Browsing by Subject "malpractice"
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Item Disciplining Physicians: Factors that Influence Severity of Punishment by a State Board: An Investigation fo the Texas State Board of Medical Examiners, 1989-1998(2001-05-01) Gustowski, Sharon; Clark, SharonPhysician conduct and competence is increasingly debated in today’s health care environment, an environment that is influenced by managed care, medical malpractice, and a more informed consumer population demanding a higher quality of medical care. Revocation of physician licenses has increased, and it has been noted that physicians older than 40 years received more disciplinary actions that their younger counterparts. Studies of disciplined physicians have been done in California, Rhode Island, Ohio, and New York. Additional studies have also been done investigating inappropriate prescribing practices and sex-related offenses committed by physicians. None of these studies identified risk factors that influenced the severity of punishment given by a state board. Additionally, data concerning osteopathic physicians was scant and not included. An important issue regarding physician conduct and competence is the comparability between osteopathic (DO) and allopathic (MD) physicians. Moreover, it is also important to know which, if any, factors influence the decision for a severe punishment (such as revocation or suspension of a license). In Texas, both DOs and MDs are licensed to practice medicine and, when warranted, disciplined by the Texas State Board of Medical Examiners (TSBME). The TSBME is the agency authorized to license and discipline physicians and other health care professionals as mandated by the Medical Practice Act. The current TSBME is composed of 9 MDs, 3 Dos, and 3 public representatives and all members are appointed by the governor for 6-year terms. Data obtained from the TSBME shows for each year from 1989 to 1998, Dos were more likely to be disciplined than MDs (figure 1). Whether or not this represents a truly great risk for Dos to be disciplined by the TSBME is unknown. Therefore, it is important to know whether the same standard of care is applied to Dos and MDs and given a compromise of that standard, whether Dos and MDs are treated equally and fairly. The purpose of this study is to determine which factors, including the type of degree a physician holds, influenced the severity of punishment given to physicians by the TSBME from 1989-1998.Item Predicting for Disciplinary Action by the Texas State Board of Medical Examiners, 1989-1998(2001-01-01) Cardarelli, Roberto; Licciardone, John C.; Ramirez, Gilbert; Marshall, MurielContext The rate of physician disciplinary action in the United States has been increasing over the lack decade. While studies have analyzed various facets of malpractice and types of physician offenses, few have attempted to investigate factors that may place physicians at risk for disciplinary action. Objective To determine predictors for physician disciplinary action. Design Case-control study using publicly available data matching 174 disciplined physicians with non-disciplined physicians on age and years in practice. Subjects Disciplined physicians reported by the Texas State Board of Medical Examiners from January 1989 to December 1998. Main Outcome Measures Characteristics of disciplined physicians and multivariate predictors of disciplinary action. Results Of the 1382 physicians disciplined during the study period, 174 cases were eligible for inclusion. Sixty six percent of the study period, 174 cases were eligible for inclusion. Sixty six percent of the study population was 40 years or less of age, while 69.5% were men. Whites composed 65.4% of the study population and internal medicine was the predominate specialty. In the multivariate analysis female physicians were less likely to receive disciplinary action (odds ratio [OR]=0.27, 95% confidence interval [CI]=0.17-0.44. Additionally, internists (OR=0.35, 95% CI=0.22-0.56), surgeons (OR=0.30, 95% CI=0.17-0.54), and pediatricians (OR=0.28, 95% CI=0.13-0.61) were less likely to be disciplined compared to family medicine physicians, while general practitioners (OR=2.48, 95% CI=1.24-4.95) were most likely to be disciplined. Conclusions Although only a small fraction practicing physicians is disciplined each year, an economic and public health issue persists. This study identified several predictors for disciplinary action, however, further studies are needed to better understand those at risk so effective interventions can be developed.