The number of medical cases botched by doctors "far exceeds the number of disciplinary actions actually imposed" by state medical boards, according to a draft federal government report.
The study, which was obtained by The Times in advance of its official release later this month, acknowledged that the boards have made "significant progress" in improving their capacity to discipline physicians. But it said they still suffer from a litany of problems, including serious case backlogs, staff shortages and a lack of meaningful data to assess their performance.
The report by the Office of Inspector General of the U.S. Department of Health and Human Services also criticizes California's "fragmented" disciplinary process, in which responsibility for physician discipline is shared by several state agencies.
In a series of articles published last month, The Times documented significant shortcomings of California's doctor disciplinary system, such as hundreds of uninvestigated patient complaints and long delays in concluding cases. Officials of the Medical Board of California have acknowledged many specific deficiencies but maintain that their overall performance is good.
The Times found that blame for the problems is shared by the medical board, which licenses and disciplines physicians, the state attorney general's office, whose lawyers try disciplinary cases against physicians, and the state Office of Administrative Hearings, whose judges hear the cases.
California ranked 42nd among the states in the number of serious disciplinary actions per 1,000 licensed physicians in 1987, the most recent year for which complete data is available.
The inspector general's report pointed out that while most state medical boards "decry assessments of their performance based strictly on the number of disciplinary actions they take, the reality is that, with rare exceptions, there is little else available upon which to base meaningful assessments."
The report added: "Even when all appropriate caveats are taken into account, the (number of botched cases and other physician misconduct warranting discipline) far exceeds the number of disciplinary actions actually imposed by the boards."
The draft report recommends more funding and investigators for state medical boards as well as increased sharing of information between state and federal agencies.
