State Lags in Disciplining Doctors, Consumer Group Says

California continues to rank among the worst states when it comes to disciplining physicians, according to a report released Wednesday by a Ralph Nader consumer group.

The number of serious disciplinary actions against physicians last year in California was barely half the national average and less than one-seventh of the disciplinary actions taken by the Oklahoma medical board, which was the nation’s most active.

“It means that there are a lot of physicians in California practicing medicine, injuring and killing patients, who would have been removed from practice in other states that did a better job of disciplining physicians,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, a group based in Washington, that has been tracking state medical boards for seven years.

The California Medical Board immediately criticized the consumer group’s methodology for comparing states. “The figures are very misleading because laws governing disclosure of disciplinary action vary from state to state and have a profound impact on data reported and the state’s national ranking,” said state medical board spokeswoman Candis Cohen.

Also, Cohen said, the California board’s disciplinary power is restricted by state law requiring more evidence against physicians than most other states before serious action can be taken--for instance, revoking or suspending a license or putting a physician on probation.

But Wolfe contends that the state data examined by Public Citizen’s is comparable to the national data.

The Public Citizen’s report also includes a two-volume list of 10,289 “questionable doctors” disciplined by the states and federal government since 1984 in 14,574 separate actions. The compilation added 3,453 names to the previous 1991 listing.

The group complained that more doctors nationwide should receive harsher penalties and their names routinely revealed to warn the public.

But the American Medical Assn. accused Public Citizen’s of “grandstanding” and contended that the list of errant doctors was misleading. “It lumps technical violations that say nothing about quality or competence with serious ones,” said Kirk B. Johnson, the AMA’s general counsel.

Wolfe said that while his group ranked the state 42nd in the nation for taking action against doctors (from a ranking of 37 the year before), it found the board does a better job when it does act.

“When they catch somebody, the generally do an adequate job of disciplining them,” Wolfe said.