Rate of ‘Serious Discipline’ of Physicians by State Medical Boards Drops from Previous Benchmark

A nationwide examination of disciplinary actions taken by state medical boards between 2019 and 2021 concluded that Michigan disciplined physician misconduct at a higher rate than any other state. Determined by the annual average number of “serious disciplinary actions” taken by each state’s medical board per 1,000 licensed physicians, Ohio ranked second, North Dakota third and Colorado fourth. The report defines serious disciplinary actions as those that had a clear impact on a physician’s ability to practice medicine.

Twenty-four states, however, had disciplinary rates less than half of Michigan’s high watermark. The District of Columbia, Nevada, New Hampshire and Georgia ranked the lowest in rate of serious disciplinary actions.

Conducted by the nonprofit consumer advocacy organization Public Citizen, the new study indicates an overall decline in the rate of serious disciplinary actions when compared to the rate between 2017 and 2019, the period covered in a previous Public Citizen report. The report’s methodology did not consider the possible effects the COVID-19 pandemic may have had on serious disciplinary actions in 2020 and 2021.

“The public deserves to be protected from dangerous doctors,” said Robert Oshel, PhD, former associate director for research at the National Practitioner Data Bank (NPDB) and advisor to Public Citizen’s Health Research Group. “There is no evidence that physicians in any state are, overall, more or less likely to be incompetent or miscreant than the physicians in any other state. Differences in discipline rates between states reflect variations in boards’ enforcement of medical practice laws, domination of licensing boards by physicians and inadequate budgets, rather than differences in physician incompetence or misbehavior.”

The District of Columbia’s medical board took the fewest serious disciplinary actions per 1,000 licensed physicians, 9-times fewer than the Michigan medical board. Michigan averaged an annual 1.74 serious disciplinary actions per 1,000 physicians, while the District of Columbia averaged 0.19 annually. Nevada, New Hampshire, Georgia, Indiana, Nebraska and South Carolina, among other states, had only marginally higher rates of serious disciplinary action than the District of Columbia.

The state with the most physicians, Califonia, ranked 27th — with 0.83 serious disciplinary actions per 1,000 patients annually. The state with the second-most physicians, New York, ranked 7th — with 1.25 serious disciplinary actions per 1,000 patients per year.

Based on the 2019-21 data, if all states had increased their annual rate of serious disciplinary actions to match Michigan’s rate, there would have been 1,133 more serious disciplinary actions taken against U.S. physicians — almost doubling the average annual number of serious state disciplinary actions nationally from 1,281 to 2,414.

The analysis also found that Michigan’s apex rate of serious state disciplinary actions was 0.55 serious actions per 1,000 physicians, significantly lower than Kentucky’s high rate of 2.29 in the 2017-19 report.

“Michigan’s rate of serious disciplinary actions against physicians is a floor, not a ceiling,” said Robert Steinbrook, MD, director of Public Citizen’s Health Research Group. “All state medical boards could do a far better job of protecting the public from dangerous doctors and improving the quality of medical care.”