WASHINGTON (TND) — Doctors are among our most respected professionals, but how do we know only competent ones are being allowed to practice? The answer, Spotlight on America has learned, may depend on where you live and the strength of the medical boards tasked with handing down discipline in your state.
Washington, D.C. is home to at least 6,000 licensed physicians according to the latest statistics. The nation's capital may be a leader in medical advancements, but when it comes to disciplining problematic doctors, the District of Columbia is at the back of the pack.
According to records obtained by Spotlight on America, in 2021 just 10 physicians were disciplined by the D.C. Board of Medicine, the agency charged with protecting the public from dangerous doctors. That's less than 1% of all practicing physicians in the city. Meanwhile, Kentucky’s Medical Board, which oversees nearly twice as many doctors as D.C. does, disciplined 10 times more of them. We found that state took action related to more than 100 physicians last year.
Dr. Sidney Wolfe, the founder of the Health Research Group at Public Citizen, a consumer advocacy group, isn't surprised by the staggering comparison between boards. He’s been a vocal critic of the doctor discipline system for decades, telling us, "Medical boards continue to have huge differences in how often or how well they do."
Those differences are highlighted in a report released last year by Public Citizen, which was authored by Dr. Wolfe. It ranks state medical boards based on the number of serious disciplinary actions they've taken against physicians for everything from sexual misconduct to improper prescribing and patient neglect.
There's no evidence that the doctors themselves are worse in one state than the other," explained Dr. Sidney Wolfe with Public Citizen. "So the differences can only be attributed to the fact that the medical boards are worse in one state than the other."
The worst medical board, according to that report is the D.C. Board of Medicine, which did not respond to Spotlight on America's repeated requests for comment. The District is ranked 51st in the country according to Public Citizen's research.
But states with nearly the same number of doctors as D.C. appear to be disciplining physicians at significantly higher rates. Kansas, Arkansas and Mississippi, whose physician totals mirror Washington, D.C., were ranked #15, #16, and #23, respectively, on Public Citizen's list.
The differences in discipline translate into real safety concerns for patients, according to Dr. Wolfe.
In every state, there are patients numbering anywhere from hundreds to thousands who are going to doctors who should not be practicing, and wouldn't be practicing if that state did more serious disciplinary actions a year," Wolfe told us.
As for the states whose medical boards are taking the most significant actions? Here are Public Citizen's Top Five:
The difference maker when it comes to discipline is often the makeup of the board itself. Spotlight on America's continued investigation into this issue found many medical boards are dominated by physicians, who Dr. Wolfe says may be sympathetic and hesitant to hand down punishment to their peers.
Dr. Wolfe and Public Citizen have long lobbied for medical boards to boost the number of public members to increase oversight of discipline and provide outside perspective. Others have called for independent citizen boards to take over the process. Among them is Tom D'Amore, an Oregon attorney who represents more than 100 women suing a physician for alleged sexual misconduct on the job.
The doctors should feel like I want to root these people out of my profession. But the instinct seems to be, for a lot of folks, to hide it or sweep it under the rug," D'Amore said. "We have to go elsewhere. It shouldn't be doctors enforcing against doctors."
With little hope for changing the makeup of boards across the nation, Dr. Wolfe says the process could benefit from audits of medical boards done by agencies at the state level.
That's something states like Georgia have already done. After decades of calling for change in a system he says is deeply flawed, Wolfe called that step encouraging, telling us, "Yes, I am still frustrated. But I see an increasing number of glimmers of hope."