You’d like to think that the doctor trusted to make treatment decisions for you or your family members would be in big trouble if he/she were found guilty of practice violations like “delivering substandard care, wrongly diagnosing surgical patients, improperly leaving surgical equipment in a patient, alcohol/substance abuse, or physical illness/impairment”.  But such is not the case, according to the non-profit watchdogs over at Public Citizen, who claim that the state of California has become delinquent in disciplining 710 physicians with documented records like this.

In fact, 102 of these California doctors have been designated by peer reviewers as an “immediate threat to health or safety” of patients – yet are still allowed to practice medicine in the state.  One question: are their patients aware of this?

Here’s the report: 

WASHINGTON, D.C. – The state of California has become delinquent in disciplining doctors with documented poor records, the non-profit watchdog Public Citizen said in a letter sent today to California Gov. Jerry Brown, urging him to take the necessary steps to correct the dangerous shortcomings of the state medical board.

California’s state medical board has failed to take disciplinary action against 710 physicians in the state, all of whom were disciplined for wrongdoing between September 1990 and the end of 2009 by California hospitals, health maintenance organizations, ambulatory surgical centers and other health care organizations. What’s more, 102 of those doctors were designated by peer reviewers as an “immediate threat to health or safety” of patients.

Some of the other violations include:

• delivering substandard care
• wrongly diagnosing surgical patients
• improperly leaving surgical equipment in a patient
• alcohol or other substance abuse
• physical illness or impairment

Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, explained:

“Unless the California Medical Board significantly improves its record of failing to discipline those California physicians previously found by their hospitals or other places they practice to present an immediate threat to health or safety, tens of thousands of California patients are at risk of being injured or killed by these doctors.”

In Public Citizen’s annual ranking of state medical boards, California used to place among the top half of states when it came to disciplining doctors. But since 2006, the rate at which doctors were disciplined has consistently dropped. In Public Citizen’s 2011 analysis, California ranked 35th in the nation, 41st in 2010.

In fact, had the state board acted against faulty physicians at the rate it had in 1997, when it ranked 18th in the country for rate of serious disciplinary actions, 164 more physicians would have been seriously disciplined in 2010 than were disciplined.

The 710 doctors represent about half of the doctors disciplined by California health care organizations in the time period Public Citizen studied. A full 35 percent of the 710 were repeat offenders.

To obtain the information sent to Gov. Brown, Public Citizen analyzed 19 years of data from the National Practitioner Data Bank, which tracks:

• state disciplinary actions
• medical malpractice payments
• clinical privilege actions taken against physicians.

Here’s their state-by-state analysis of doctors disciplined by hospitals and other health care organizations – but never disciplined by state medical boards.

Nationally, 220 physicians were designated by peer reviewers as an “immediate threat to health or safety” of patients – California physicians comprising nearly half of them.

For all of these physicians, hospitals or other health care entities have already suspended, limited or revoked their clinical privileges.

Public Citizen sent a letter on March 14, 2011, to California’s medical board asking it to work with the Health Resources and Services Administration of the U.S. Department of Health and Human Services to identify the faulty physicians.

The medical board responded in April, noting that understaffing and lack of resources may affect its ability to follow up on the 710 physicians that Public Citizen identified as having escaped punishment.

California’s poor performance in disciplining bad doctors is not new. A 2005 report by the California Medical Board Enforcement Program Monitor analyzed the state medical board’s performance; nearly six years later, some of the most significant recommendations from the report have yet to be implemented, Dr. Wolfe said.

These suggestions, which Public Citizen endorses, include transferring medical board investigators to the California Department of Justice, where they could work more seamlessly with prosecutors of the Health Quality Enforcement Section, and raising licensing fees to increase the medical board’s budget. (Although fees were raised, there has been no commensurate increase in board enforcement staff.)

© 2011 Public Citizen

And by the way, it’s not just California physicians who are getting off scott-free. California’s Board of Registered Nursing has failed to act against nurses whose misconduct had already been thoroughly documented and sanctioned by others. Los Angeles Times investigative reporters identified more than 120 nurses who have been suspended or fired by employers, disciplined by another California licensing board, or restricted from practice by other states – yet have blemish-free records with the California nursing board. Find out more at:  When Caregivers Harm: Problem Nurses Stay on the Job as Patients Suffer from the Pulitzer Prize-winning journalists at ProPublica.

This news report made me wonder how health care professionals here in my own province of British Columbia are disciplined by their governing agencies. Here are news releases about recent disciplinary actions towards doctors, listed online at the B.C. College of Physicians and Surgeons.  Such news releases are sent out to the media by the B.C.  College.  Offenses listed are mostly for “unprofessional conduct” ranging from knowingly prescribing drugs not for an individual patient’s use to sexual touching of an under-age patient.

And disciplined nurses here in B.C. are similarly named by their College of Registered Nurses of British Columbia.  The Complaints & Concerns section of their website includes, for example, lists of nurses by name on their Criminal Record Review Non-Compliance and Discipline Committee Orders pages.

If you’re a patient, check out your local professional regulatory body to see if your own health care professional is on such a list.

See also: What Doctors Should Do – But Don’t – When Their Colleagues Are “Significantly Impaired or Incompetent to Practice Medicine”