Doctor disciplinary actions decline

By Phil Galewitz
Palm Beach Post Staff Writer
http://www.palmbeachpost.com

The Florida Board of Medicine took far fewer disciplinary actions against the state’s doctors last year compared with 2005, according to a report this month by the Federation of State Medical Boards.

Overall, the board penalized 523 doctors last year, compared with 834 in 2005 — a 37 percent drop, the report found.

The board removed the licenses of 88 doctors last year, down from 137 in 2005 – a 36 percent decline.

About 44,000 doctors practice in Florida.

Larry McPherson, executive director of the state medical board, said a big reason there were fewer disciplinary actions last year was that Florida in 2006 began considering first-time “citations” imposed for minor violations “nondisciplinary.”

As a result, those actions were not passed onto the federation for its annual tally.

Citations, which include a monetary fine, are most frequently issued for failing to meet continuing medical education requirements, particularly for initial licensing.

“Unfortunately, many new licensees forgot to get the continuing education on time,” McPherson said.

McPherson could not explain why the number of serious disciplinary actions, such as loss of license and license restrictions, had fallen. He said the board acted appropriately in the cases before it.

Until last year, the number of Florida doctors annually losing their license had risen steadily, from 65 in 2002 to 137 in 2005.

“As in the criminal justice system, where not every criminal violation merits a life sentence, not every violation merits revocation or restriction of license,” McPherson said.

Peter Lurie, deputy director of the consumer group Public Citizen Health Research Group, said the big drop in serious disciplinary action raises questions about whether the board let doctors off easier last year than in previous years.

“It’s likely due to a decision by the state board to go easy on the doctors,” Lurie said.

Board Chairman Dr. Frank Farmer, a Daytona Beach internist, disagreed. He said the decline in severe actions by the board does not reflect greater leniency toward doctors.

He said it is more fair for the public to look at trends rather than focus on a one-year change.

“These things wax and wane because of the large number of cases,” he said.

Thousands of complaints are filed each year with the state against doctors.

Many are dismissed because they either are not proven or involve issues that the medical board does not handle, such as billing complaints.

Typically, a case takes at least 18 months to go from a complaint to an investigation to being heard before the medical board.

One possible explanation for the drop in license suspensions is that fewer medical malpractice suits have been filed in recent years in Florida and thus fewer cases have been referred to the medical board, said board member Dr. Steven Rosenberg, a West Palm Beach dermatologist.

The numbers of suits has dropped since the state passed a $500,000 cap on “pain and suffering” damages in 2003.

“It’s not unusual to see fluctuations year to year in the number of disciplinary actions,” said Dr. James Thompson, CEO of the Federation of State Medical Boards.

Medical boards are not like the police forces that go out looking for misconduct, he said. The boards rely on complaints.

The 15-member Florida medical board, which works with the state Department of Health in overseeing doctors, includes 12 physicians. It makes the final decisions on doctor discipline.

Last year, The Palm Beach Post wrote several stories that showed the board took several years to act against erring doctors, even in cases involving patient deaths.

Board officials said they were working to speed the disciplinary system while ensuring doctors’ rights.

Although the federation report does not compare state medical boards, Public Citizen ranks the Florida board 32nd in terms of serious actions.

The federation is a trade group of 70 medical boards across the country.

The total number of actions taken by medical boards in the United States rose from 4,875 in 2002 to 5,54 in 2006, the report found.

The federation’s report showed Florida disciplined more doctors than some states, fewer than others.

For example, although Texas has about the same number of doctors, Texas removed only 58 medical licenses, compared with Florida’s 88.

But Ohio took away 101 medical licenses, even though that state has 12,000 fewer doctors than Florida.

One factor that complicates comparing state medical boards is that legal standards differ in determining whether a doctor acted wrongly. Florida is one of 15 states that has a “clear and convincing” standard. Most states use the less stringent “preponderance of the evidence” standard.

Doctor checkup

To access physician information in Florida, go to www.FLhealthsource.com. The site contains licensing and disciplinary history information and online access to disciplinary orders.

To access the federation report, go to www.fsmb.org

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