One common misconception among medical staff services departments is the assumption that the state medical license boards proactively discipline physicians with a history of misconduct. After all, don’t most boards require criminal background checks before granting licensure? While this is certainly a valid point, various studies have recently indicated that medical license boards are not very efficient in taking action against physicians with misconduct. As PreCheck prepares to attend the National Association Medical Staff Services Conference next week, I thought it would be appropriate to review these recent findings at this time.

Bad Doctors Allowed to Continue to See Patients

Dr. Greggory Phillips, who appeared before the Texas Medical Board in 2011 regarding the death of Jennifer Chaney, had over a decade of history of misconduct—yet the board let him continue to practice medicine, although fines were imposed and he had been placed on probation. Although a woman died under his care in 2008, it took four years of negotiations and investigations before the state board finally forbid Dr. Phillips from seeing patients. Unfortunately, Dr. Phillips' case is only one of thousands.

America’s state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct, revealed a recent investigation by USA TODAY. While hospitals and other healthcare employers have taken action against these physicians, their medical licenses—and their ability to harm patients—remain intact. USA TODAY’s investigation reviewed records from various sources, including the public file of the National Practitioner Data Bank, which contains records of the nation’s licensed doctors who have faced “disciplinary actions.” The findings are alarming, to say the least.

• From 2001 to 2011, more than half of doctors who had their clinical privileges restricted or taken away by healthcare organizations were never fined or hit with a license restriction, suspension or revocation by a state medical board.
• About 900 doctors were cited for substandard care, negligence, incompetence or malpractice—and kept practicing with no licensure action.
• Fewer than 20% of nearly 100,000 doctors with malpractice records received any sort of licensure disciplinary action by state medical boards.

State Medical Boards: A History of Criticism

Unfortunately, USA TODAY’s recent investigation is not exactly news. In 1986, the U.S. Department of Health and Human Services Office of Inspector General (OIG) criticized the boards at the time for imposing “strikingly few disciplinary actions” for physician misconduct. The OIG’s jurisdiction over state boards was rescinded in the early 90’s so there is no recent report from this federal agency. In 2011, however, the consumer group Public Citizen conducted a study that also found medical boards “are not properly acting on (clinical privilege) reports after becoming aware of them.”

Mitigating Risk and Protecting Patient Safety

As both of the studies indicate, healthcare organizations and medical staff services managers cannot rely on the state medical boards to discipline problem physicians. In fact, according to data from the U.S. Health Resources and Services Administration, 47% of hospitals have never reported restricting or revoking a doctor’s clinical privileges to the National Practitioner Data Bank. With statistics like these, healthcare organizations must be proactive to protect the safety of their patients from physicians with misconduct. At PreCheck, patient safety is extremely important to us—that’s why it’s written in our mission statement. As a healthcare organization or medical staff services office, if you’ve ever questioned whether physician background checks are a necessary risk mitigation tool, I hope these findings will serve as food for thought. If you have any questions about your current physician screening process, feel free to contact us to discuss how we can help you safeguard your organization.

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