Public Citizen, a consumer group with a focus on health care, issued its annual listing comparing medical boards based on how regularly they discipline doctors. Not only does Massachusetts rank poorly, at No. 47, but it is among a handful of states that have dropped significantly in recent years. Seven years ago, the state was ranked solidly in the middle of the pack at No. 23.
The report ranks states based on the per capita number of serious disciplinary actions, or those that lead to a license revocation, suspension or probation, over three years. For every 1,000 doctors in Massachusetts, there were 1.83 serious actions.
The figure reflects success in a decade-long effort to improve patient safety by eliminating problem doctors in Massachusetts, said Russell Aims, spokesman for the state medical board.
"For the last 10 years, the entirety of the Massachusetts health care system... has been focused on patient safety," he said. "It's a mantra here."
Every New England state except Maine (No. 17) fell in the bottom 10 in the latest ranking, which looked at three years of board activity. Aims took that to mean that maybe the region's thinking about itself is right: "Our health care system is just that much better."
That's the kind of response that officials in North Carolina, now ranked at 16, gave a few years ago when the report ranked it at No. 41, said Dr. Sidney Wolfe, director of Public Citizen's Health Research Group. But disciplinary activity there has increased in recent years. That's not because the state saw an influx of bad doctors, Wolfe said. It changed because the board changed its ways.
Between Minnesota at the bottom of the ranking and Louisiana at the top, the group found a nearly five-fold difference in the number of actions taken per capita. That variability is significant, according the group's report:
Absent any evidence that the prevalence of physicians deserving of discipline varies substantially from state to state, this variability must be considered the result of the boards? practices. Indeed, the ?ability? of certain states to rapidly increase or rapidly decrease their rankings (even when these are calculated on the basis of three-year averages) can only be due to changes in practices at the board level; the prevalence of physicians eligible for discipline cannot change so rapidly.
Aims said the state has had fewer serious complaints against doctors. From 2007 to 2010, the number of complaints that were docketed for investigation dropped 42 percent, from 758 to 439. Meanwhile, the number of complaints that the board staff found did not warrant investigation increased 30 percent from 224 to 291.
Dr. Humayun Chaudhry, director of the Federation of State Medical Boards, questioned whether states could be compared to one another. For one thing, he said, some states have had their budgets cut in the past few years. Some board staffs have had to take furlough days, which limit their ability to investigate cases.
But isn't that a good reason to look at the Public Citizen numbers, as a way of judging the impact of those cuts?
He said: "Try not to read too much into the data, although obviously the data is a good reminder to all of those states to make sure that their boards have resources."
The Massachusetts board had its state appropriation cut in half from fiscal year 2009 to fiscal year 2011, Aims said. But it made up for the change by increasing license renewal fees 50 percent to a $600 fee, paid every other year.
Tell me what you think: How is the Massachusetts board and its investigators doing weeding out bad doctors and keeping the good ones in operation? Are they too strict? Too lenient? Have you filed a complaint? How was it handled?
About white coat notes
|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at firstname.lastname@example.org. Follow her on Twitter: @cconaboy.|
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