer never to be seen or require a doctor to take a class. We found multiple instances where doctors who had failed to pay their taxes or fell behind on their licensing fees lost their licenses while doctors who had actually harmed patients were allowed to continue practicing."
This makes it hard to do an apples-to-apples comparison. But the bottom line for Public Citizen, and for Antidote, is whether most of these doctors still have been allowed to practice. Despite the fact that the 51 doctors I profiled were responsible for injuring or killing 290 patients, including overdosing patients, blinding patients, and diagnosing patients incorrectly, 82% of the doctors were still in practice as of December 2010.
Public Citizen wrote a letter to Health and Human Services Secretary Kathleen Sebelius asking her to "re-initiate previous, but currently non-existent Office of Inspector General (OIG) investigations concerning the dangerously lax disciplinary actions by so many state medical boards."
As part of the letter, Public Citizen's director, Dr. Sidney Wolfe, included a few of my Doctors Behaving Badly posts, from Maine and Mississippi.
Of course, we're flattered.
Have an idea? Post a comment below or write askantidote@gmail.com. Also, you can follow Antidote on Twitter @wheisel.
Comments
Richard you forgot to include
Richard you forgot to include Colorado as one of the most inclusive states for consumer information.
Hope all is well.
Patty Skolnik
Citizens for Patient Safety
Bill, CBS in Utah did a story
Bill,
CBS in Utah did a story on their Medical Board last Monday using Colorado as a great example of what should be done!!
~P
Patty, Who is Richard? In
Patty,
Who is Richard? In Colorado, I actually found the documents to be some of the most frustratingly vague of all the medical boards I reviewed. I know that you and your group have made some headway there, so I will be sure to check back.
http://www.reportingonhealth.org/blogs/doctors-behaving-badly-part-1-rosencrantz-and-guildenstern-colorado
http://www.reportingonhealth.org/blogs/doctors-behaving-badly-rosencrantz-and-guildenstern-colorado-part-2-0
Bill
Bill, I was multi-tasking
Bill,
I was multi-tasking with a peer named Richard ..forgive me but you would like him!! We have now passed 3 bills in 3 years in Michael's name so I am a bit sensitive but they have just changed the profile one more time...go to BME website look on left hand side Health Professionals Profiles and click...you can also go to PatientsRighttoKnow.org click on CO and it takes you to the exact page. Put in David Miller...Glenwood Springs and then click on his name and his profile will come up. Look at the questions especially about malpractice insurance. Michael will be dead 7 years on Saturday we have worked veery hard to get this far with transparency we do more each year...Colorado is starting to walk its talk...they even have me doing a PSA on CBS that they paid for about profiling..you won't find that anywhere else. We are trying to get other states to model CO bills. We need to give praise as well as criticism for folks to keep moving in the right direction even if its slower then we like. Look at the PSA from DORA on www.citizensforpatientsafety.org
Warmly,
Patty
Best, Patty
invalidity of disciplinary rankings
Hi Mr. Heisel,
One of my colleagues at the Center for Physician Advocacy pointed me to your article.
I was noting the date (2011) and was wondering if, when this was written, you had read The Report on a Flawed “Report Card”: The Public Citizens Ranking of Medical Licensing Boards" by Darold A. Treffert, MD; Sidney E. Johnson, MD in the Wisconsin Medical Journal • 2005 • Volume 104, No. 2. It clearly invalidated the basis for this falsely premised contest. Ultimately, as you may know, FSMB removed endorsement of this sham moral panic.
The reason why I write is that a number of us are examining what appears to be a pattern of abuses of authority and process by several medical boards.
I reviewed USC Annenberg's reporting on oversight and accountability of state medical licensing boards and affiliated physician health programs and found nothing written on this topic. I would like to share with you several developments occurring in NC and MA over a period of several years pertaining to what appears to be clear and profound violation of FSMB's code of ethics and IOM's position paper on Professionalism in Medicine.
For one, it will be instructive to review the NC office of the State Auditor's report of its Performance Evaluation of NCPHP which found pervasive violation of due process, multiple conflicts of interest and complete lack of oversight of its adherence to law. (see: http://www.ncauditor.net/EPSWeb/Reports/Performance/PER-2013-8141.pdf)
I am hoping that the CA Endowment for Health Journalism might report on some of these concerns which have now been extensively validated.
Personally, I believe we are soon to see an expose' of the pattern of violations committed by these due process-depriving agencies.. I will be happy to put you in touch with multiple physicians, one of whom has studied this issue for the last five years.