Public Citizen Ranks State Medical Boards for Serious Disciplinary Actions

Even though the Federation of State Medical Boards (FSMB) discourages people from using their Summary of Board Actions report to rank medical boards in different states, the Public Citizen has published a "Ranking of State Medical Boards’ Serious Disciplinary Actions: 2007-2009."

10 Lowest States (lowest three-year rate of serious disciplinary actions):

* Minnesota (1.07 actions per 1000 physicians)
* South Carolina (1.09)
* Wisconsin (1.59)
* New Hampshire (1.65)
* Connecticut (1.80)
* Massachusetts (1.93)
* Mississippi (2.17)
* Florida (2.25)
* Maryland (2.30)
* Vermont (2.34) 

10 Highest States (highest three-year rates of serious disciplinary actions)

* Alaska (7.89 serious actions per 1,000 physicians)
* North Dakota (6.01)
* Kentucky (5.67)
* Ohio (5.43)
* Arizona (5.20)
* Oklahoma (5.01)
* Colorado (4.99)
* Louisiana (4.76)
* New Mexico (4.13)
* Hawaii (4.03)

Here are my questions: Are high rates of serious disciplinary actions a good thing or a bad thing? Why are the rates so different? Is it because some state medical boards aren't doing an adequate job, or because there are fewer physicians requiring disciplinary actions in certain states? Do we assume that each state roughly has the same proportion of physicians who require disciplinary actions?  You can view the Public Citizen summary here.

5,721 disciplinary actions against physicians in 2009

According to an annual report from the Federation of State Medical Boards titled, Summary of Board Actions, state medical boards initiated 5,721 disciplinary actions against physicians in 2009. This is roughly a 6% increase from 2008.  You can view the 2009 annual report from the FSMB here.

Each year, the Federation of State Medical Boards publishes the Summary of Board Actions, a compilation of disciplinary actions initiated by its 70 member medical boards. In addition to providing disciplinary data, the report includes information about the context in which each board operates, including standards of proof required when prosecuting cases and the health care professions regulated. This year’s report includes disciplinary data for each board from 2005-09. During 2009, state medical boards took 5,721 actions against physicians, an increase of 342 actions over 2008. To view annual Summary of Board Actions reports since 1990, please go to “Physician Data Center” at www.fsmb.org.

The FSMB emphasizes that the data from this report should not be used to compare or rank states. Why? Because each state operates with different financial resources, levels of autonomy, legal constraints and staffing levels. The Summary of Board Actions is most useful in tracking trends in physician discipline within each state over time.

State-specific Requirements for Initial Medical Licensure

A common question that comes up frequently is: "I don't want to complete my residency training. Should I just get my medical license and start working?"

As you can imagine, many residents don't enjoy residency training. The grueling hours and the sleep deprivation can be disheartening.

Back in the "old days," it was relatively easy to finish internship and practice medicine as a GP (general practitioner). Many states will still grant a medical license to a medical school graduate who has completed a single year of post-graduate training (internship) if you graduated from a U.S. medical school. If you're an international/foreign medical graduate (IMG or FMG), then you'll be required to complete 2-3 years of residency training in many states.

Right now, Nevada appears to be the only state that requires 3 years of residency for U.S. medical graduates who wish to obtain a medical license. 

The Federation of State Medical Boards (FSMB) maintains a chart that outlines the State-specific Requirements for Initial Medical Licensure. The current version was updated in June 2009 and you can view it here. 

Disciplinary Actions Against Physicians Up in 2008

Each year, the Federation of State Medical Boards (FSMB) publishes the Summary of Board Actions , which is a collection of disciplinary actions initiated by its 70 member medical boards. There are currently over 960,000 physicians in the United States. According to the summary report, in 2008, state medical boards took 5,379 actions against physicians, an increase of 60 actions over 2007.

The Public Citizen also produces a report and ranks different states:
Public Citizen’s Health Research Group Ranking of the Rate of State Medical Boards’ Serious Disciplinary Actions, 2006-2008 (HRG Publication #1868). A low ranking state identified by the Public Citizen often results in increased activity or funding for that state’s medical board.

Get ready for some acronyms now, because here are the professions regulated by a Board. I thought that you might find this interesting because you may not realize that all these healthcare professions are regulated by a Board.

AT-athletic trainer; ACU-acupuncturist; ANA-anesthetist assistant; AUD-audiologist;
BLD-biological lab director; CP-clinical perfusionist; CT-cosmetic therapist; CHI chiropractor;
CIS-cardiovascular invasive specialist; CPM-certified professional midwife;
CPP-clinical pharmacist practitioners; DO-osteopathic physician; DEH-dental hygienist;
DEI-dietician; ELE-electrologist; EMT-emergency medical technician; GC-Genetic
counselors; HAD-hearing aid dispenser; HYP-hypnotherapist; ICU-mobile intensive care
unit; LO-licensed orthotist; LP-licensed perfusionist; LPR-licensed prosthetist; LPED licensed
pedorthist; MA-medical assistant; MD-allopathic physician; MDX-MD X-ray
operator; MP-medical physicist; MR-medical resident; MT-massage therapist; MW midwife;
NA-nurse anesthetist; NAT-naturopath; ND-nutritionist; NM-nurse midwife;
NP-nurse practitioner; OT-occupational therapist; OP-optometrist; OTA-occupational
therapist assistant; ORT-orthotist; PA-physician assistant; PER-perfusionist; PT-physical
therapist; PTA-physical therapist assistant; POD-podiatrist; POL-polysomnograph
personnel; POM-Practitioner Oriental Medicine; PRO-prosthetist; RA-radiology
assistant; RE- registered electrologist; RN-registered nurse; RAT-radiological
technologist; RCP-respitory care practitioner; RET-respiratory therapist; RIT-resident in
training; RTL-radiological technologists limited; RPA-radiology practitioner assistant;
RRT-radiological technician; SA-surgical assistant; SL-speech language pathologist;
SLA-speech language pathologist assistant; SPA-Specialist Assistant