Sept. 4, 2002
Public Citizen Releases Database With Names of 532 “Questionable Doctors” in Maryland – Most Still Practicing
Consumers Can Search Online for Their Doctor
WASHINGTON, D.C. – The consumer advocacy group Public Citizen today released new information about 532 physicians who have been disciplined by Maryland’s state medical board for incompetence, misprescribing drugs, sexual misconduct, criminal convictions, ethical lapses and other offenses. Most of the doctors were not required to stop practicing, even temporarily.
Public Citizen also denounced the state’s medical board, the Maryland Board of Physician Quality Assurance, which is supposed to sanction doctors, for having a cozy relationship with the state medical association, which looks out for the doctors’ best interests.
Public Citizen has been publishing national and regional editions of its Questionable Doctors database in book form for more than a decade. But now, for the first time, the database is available on the World Wide Web (the books are no longer available). The Questionable Doctors Online Web site is www.questionabledoctors.org. Also added today to the site was information about doctors in Virginia, the District of Columbia and eight Western states.
Consumers will be able to search the list of disciplined doctors for free. For $10, they can view and print disciplinary reports on up to 10 individual doctors over a three-month period in any state listed. The Web site contains information about doctors in Alabama, Alaska, California, Colorado, Connecticut, the District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Mexico, Ohio, Oklahoma, Rhode Island, Texas, Utah, Vermont and Virginia. More states will be added throughout the year.
Public Citizen criticized the Maryland Board of Physician Quality Assurance’s poor record of disciplining doctors – in Public Citizen’s annual rankings, it is among the worst. Even when the state takes action against a doctor, it usually doesn’t stop them from practicing. Doctors who were disciplined but are currently allowed to practice in Maryland include:
- A doctor who breached the standard of care for the delivery of quality anesthesiology to 21 patients out of 23 cases reviewed by peers. He was reprimanded and some restrictions were placed on his practice, but he was allowed to continue practicing;
- A doctor who failed to meet the standard of care based on a peer review of his treatment of two patients. He was fined, reprimanded and placed on probation for 36 months in 1996. Subsequent peer review found that he failed to meet the standard of care for nine patients. He was placed on probation for another 36 months and reprimanded, but he was still permitted to practice; and
- A doctor who failed to deliver quality medical care for 13 patients and was found to have made false statements to collect a fee. He was reprimanded and put on probation for 18 months but continued to practice.
“For many of the offenses committed by Maryland doctors, the disciplinary actions have been dangerously lenient,” said Sidney Wolfe, M.D., director of Public Citizen’s Health Research Group. “The majority of Maryland doctors who committed the three of the most serious offenses weren’t required to stop practicing, even temporarily. Therefore, it is likely that they are still practicing in Maryland and that their patients are not aware of their offenses.”
Counting only the two most serious disciplinary actions taken against a physician in each case, there were 890 disciplinary actions issued against 532 doctors in Maryland over the 10-year period covered by the Questionable Doctors Online database. For the five most serious offenses, there were: 82 actions taken against doctors because of criminal convictions; 182 for substandard care, incompetence or negligence; 41 for misprescribing or overprescribing drugs; 21 for substance abuse; and 56 for sexual abuse of or sexual misconduct with a patient.
Of the 182 actions taken against doctors for substandard care, incompetence or negligence, only 49 (27 percent) involved license revocation, suspension or surrender. Similarly, of the 41 actions taken for misprescribing or overprescribing drugs, only 14 (34 percent) involved revocation, suspension or surrender.
“All too often, state medical boards are more concerned about protecting the reputations of doctors than doing their job, which is to protect unsuspecting patients from doctors who may be incompetent or negligent,” Wolfe said. “Maryland has an appalling record of letting serious and sometimes repeat offenders off the hook.”
Public Citizen also has published a ranking of state medical boards, based on the number of serious disciplinary actions (license revocations, surrenders, suspensions and probation/restrictions) per 1,000 doctors in each state. In 2001, nationally there were 3.36 serious actions taken for every 1,000 physicians. Maryland ranked No. 43 on the list, with 39 serious sanctions levied against 21,883 doctors, for a rate of 1.78 per 1,000 doctors. (To view the ranking, click here.)
Maryland’s standing in the rankings has been steadily sinking over than past 10 years. In 1993, it ranked 19th but in 1995, it slipped to 29th. It hit 41st in 1996, tied for 36th and 37th in 1998 and was 40th in 2000.
What makes Maryland perhaps unique – and explains why it has ranked so poorly in Public Citizen’s annual rankings – is its cozy, legally mandated relationship between the state doctors’ medical association (called the Medical and Chirurgical Faculty of Maryland) and the Maryland Board of Physician Quality Assurance. Under Maryland law, the board – after doing a preliminary investigation of an allegation against a doctor – must refer the allegation involving standards of medical care to the doctors’ association for further investigation and peer review. The association then reports its findings to the board, which uses that to determine whether to sanction the doctor.
Also problematic is the fact that neither the doctors’ association nor the board completes its work in a timely fashion. According to a 2002 audit conducted by the state Office of Legislative Audits, the doctors’ association has been late in reporting findings to the board since at least 1994. The law requires the findings to be sent to the board within 90 days, but in 2000, 83 percent of the cases were not completed in that time frame, the audit found.
State auditors were similarly critical of the medical board. In a May 2000 audit of state health regulatory agencies, the auditors noted that as of June 30, 1999, 31 (17 percent) of the Board of Physician Quality Assurance’s 181 open complaints had not been resolved from 20 months to in excess of four years from the date the complaint was received. The law requires that complaints be completed within 18 months after receipt.
“The relationship between the board and the medical association is untenable and is detrimental to patients who may have been harmed by bad doctors,” Wolfe said. “And the fact that they drag their feet in investigating complaints is yet another alarming indication that Maryland simply doesn’t take patient protection very seriously.”
Maryland’s medical board Web site, however, fared better in a Public Citizen analysis. It was given and “A” for both content and user-friendliness (to view the analysis, click here).
Public Citizen recommends that states promptly make public all of their board disciplinary actions, malpractice payouts and hospital disciplinary actions; strengthen medical practice statutes; restructure their medical boards to sever any links with state medical societies; and increase funding and staffing for medical boards.
Public Citizen has long sought greater consumer access to information about doctors, and there have been recent improvements in making that information available. Most state medical boards now provide some physician information on the Internet, but the information about disciplinary actions varies greatly, is often inadequate and can be difficult for people to access.
Information about doctor discipline, including state sanctions, hospital disciplinary actions and medical malpractice awards is now contained in the National Practitioner Data Bank, but that database is kept secret from the public.
“HMOs, hospitals and medical boards can look at the National Practitioner Data Bank, but consumers cannot,” Wolfe said. “It is time we lifted the veil of secrecy surrounding doctors and allowed the people who have the most to lose from questionable doctors to get the information they need to protect themselves and their families. But until Congress finds the will to open up this information, Public Citizen will provide the public with as much of the data as we can obtain.”
With today’s addition of Maryland, Virginia, the District of Columbia and eight states in the West, Questionable Doctors Online lists doctors disciplined in 26 states and the District of Columbia from 1992 through 2001. Information comes from all 50 state medical boards, the District of Columbia, the U.S. Department of Health and Human Services, the Drug Enforcement Administration, and the Food and Drug Administration. Previously listed physicians sanctioned in 1990 and 1991 were removed.
Using the information from the state and federal agencies, Public Citizen created a database containing the doctor’s name, degree, license number, date of birth, location, the disciplinary state or agency, the date of the disciplinary action, the nature of the discipline and available information about the case. Public Citizen asked all the state medical boards to provide information about court actions that may have overruled or changed previous disciplinary actions. Any disciplinary actions that were overturned by courts or for which litigation ended in the doctor’s favor were deleted from the database.
CONSUMER INFORMATION: Consumers will be able to search for names of disciplined doctors in the online database for free. For a $10 subscription, they can obtain detailed disciplinary reports on up to 10 physicians over a three-month period in any of the states listed. States available are Alabama, Alaska, California, Colorado, Connecticut, the District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Mexico, Ohio, Oklahoma, Rhode Island, Texas, Utah, Vermont and Virginia. Additional states will be added as the information becomes available. To order on the Internet, click here.