Over the 10-year period covered by the Questionable Doctors Online database,
there were a total of 2,106 disciplinary actions issued against 1,111 doctors
in Texas. For the five most serious offenses, there were: 106 actions taken against
doctors because of criminal convictions; 220 for substandard care, incompetence
or negligence; 190 for misprescribing or overprescribing drugs; 290 for substance
abuse; and 95 for sexual abuse of or sexual misconduct with a patient.
Of the 220 actions taken against doctors for substandard care, incompetence
or negligence, only six (3 percent) involved revocation or suspension. Similarly,
of the 95 actions taken for sexual abuse of or sexual misconduct with a patient,
only 14 (15 percent) involved suspension or revocation.
"All too often, state medical boards are more concerned about protecting
the reputations of doctors than doing their job, which is to protect unsuspecting
patients from doctors who may be incompetent or negligent," Wolfe said. "Texas
has an appalling record of letting serious and sometimes repeat offenders off
Public Citizen also has published a ranking of state medical boards, based
on the number of serious disciplinary actions (license revocations, surrenders,
suspensions and probation/restrictions) per 1,000 doctors in each state. In 2001,
nationally there were 3.36 serious actions taken for every 1,000 physicians. Texas
ranked No. 30 (tied with New Mexico and North Carolina) on the list, with 122
serious sanctions levied against 47,994 doctors, for a rate of 2.54 per 1,000
doctors. (To view the ranking, click
For each of the past six years (1996-2001) Texas has ranked in the bottom half
of states in the rate of serious disciplinary actions per 1,000 doctors, never
higher than 28/29 and as low as 38. In 2001, there were 10 states that disciplined
more than twice as many doctors per 1,000 doctors in those states than Texas did,
including Arizona, Oklahoma, Ohio and Kentucky. If Texas had done as well as any
of these 10 states, there would have been an additional 122 physicians subjected
to serious disciplinary actions last year.
"Nationwide, an extremely tiny fraction of doctors face disciplinary action,"
Wolfe said. "And Texas is well below the national average. The state needs
to start doing a better job of protecting the public."
Wolfe also criticized the Texas Board of Medical Examiners for the lack of
information about physician offenses that is posted on the board’s web site.
"The board’s web site is woefully uninformative," Wolfe said.
"Most of the time, there is little or no information about the doctor’s
offense, only vague references to the offenses such as ‘unprofessional’
or ‘dishonorable’ conduct. This is unacceptable, because patients
need to be able to make informed decisions about which doctor they choose to see."
To read a survey of state medical board web sites, click
Public Citizen recommends that states promptly make public all of their board
disciplinary actions, malpractice payouts and hospital disciplinary actions; strengthen
medical practice statutes; restructure their medical boards to sever any links
with state medical societies; and increase funding and staffing for medical boards.
Public Citizen has long sought greater consumer access to information about
doctors, and there have been recent improvements in making that information available.
Most state medical boards now provide some physician information on the Internet,
but the information about disciplinary actions varies greatly, is often inadequate
and can be difficult for people to access.
Information about doctor discipline, including state sanctions, hospital disciplinary
actions and medical malpractice awards is now contained in the National Practitioner
Data Bank, but that database is kept secret from the public.
"HMOs, hospitals and medical boards can look at the National Practitioner
Data Bank, but consumers cannot," Wolfe said. "It is time we lifted
the veil of secrecy surrounding doctors and allowed the people who have the most
to lose from questionable doctors to get the information they need to protect
themselves and their families. But until Congress finds the will to open up this
information, Public Citizen will provide the public with as much of the data as
we can obtain."
With the addition of Texas, Questionable Doctors Online now lists doctors disciplined
in 13 states from 1992 through 2001. Information comes from all 50 state medical
boards, the District of Columbia, the U.S. Department of Health and Human Services,
the Drug Enforcement Administration, and the Food and Drug Administration. Previously
listed physicians sanctioned in 1990 and 1991 were removed.
Using the information from the state and federal agencies, Public Citizen created
a database containing the doctor’s name, degree, license number, date of
birth, location, the disciplinary state or agency, the date of the disciplinary
action, the nature of the discipline and available information about the case.
Public Citizen asked all the state medical boards to provide information about
court actions that may have overruled or changed previous disciplinary actions.
Any disciplinary actions that were overturned by courts or for which litigation
ended in the doctor’s favor were deleted from the database.