News of the Day ... In Perspective09/2/2006
Public Citizen demands harsher punishment of doctors
Based on a survey by Public Citizen, USA Today announced that “Bad doctors get slapped on wrist.”
“Doctors who commit crimes often escape harsh professional punishment by state and federal agencies,” writes Janet Kornblum, citing a study of 2,247 physicians disciplined for criminal conduct between 1990 and 1999. “Boards are particularly light on doctors who have committed insurance fraud and who have been involved in crimes related to drugs, including prescribing violations,” she states (USA Today 8/30/06).
Calling the article “another outrage instigated by Public Citizen,” AAPS General Counsel Andrew Schlafly noted that less than 10% of the criminal convictions of doctors concerned rape, murder, and other bodily harm. Rather, the vast majority of “crimes” included doctors trying to help patients, as by writing a prescription (29%) or billing an insurer (33%). See Table 4.
Medical boards may have thought it “absurd to discipline a doctor for treating pain, or running afoul of an insurance company and government attempts to deny payments for necessary services,” Schlafly remarked.
Public Citizen considered a “serious” disciplinary action to be one that involved restriction, suspension, or revocation of licensure. “Non-severe” orders included fines, reprimands, enrollment in alcohol or drug treatment, monitoring of the physician’s practice, cease-and-desist orders, or education, no matter how costly or destructive to a physician’s livelihood.
The study found that the number of physicians who “committed criminal acts and were disciplined” remained stable from 1990 to 1999, as the total number of physicians increased. The percentage of physicians with discipline related to criminal convictions decreased nonsignificantly from 0.04% to 0.03%.
Over the 10-year period, 153 physicians (out of more than 750,000) had a sex-related conviction; 25, a conviction for murder, manslaughter, or involuntary manslaughter; and 60, a conviction for an alcohol-related offense. More than 90% of these physicians received a “serious” punishment from a licensure board.
Physicians between the ages of 55 and 64 had the highest risk ratio (1.69) of any age group for disciplinary orders for criminal activity. Public Citizen speculates that “younger physicians may not have practiced long enough to develop a tendency toward criminal behavior or to find opportunities to engage in criminal behavior.”
Older physicians have usually accumulated assets and are a more lucrative target for prosecutors seeking to extract enormous penalties under the False Claims Act, noted AAPS Executive Director Jane Orient, M.D.
In order to accomplish its goal of relentless and harsh punishment of physicians who stumble or fall out of favor, Public Citizen advocates “a national licensing system or a shared licensing data system among states.” This could focus media pressure on one bureaucratic entity and assure that any injustice would be national in scope and even less likely to be remediable than is now the case.