However, Wolfe said dismissing state-by-state comparisons because some boards have better funding, tougher laws, and larger staffs doesn't make sense. He added that Arizona's state medical board, which for several years had been among the worst in the nation, improved dramatically when the state legislature increased the board's staff and budget, and hired new leadership.
"That is exactly why you need to compare them. That is something that needs to happen to get those states that aren't doing such a good job to do a better job," he says.
Wolfe says that FSMB is a trade association that wants to protect all its members.
"It's difficult because some boards are doing better than others," he says. "If you don't want to make some boards look better than others, the easy way, the cop out, is to say ‘you shouldn't rank them because it makes some boards look better than others.' That is ridiculous."
The Public Citizen report said boards are likely to do better jobs disciplining physicians if they have good leadership, are independent, proactive, adequately staffed, and adequately funded, with all money from license fees going to fund board activities instead of going into the state treasury for general purposes.
In addition, Public Citizen said effective medical boards need a "reasonable legal framework" for disciplining doctors, such as "preponderance of the evidence" rather than "beyond reasonable doubt" or "clear and convincing evidence."