Whether it's because of budget issues or politics, many states aren't moving quickly on doctor discipline cases. An analysis of the National Practitioner Data Bank Public Use File for 1990-2009 found that a total of 10,672 physicians have hospital sanctions, known as clinical privilege actions, against them for improper conduct. As many as 5,887 of these doctors—or 55%—have no pending state licensing actions, however, according to the Public Citizen report.
The hospital clinical privilege actions are peer review orders that Public Citizen says are one of the most important pieces of information used for medical board oversight. But, state board actions against a physician's license provide better assurance that a practitioner would be monitored or limited in work, the organization states.
A Public Citizen analysis says this "raises serious questions about whether state medical boards are responding adequately to hospital disciplinary reports and whether, as required by federal law, state medical boards are receiving such reports."
As a result, many of the doctors disciplined by their hospitals continue to practice unfettered, Wolfe says. "A large number have been thrown off the staff of hospitals and never disciplined," Wolfe adds.
"Part of the reason is that the executive branches of state governments are taking money dedicated to state doctors' licensing fees that are supposed to fund the medical boards and they are using it to try to balance the budgets for the rest of the state's [needs]. That's been going on in a number of states. It means the states are not taking a serious responsibility to discipline doctors who really need to be disciplined."