Public Citizen's Health Research Group cites 20,125 US physicians who have been disciplined by state medical boards for various offenses in the 2000 edition of its new publication "Questionable Doctors."

• Public Citizen generated a database of 20,125 doctors who had a total of 38,589 disciplinary actions taken against them between 1990 and 1999.

• They used information from state medical boards, the US Department of Health and Human Services, the Drug Enforcement Administration, and the Food and Drug Administration.

• Public Citizen notes that about 90% of the disciplinary actions were for serious offenses, such as:

  • substandard care
  • criminal conviction
  • substance abuse
  • sex-related offenses
  • misprescribing of drugs
  • providing false information to the state board
  • loss of hospital privileges
  • insurance fraud

However, the group states that the sanctions did not equal the seriousness of the offenses:

• Only 48% of the disciplinary actions were serious: revocation, suspension or surrender of license, or probation/restriction of license.

• Most doctors who were disciplined for the five most serious offenses were not required to stop practicing, even temporarily. These offenses were:

  • sexual abuse or sexual misconduct
  • substandard care
  • incompetence or negligence
  • criminal conviction
  • misprescribing or overprescribing of drugs
  • substance abuse

"A key problem is that too many state medical boards believe their first responsibility is to protect the doctor from the public, rather than the other way around," according to Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group.

They give several examples of physicians committing serious infractions and not being punished accordingly:

• A doctor in Virginia inseminated a woman with known HIV-positive semen. The physician subsequently repeated this in another case. His only punishment was a reprimand.

• A physician who had sexual relations with at least 16 of his patients, received only restrictions on his medical license.

Public Citizen's book is the only publicly available list of physicians who have been sanctioned. They note that "a similar federal database, called the National Practitioner Data Bank, is kept secret by act of Congress."

• The American Medical Association (AMA) opposes making this databank available to the public

• Congressman Thomas Bliley (VA-Rep) plans to introduce legislation in the fall that would overturn the act by Congress that keeps the Practitioner Data Bank secret.

It also contains a ranking of the states by their performance in regulating the medical profession.

• Alaska, North Dakota and Wyoming are ranked the three best performing states

• Delaware, Nebraska and Tennessee are ranked the three worst.

Public Citizen recommends "that states promptly make public all their disciplinary actions, strengthen their medical practice statutes, restructure their medical boards to sever any links with state medical societies, and better staff and fund their medical boards."

In addition, "states should establish programs to weed out bad doctors and encourage complaints," and "Congress should consider legislation requiring doctors who accept Medicare patients to be periodically recertified for competency," the group advises.

The group has broken it's publication into regional editions, which are available for $20 each. The complete national edition is $4000.

Public Citizen's Health Research Group August 2000