Physician Licensing and Disciplining: Lessons from Indiana
26 Pages Posted: 1 Jul 2019 Last revised: 2 Oct 2020
Date Written: October 1, 2020
State medical boards use professional licensing and discipline to enforce minimum performance standards. Using 43 years of data (1972-2015) obtained from the Indiana Professional Licensing Agency, we examine the performance of the disciplinary process. Only a small number (1.2%) of the 63,485 physicians in our dataset were disciplined. Three forms of misconduct (drug diversion, substance abuse, and sex) account for 60% of all disciplinary actions. Male physicians are at higher risk for disciplinary action for sexual misconduct and drug diversion, but not for other types of misconduct. Graduates of non-U.S. medical schools have the same overall risk of disciplinary action as physicians who attended medical school in the U.S., but this is the result of averaging a significantly lower risk of discipline for alcohol abuse and drug abuse with a significantly higher risk of discipline for negligence/incompetence and sexual misconduct. Among graduates of non-U.S. medical schools, physicians who attended a medical school in the Caribbean have a significantly higher risk of negligence/incompetence. The risk of disciplinary action varies greatly by specialty, and sanction severity varies greatly by offense type.
Keywords: physician discipline, disciplinary sanctions, licensure, quality of care
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