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Medical Boards, Protecting Patients and Helping Physicians – Not Mutually Exclusive

It is frequently said that the primary role of a state medical regulatory board is to protect the public. Unfortunately, this concept has evolved in some regions suggesting there is a conflict between patients and their physicians.[1] In other words, the message can be sent that patients must be protected from physicians. Truly there have been examples of unscrupulous health professionals who have taken advantage of patients or who, for one reason or another, have failed to provide proper care. Thankfully this is rare. By far, most health professionals entered their profession honestly and have maintained a sincere desire to help people and they take great care to do so.

Anything that leads to the promulgation of the belief that physicians are untrustworthy or dangerous can actually be detrimental to public health. Unfortunately, this view, that going to the doctor is dangerous, seems to be increasing. It is important for people to seek medical care when needed. It is the job of the medical board to assure that licensed physicians are qualified to practice. Patients should not be burdened with the task of wondering if their doctor is competent. Promoting the idea, intentional or not, that doctors cannot be trusted actually increases risk for patients.

Boards report disciplinary actions to document their activities, to show that they are “on duty” protecting the public. This practice can actually be increasing patient risk and causing harm. Other agencies, including the media and consumer advocacy groups, benefit from promoting the idea that doctors are dangerous. The public seems to have a morbid interest in hearing about bad doctors. In part, this is likely due to the cognitive dissonance between what people actually experience, trusting their doctors, and the idea that they are not to be trusted. The media capitalize on this and make big headlines when an unethical doctor is discovered. To find these cases the media often go to regulatory board meetings for leads. Likewise, consumer advocacy groups benefit when bad doctors are publicized because they raise funds by filling the role of patient advocate. One only has to do a search online of, “physician harms patient,” to see that there are many articles such as, “Why do doctors kill their patients?”, “The voices of patient harm – ProPublica,” and, “When a physician harms a patient.”

Another paradoxical issue is the concept of exposing facts about doctors so the public can be informed. This, of course, assumes that information about doctors can help patients make better decisions and supposedly could increase their safety. For example, should we require doctors to tell patients about their history of trouble that led to their license being on probation? Such a measure, Senate Bill 1448, was passed by the California legislature in 2018. The act is called, The Patient’s Right to Know Act, and requires physicians and surgeons who are placed on probation to obtain informed consent from new patients after informing them of the details of the problems. The legislature, like the regulatory boards, want the public to know they are “on duty” and protecting the public. This also leads to more stories for the media and promotes the benefits of consumer advocacy groups who lobbied for this bill. But does it really increase patient safety? It can be argued that the doctor on probation, who is being scrutinized by the board, is actually safer than other physicians not under as close of board scrutiny. This type of bill can lead to the appearance that the medical board is the enemy of physicians and is out to expose their problems. In this atmosphere, it is far less likely that an impaired colleague would be reported or that a physician needing help would seek help on their own.

So, what is the solution? The medical boards should resist pressure from consumer groups and media that they are there “only to protect the public” and not to “help doctors.” Medical boards’ primary calling may be to protect the public, but they should also help physicians. These two goals are not in conflict but, to the contrary, they are aligned. Healthy doctors provide better care to their patients. So, promoting policies that encourage doctors to get help early actually protects patients. To do this, boards need to promote the idea that they are there to help physicians, not just to punish them. And their policies should reflect that they are aware that doctors have difficulties and promote programs that encourage doctors to obtain help. Boards should not be seen as the enemy of their licensees.


By Greg Skipper, MD, Medical Director, Center for Professional Recovery






[1] This article refers to physicians, but the concepts can equally apply to any other type of health professional, therefore whenever physician is used, it can be interpreted to any health professional.

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