State Medical Licensing Boards Fail to Discipline Physicians Sanctioned by the FDA
Obtaining a legitimate license from a state medical license board to practice medicine is a long, arduous educational process followed by a rigorous practicum of many years to demonstrate the level of skill and knowledge required to treat patients. Once a license is issued, there are steps to assure the licensed provider remains compliant to the requirements set by the state medical licensing board.
In our health care system, we have always simply trusted that the framed license on the wall is sufficient proof of good standing, even though there is no expiration date as there is on a driver’s license or passport, nor is there a list of any possible transgressions of the provider. The patient relies solely on state medical licensing boards to keep them safe by disciplining and removing those practitioners who cause harm.
Unfortunately, a provider can hold a medical license even after clear misconduct and repeated endangerment to patients. A recent story, co-published in USA Today and Medpage Today on August 16, 2018 by investigative health care journalists, John Fauber and Matt Wynn, illustrates just a few examples of such misconduct. According to the article, over a five-year period, 73 warning letters were sent by the U.S. Food and Drug Administration (FDA), to doctors in 28 states about the violations found following inspection. The warning letters are sent to doctors by the FDA when there are violations of federal rules that have been put into place to protect patients. Only one of the 73 doctors was actually disciplined by the state medical board. The letters are also available on the FDA website, and licensing boards can check the website for warning signs on licensees.
Reasons for the FDA sanctioning practitioners include administering unfounded cures for cancer, skipping quality control testing in research, not testing for communicable disease in donor eggs and sperm, contaminated stem cell product, and the list goes on. Imagine if you or a loved one were hoping or relying on these professionals for treatment while these disturbing practices were going on?
Although the vast majority of physicians and other health care providers are qualified and dedicated caregivers, there are these examples which can tarnish the medical profession and endanger patients. These examples represent only the type of misconduct within the purview of the FDA. Unfortunately there are other examples of misconduct outside of the FDA.
The article says that state medical boards get information from multiple sources such as courts, accrediting bodies, the FDA website, hospitals, and a malpractice database created by Congress. If this is true, then a state medical board would have to seek out data from thousands of primary source publishers, aggregate this information and accurately match to its current licensees to be fully aware of the actions of its licensed provider universe.
Sadly, the FDA letters are just one example of a gap in the system, in which, pertinent information is not being sent to or tracked by the state licensing boards. Likewise, the federal government has not created a centralized, verified data set that creates a single source of information on health care providers from the thousands of available primary sources. However, a comprehensive data set called FACIS (Fraud Abuse Control Information System) is available commercially that could and should be accessed universally by state boards; but is not utilized this creates the gap in access to data and actionable measures.
State medical licensing boards have a responsibility to assure the public is served by competent physicians and other providers who are in good standing—those who provide quality care. Hospitals and clinics rely on state medical licensing boards to provide verification of intact licensure prior to onboarding a physician; and the Department of Health and Human Services, (HHS) Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) also relies on medical licensing board disciplinary and revocation actions to determine federal reimbursement privileges.
When licensing boards are not made aware of improper conduct or do not have the technology or capabilities to aggregate data and link it to the appropriate provider for a 360 view, they can fall short in taking action against a provider.
This also prevents licensing boards from being proactive in continuously monitoring licensed individuals and entities and being alerted to leading indicators in near real time. This leads to an exponential ripple effect that impacts the viability of federal reimbursement programs and most importantly, threatens patient safety. Fortunately, there are ways to partner with data technology companies and utilize a 360-degree view of licensees for the advantage of total transparency.