State medical boards across the country are essentially giving a free pass to doctors who have been found liable for serious and repeated misconduct by allowing them to keep their licenses, according to a USA Today article this month.

Physicians that have been disciplined and even barred by certain hospitals often keep clean licenses, according to the newspaper’s report. From 2001 – 2011, about 6,000 doctors had their clinical privileges restricted or revoked by hospitals or medical institutions. But only about half of those doctors were fined or had their license restricted by the state board.

And some of the nation’s worst offenders, the nearly 250 doctors called an "immediate threat to health and safety" by medical institutions – who reported their findings to a national database available to state boards – did not have their licenses restricted. Additionally, the approximately 900 doctors cited for substandard care also went undisciplined by their state board.

As for medical malpractice, less than one percent of doctors account for about 10 percent of malpractice awards. Yet only about one in five of these “worrisome one-percenters” had any action taken on their medical license.

Though the lack of disciplinary action may seem to demonstrate a lack of oversight by state boards, officials argue that it is a complex issue and problems can often be corrected by training rather than discipline.

Lisa Robin, chief advocacy officer at the Federation of State Medical Boards said disciplinary boards use a broad range of options to improve physician care. "It could be a letter requiring that you get training, or it could be monitoring of (a doctor's) practices or, where there is patient harm, it could be something as severe as a (license) suspension or revocation." The state boards "take their responsibility very seriously in taking actions, being thoughtful, and … protecting the public."

The newspaper cited a few of the worst offenders, whose names are kept confidential by the state medical boards.

• A California doctor made eight payments totaling about $2.1 million to resolve malpractice claims from 1991 to 2008. The doctor's hospital privileges were restricted twice in 2007, once for misconduct that posed an "immediate threat to health or safety" of patients, and surrendered for good in 2008. No action has been taken against the doctor's license.

• A Florida doctor made six payments totaling about $1.1 million to resolve malpractice claims from 1993 to 2009. In 2004, the doctor was hit with an emergency suspension of hospital privileges for misconduct that posed an "immediate threat to health or safety" of patients, and a managed care organization took similar action in 2005. He also kept a clean license.

• A Louisiana doctor made nine payments totaling about $2.7 million to resolve malpractice claims from 1992 to 2007, and at least five payments involved patient deaths, including two young girls. In 2008, a managed care organization indefinitely denied the doctor's clinical privileges. But the doctor's license remains unrestricted.

Gerry Oginski
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