Predicting for Disciplinary Action by the Texas State Board of Medical Examiners, 1989-1998

Context 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.