The limits of medical boards: The risk physicians can’t afford to ignore
Industry Buzz
It is often difficult to discern if a bad outcome was the result of incompetence or [of] legitimate care with unavoidable harm.
—Peter Kowey, MD
When it comes to medical malpractice, state medical boards are the primary agencies that monitor, investigate, and pursue complaints. They are paramount in protecting patient safety and regulating healthcare, according to a report published in 2021. []
But, in many cases, it can take years for them to revoke a physician’s license. A recent investigation published by ProPublica chronicled how one physician, a Montana-based oncologist named Thomas C. Weiner, was able to retain his license for years, despite growing complaints he was inappropriately treating and harming patients. []
Alex J. Keoskey, a partner at Frier Levitt who specialties in healthcare litigation and licensing board hearings, says each state in the United States has laws and regulations in place, enforcing reporting of any healthcare providers who have been the subject of discipline by a healthcare system or whose care may be a threat to patient safety.
These physicians may be reported to a confidential system called the National Practitioner Data Bank (NPDB), which is continuously monitored. “This ensures that doctors with a pattern of misconduct or malpractice do not slip under the radar,” says Keoskey.
According to Peter Kowey, MD, a professor of medicine and clinical pharmacology at Thomas Jefferson University and author of Failure to Treat, most boards operate post facto. They “revoke the licenses of practitioners convicted of a crime, or found guilty of gross impropriety, such as groping patients or selling narcotics, especially if those cases end up in the news.”
Determining if a physician is in the wrong can be a complex matter. “It is often difficult to discern if a bad outcome was the result of incompetence or [of] legitimate care with unavoidable harm,” says Dr. Kowey. Cases must be carefully reviewed by experienced and non-biased clinicians, he adds, and licensing boards do not always have access to that level of expertise.
Related: The legal battlefield of medicine: Insights into medical malpractice nationwideWhat reforms may help improve the timeliness and effectiveness of medical boards?
Dr. Kowey recommends taking a cue from reporting practices in place abroad and following suit. “There, cases in which there may be harm caused by negligence are brought forward without delay,” he says. “They are expeditiously adjudicated by an expert panel of judges, lawyers, and physicians, and victims [are] promptly compensated for their loss.”
Ultimately, healthcare workers should feel safe and comfortable reporting any colleague with questionable patient care practices to their institution or the state licensing board.
“Hospital employers should ensure that full immunity is granted to any health care provider who conveys such reporting in good faith and ensure that the provider is not subject to ostracism or retaliation,” says Keoskey.
Related: 4 common reasons doctors get disciplined by state medical boards