Disciplining Doctors: A Washington Post Investigation, published April 10-12, 2005
Part 1: "Medical Boards Let Physicians Practice Despite Drug Abuse"
Part 2: "D.C. Board Rarely Punishes Physicians"
Part 3: "Physicians Outrun Poor Records"
This startling investigation reveals rampant problems with medical boards in the Washington area and nationwide, including:
Thousands of physicians in the Washington, D.C., area and across the nation have been given numerous chances to practice, despite evidence of well-documented drug and alcohol problems. With permission of state medical boards and hospitals, they have remained in business, even when many have relapsed multiple times and posed a danger to patients, medical board records show.
74 doctors in the District, Maryland and Virginia were disciplined for substance abuse from 1999 through 2004. In five other cases, these state boards found that doctors violated the law by abusing drugs or alcohol but took no action. Of the 74 physicians, 53 percent have been disciplined more than once for alcohol or drug use during their medical careers. Nine were sanctioned at least three times by the same board.
A physician in Maryland or Virginia is approximately twice as likely to be disciplined as a doctor in the District, according to medical board records and statistics gathered from the Federation of State Medical Boards for 1999 through 2004.
Among doctors licensed in the District, Maryland and Virginia, nearly two dozen were disciplined in one jurisdiction but then moved elsewhere to practice, according to a Post analysis of medical board records between 1999 and 2004.
Nationally, 972 physicians during that period were disciplined in one state, but then moved at least once more, and then were disciplined again for a separate infraction, according to federal statistics. Nineteen were disciplined in four or more states over five years.
Doctors who are disciplined can move around because many are never reported to the National Practitioner Data Bank, the national repository for doctor discipline records. The data bank is supposed to allow licensing boards and employers to check on doctors' records before they are hired and to prevent problem doctors from state-hopping.
However, almost 54 percent of all hospitals have never reported a disciplinary action to the data bank, according to the federal Department of Health and Human Services.
Federal law requires that hospitals and medical boards be penalized if they don't report action to the data bank. Yet federal government officials acknowledge that no penalty or fine has ever been levied.
As part of a leave agreement, hospitals often agree not to report doctors they are forcing out. This mistakenly signals to other states and medical facilities that the doctor has a clean history.
In some instances, doctors' names are removed from malpractice settlements to keep them off data bank records. Only those physicians named in the final settlement must be reported.
Between 1999 and 2004, the D.C. medical board disciplined 49 physicians, according to board records. Thirty-four of the physicians — nearly 70 percent — were punished based on action taken elsewhere. By comparison, that figure was 16 percent in Maryland and 12 percent in Virginia.
Several D.C. doctors (including one internist who failed drug tests 5 years in a row) who have been charged with drug possession or misuse have never been disciplined or taken out of practice by the D.C. board.
In Maryland, about 3 percent of the more than 10,800 complaints the state board received between 1999 and 2004 led to discipline against doctors, according to its records. In Virginia, the amount was about 9 percent of its more than 8,725 complaints during that period. In the District, about 1 percent—four of roughly 318—led to discipline.