Survey shows isles at 40th in nation for rate of disciplining doctors
Hawaii's state Medical Board rates among the 10 worst in the nation for disciplining doctors, according to a national survey published yesterday by Public Citizen, a Washington, D.C.-based consumer watchdog group founded by Ralph Nader.
For the survey period 2003-2005, Hawaii ranked 40th for the rate of "serious disciplinary actions" (license revocations, surrenders, suspensions and probation/restrictions) taken per 1,000 physicians in a state.
Public Citizen conducts its survey based on state data compiled by the Federation of State Medical Boards.
The survey reported that Hawaii, along with Wisconsin, Minnesota and Delaware, has been in the bottom-ranking 15 states for the past 10 survey periods.
This year, Mississippi ranked worst with 1.62 serious disciplinary actions per 1,000 physicians, compared with Hawaii's 2.19. Kentucky topped the survey with 9.08 serious actions per 1,000.
"I think we are doing a crummy job disciplining our physicians. And when they do discipline them, they want secrecy," said Honolulu attorney Richard Fried, who has won high-profile medical malpractice cases.
"It should be emphasized that it is a small number of doctors that have the malpractice cases. But we need better discipline to take care of those habitual offenders," he said.
But Dr. Patricia Blanchette, president of the Hawaii Medical Association, defended the board's disciplinary standards and said, "Luckily, we don't require many disciplinary actions. And we have a very strict board."
Blanchette, who served on the medical review board from 1996 until 2004, said several factors skew the results, making it appear that Hawaii is less vigilant than it is.
First, she noted that there are many doctors registered to practice in Hawaii who practice in another state or are retired, meaning they would count among the state's physicians but would never come before the board for discipline.
She also said that if a physician is disciplined, only the most stringent action, usually revocation, is counted and reported to the federation. She said other states often levy multiple actions on the same physician for the same infraction, skewing the number of actions per 1,000 physicians.
Blanchette noted that Hawaii is strict in screening who can practice here. She also noted that the vast majority of doctors who are disciplined are not trained here.
"We have very good doctors here," said Blanchette, chairwoman of the Department of Geriatric Medicine at the John A. Burns School of Medicine at the University of Hawaii-Manoa.