Humayun Chaudhry, DO, president and CEO of the Federation of State Medical Boards, says Public Citizen's report serves "as a reminder of the collaboration required by many parties to better protect the public."
That said, however, many state Medical Boards "will tell you that there is significant under-reporting of sanctions taken by hospitals, and this is not a surprise to us."
Additionally, he says, there may be some legitimate reasons why a gap exists between disciplinary actions listed by the NPDB and actions taken by a state medical board against those doctors.
"States do the best job they can to license and discipline doctors as appropriate, but not all hospital actions result in or require a licensure action," he says.
Another reason may be that the medical board received the hospital's report and is in the process of investigating. "Each report has to be carefully considered by the board," Chaudhry says. "Hospitals are required to take and share action, but they may not share the investigation and work that led to it," which means that those state boards have to do that work themselves.
Or, it may be that the state board did take action, but that action may remain confidential, dependent on until the successful completion of a drug or alcohol diversion, or it may be a much lower level of discipline. "How do you know if you don't have the name of the physician?" he says.
A new project started last year means the NPDB and the Health Resources and Services Administration are working with state medical boards to cross check data they have on physicians, "and where there is something missing or doesn't make sense, they (the state boards) are going to act on it," Chaudhry said.