Florida rated 35th nationwide in physician discipline actions

By Liz Freeman

Despite efforts to crack down sooner against physicians in Florida who harm patients, the state Board of Medicine has a mediocre standing when it comes to serious disciplinary measures against physicians, according to a new analysis.
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The Florida Board of Medicine ranks 35th among the nation’s 51 state medical boards, including the District of Columbia’s, for its rate of serious disciplinary action per 1,000 physicians, according to an annual ranking by Public Citizen, a Washington, D.C., watchdog group founded by Ralph Nader.

That means 34 state medical boards imposed tougher sanctions, based on averaging three years of disciplinary action by each medical board from 2004 through 2006. Serious discipline includes license revocation and suspension, probation and restrictions.

Public Citizen used discipline data from the Federation of State Medical Boards, FSMB, for its ranking and what the American Medical Association reports for how many doctors are practicing in each state.

Florida averaged 2.93 serious disciplinary actions for every 1,000 physicians for the three years, according to the watchdog group. That is slightly below the national average of 3.18 serious disciplinary actions.

In 2006 alone, the Florida board took 113 serious actions; there are 52,343 licensed physicians in the state.

Alaska came in at the top of the ranking with a rate of 7.3 serious actions per 1,000 physicians, while Mississippi came in at the bottom with 1.41 tough sanctions for every 1,000 doctors in the state, according to Public Citizen.

Leaders of Florida’s medical board could not be reached for comment Thursday.

Officials with the state Department of Health, which performs investigations of physicians following complaints, said the board has increased its disciplinary actions over the last three years.

“The Board of Medicine makes a decision in each case what’s necessary to protect the public and not every case requires a specific restriction or suspension of practice to meet this purpose,� said Eulinda Jackson, spokeswoman for the state health department. “However, the board in many cases uses rehabilitation and evaluation in order to ensure the practitioner is safe to practice.�

Likewise, the federation said ranking medical boards based on disciplinary actions alone may not accurately reflect what is going on in each state, given how many other factors come into play such as differences in autonomy, funding, and staffing, said Dr. James Thompson, president and chief executive officer of the Dallas-based federation.

“To simply rank a board based on numbers of discipline actions, we think, is not a valid representation of the data,� he said. “We do not rank state boards because there is not enough uniformity and consistency to rank them.�

At the same time, he lauded Public Citizen for highlighting that medical boards can do a better job in disciplinary action with adequate funding and staffing, proactive investigations and greater autonomy.

“They do a great service in identifying that,� Thompson said.

Florida’s standing in the annual ranking has been consistent in the last few years. The state ranked 32nd in 2005, 37th in 2004 and 36th in 2003.

But in 2001, Florida ranked 26th for its discipline rate, following a boosted effort in 1999 by then-Gov. Jeb Bush and state health leaders to address a backlog of cases.

Dr. Sidney Wolfe, director of Public Citizen’s health research group, said that every time a state moves up or down in ranking, there is a reason and it isn’t the quality of the physicians.

“It is the quality and the effectiveness of the medical board,� he said, adding that changes in leadership, staffing and funding are the culprit.

For instance, Arizona ranked near the bottom 10 years ago but the Arizona Legislature woke up and empowered its medical board and it now ranks ninth, so in the top 10 states, Wolfe said.

“When something like this happens, a number of variables are working in the right direction or the wrong direction,� he said.

State medical boards need greater autonomy and less pressure from the political arena and from state medical associations in order to focus on its mission of public advocacy, he said.

The fact that Florida was once middle of the road and dropped down should send a strong message to the Florida Legislature and residents, he said.

“From physicians’ perspective, I cannot understand why this is not a priority issue,� he said. “It affects the health and lives of so many people in the state.�
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