scholarly journals Protecting Patients from Egregious Wrongdoing by Physicians: Consensus Recommendations from State Medical Board Members and Staff

2021 ◽  
Vol 107 (3) ◽  
pp. 5-18
Author(s):  
Tristan McIntosh ◽  
Elizabeth Pendo ◽  
Heidi Walsh ◽  
Kari Baldwin ◽  
James M. DuBois
Keyword(s):  
State Government ◽  
The United States ◽  
External Support ◽  
Board Members ◽  
Delphi Panel ◽  
Legal Counsel ◽  
Modified Delphi ◽  
Wide Variability ◽  
State Medical Boards ◽  
State Medical Board

ABSTRACT Purpose There is wide variability in the frequency and severity of disciplinary actions imposed by state medical boards (SMBs) against physicians who engage in egregious wrongdoing. We sought to identify cutting-edge and particularly effective practices, resources, and statutory provisions that SMBs can adopt to better protect patients from harmful physicians. Main findings Using a modified Delphi panel, expert consensus was reached for 51 recommendations that were rated as highly important for SMBs. Panelists included physicians, executive members, legal counsel, and public members from approximately 50% of the 71 SMBs that serve the United States and its territories. Conclusion The expert-informed list of recommendations can help support more effective and transparent actions and processes by SMBs when addressing suspected egregious wrongdoing. While some SMBs may be limited in what policies and provisions they can adopt without approval or assistance from state government, many of these recommendations can be autonomously adopted by SMBs without external support.

State Medical Board Exposure to Threats of Violence

2013 ◽  
Vol 99 (3) ◽  
pp. 11-17
Author(s):  
Kelly C. Alfred ◽  
Timothy Turner ◽  
Aaron Young
Keyword(s):  
Threat Assessment ◽  
The State ◽  
Board Members ◽  
Security Level ◽  
Stressful Situation ◽  
Medical Board ◽  
Local Law Enforcement ◽  
Training Resources ◽  
State Medical Boards ◽  
State Medical Board

ABSTRACT Between 2010 and 2012, the Federation of State Medical Boards Research and Education Foundation (FSMB Foundation) conducted a survey of state medical boards in an effort to ascertain the extent to which state medical board members and staff have experienced threats of violence and the actions taken by state boards in response to such threats. The survey also assessed current and anticipated levels of security being provided by state boards. Of the 70 boards queried, 37 responded, with 73% (n=27) of these boards reporting that their board members and/or staff had experienced either explicit or implied threats of violence. These threats targeted board members (85%), board staff (78%) and others (15%). Many of the threats directed at board members occurred after board meetings and/or hearings and were made by either a physician or a family member of a physician. Most of the threats directed at board members, staff and others were verbal, including threats of death. Most boards provide a security presence at board meetings, ranging from local law enforcement agencies to private security firms, but less than half of the respondents in the survey expressed satisfaction with their present security level. The results of the survey suggest that the state medical board community should be aware of the potential for violence against board members and staff, and should formulate prevention and threat-assessment policies as a precaution. Educational and training resources may be needed at the state board level. This could include the development of educational modules to train state public officials in conflict management, the prevention and handling of acts of violence, and how to identify and assess the seriousness of a potentially violent or stressful situation.

Improving State Medical Board Policies: Influence of a Model

2003 ◽  
Vol 31 (1) ◽  
pp. 119-129 ◽  
Author(s):  
Aaron M. Gilson ◽  
David E. Joranson ◽  
Martha A. Maurer
Keyword(s):  
Pain Management ◽  
Inappropriate Prescribing ◽  
Medical Knowledge ◽  
Opioid Analgesics ◽  
The United States ◽  
Long Term Effects ◽  
Controlled Substances ◽  
Regulatory Systems ◽  
State Medical Boards ◽  
State Medical Board

Despite advances in medical knowledge regarding pain management, pain continues to be significantly undertreated in the United States. There are many drug and nondrug treatments, but the use of controlled substances, particularly the opioid analgesics, is universally accepted for the treatment of pain from cancer. Although opioid analgesics are safe and effective in treating chronic pain, there is continued research and discussion about patient selection and long-term effects. A number of barriers in the health care and drug regulatory systems account for the gap between what is known about pain management and what is practiced. Among the barriers are physicians’ fears of being disciplined by state regulatory boards for inappropriate prescribing.State medical boards are in a unique position not only to address physicians’ concerns about being investigated, but also to encourage pain management. Prior to 1989, a few state medical boards had policies relating to controlled substances or pain. Subsequently, state medical boards began adopting policies regarding the prescribing of opioids for the treatment of pain; many of these specifically addressed physicians’ fear of regulatory scrutiny.

Improving Pain Management through Policy Making and Education for Medical Regulators

1996 ◽  
Vol 24 (4) ◽  
pp. 344-347 ◽  
Author(s):  
David E. Joranson ◽  
Aaron M. Gilson
Keyword(s):  
Pain Management ◽  
Board Members ◽  
Substantial Impact ◽  
Medical Board ◽  
Appropriate Prescribing ◽  
Regulatory Scrutiny ◽  
Regulatory Barriers ◽  
Effective Pain Relief ◽  
State Medical Boards ◽  
State Medical Board

Physician concern about regulatory scrutiny as a barrier to appropriate prescribing for pain management has been identified and studied. A 1991 Pain Research Group survey demonstrated a need to provide updated information about opioids and pain management to state medical board members. Indeed, a national survey even showed a need to provide more education about pain management to oncology Physicians. Two approaches for responding to these concerns have been undertaken in several states by the state medical boards and the pain management community: the development and adoption of administrative policies designed to bring disciplinary standards in line with clinical practice; and the creation of education programs for state medical board members and staffs. Each can have a substantial impact on removing real and perceived regulatory barriers to effective pain relief.

Consumer background and composition on state medical boards: Who are these citizen members and do they adequately protect the public?

2021 ◽  
pp. 251604352110543
Author(s):  
Doug Wojcieszak
Keyword(s):  
Patient Safety ◽  
Public Perception ◽  
Medical Profession ◽  
The United States ◽  
Policy Recommendations ◽  
Medical Expertise ◽  
The Public ◽  
Medical Board ◽  
State Medical Boards ◽  
State Medical Board

The composition and background of members of state medical boards, including public or citizen members, can impact the functionality and public perception of medical boards in the United States. This study analyzed the number of public members on each state medical board and their professional backgrounds or expertise to regulate the medical profession. The findings show that for nearly half of state medical boards public members comprise at least a quarter of their voting members; however, more than half of public members for all state medical boards have no measurable medical experience or background, including in patient safety. The need for public members to have medical expertise or background – especially in patient safety -- is discussed along with potential policy recommendations.

Varied Responses to Human-Induced Seismicity in the City of Azle, Texas

2019 ◽  
Vol 3 (1) ◽  
pp. 1-8
Author(s):  
Sarmistha R. Majumdar
Keyword(s):  
State Government ◽  
Induced Seismicity ◽  
Oil And Gas ◽  
The United States ◽  
The State ◽  
Prior History ◽  
Small Community ◽  
Regulatory Policies ◽  
The Status

Fracking has helped to usher in an era of energy abundance in the United States. This advanced drilling procedure has helped the nation to attain the status of the largest producer of crude oil and natural gas in the world, but some of its negative externalities, such as human-induced seismicity, can no longer be ignored. The occurrence of earthquakes in communities located at proximity to disposal wells with no prior history of seismicity has shocked residents and have caused damages to properties. It has evoked individuals’ resentment against the practice of injection of fracking’s wastewater under pressure into underground disposal wells. Though the oil and gas companies have denied the existence of a link between such a practice and earthquakes and the local and state governments have delayed their responses to the unforeseen seismic events, the issue has gained in prominence among researchers, affected community residents, and the media. This case study has offered a glimpse into the varied responses of stakeholders to human-induced seismicity in a small city in the state of Texas. It is evident from this case study that although individuals’ complaints and protests from a small community may not be successful in bringing about statewide changes in regulatory policies on disposal of fracking’s wastewater, they can add to the public pressure on the state government to do something to address the problem in a state that supports fracking.

State Medical Board Disciplinary Hearings as Tools for Teaching Professionalism in Medical Education

2011 ◽  
Vol 97 (3) ◽  
pp. 8-12
Author(s):  
Onelia G. Lage ◽  
Sydney F. Pomenti ◽  
Edwin Hayes ◽  
Kristen Barrie ◽  
Nancy Baker
Keyword(s):  
Medical Students ◽  
Ethics Education ◽  
Faculty Members ◽  
Specific Method ◽  
Pilot Studies ◽  
Medical Board ◽  
Medical Institutions ◽  
State Medical Boards ◽  
State Medical Board ◽  
The Impact

ABSTRACT This article proposes a partnership of state medical boards with medical schools to supplement professionalism and ethics education for medical students, residents, physicians and faculty members of medical institutions. The importance of professionalism has been recognized by several studies, but a specific method of teaching and developing professionalism has yet to emerge. Studies suggest that there is an association between a lack of professionalism in medical school and future disciplinary actions by medical boards. However, there has been little collaboration between these institutions in addressing unprofessional behaviors. One collaborative concept that holds promise, however, is the idea of inviting medical students to attend physician disciplinary hearings. Students and physicians alike report that watching a hearing can significantly impact attitudes about professionalism as a part of medical practice. While formal research is scarce, the positive response of individual students who experience disciplinary hearings firsthand suggests that further pilot studies may be useful. Presented in this paper are the perspectives of three individuals — a medical student, a faculty member and a medical board chair — who discuss the impact and potential of attending disciplinary hearings in developing professionalism and ethics. Also included is a review of the current literature.

Characteristics of Physicians Referred for a Competence Assessment: A Comparison of State Medical Board and Hospital Referred Physicians

2010 ◽  
Vol 96 (3) ◽  
pp. 8-15 ◽  
Author(s):  
Elizabeth S. Grace ◽  
Elizabeth J. Korinek ◽  
Zung V. Tran
Keyword(s):  
Clinical Competence ◽  
Competence Assessment ◽  
Average Performance ◽  
Medical Board ◽  
Key Characteristics ◽  
Different Types ◽  
Specialty Board ◽  
And Performance ◽  
State Medical Boards ◽  
State Medical Board

ABSTRACT This study compares key characteristics and performance of physicians referred to a clinical competence assessment and education program by state medical boards (boards) and hospitals. Physicians referred by boards (400) and by hospitals (102) completed a CPEP clinical competence assessment between July 2002 and June 2010. Key characteristics, self-reported specialty, and average performance rating for each group are reported and compared. Results show that, compared with hospital-referred physicians, board-referred physicians were more likely to be male (75.5% versus 88.3%), older (average age 54.1 versus 50.3 years), and less likely to be currently specialty board certified (80.4% versus 61.8%). On a scale of 1 (best) to 4 (worst), average performance was 2.62 for board referrals and 2.36 for hospital referrals. There were no significant differences between board and hospital referrals in the percentage of physicians who graduated from U.S. and Canadian medical schools. The most common specialties referred differed for boards and hospitals. Conclusion: Characteristics of physicians referred to a clinical competence program by boards and hospitals differ in important respects. The authors consider the potential reasons for these differences and whether boards and hospitals are dealing with different subsets of physicians with different types of performance problems. Further study is warranted.

State Medical Boards' Perceptions of a Minimum Data Set and Current Practices for Collecting Physician Information

2013 ◽  
Vol 99 (4) ◽  
pp. 40-45 ◽  
Author(s):  
Aaron Young ◽  
Philip Davignon ◽  
Margaret B. Hansen ◽  
Mark A. Eggen
Keyword(s):  
Media Coverage ◽  
The United States ◽  
Minimum Data Set ◽  
Direct Patient Care ◽  
Physician Workforce ◽  
Data Set ◽  
Minimum Data ◽  
State Medical Boards ◽  
The Impact ◽  
Current Practices

ABSTRACT Recent media coverage has focused on the supply of physicians in the United States, especially with the impact of a growing physician shortage and the Affordable Care Act. State medical boards and other entities maintain data on physician licensure and discipline, as well as some biographical data describing their physician populations. However, there are gaps of workforce information in these sources. The Federation of State Medical Boards' (FSMB) Census of Licensed Physicians and the AMA Masterfile, for example, offer valuable information, but they provide a limited picture of the physician workforce. Furthermore, they are unable to shed light on some of the nuances in physician availability, such as how much time physicians spend providing direct patient care. In response to these gaps, policymakers and regulators have in recent years discussed the creation of a physician minimum data set (MDS), which would be gathered periodically and would provide key physician workforce information. While proponents of an MDS believe it would provide benefits to a variety of stakeholders, an effort has not been attempted to determine whether state medical boards think it is important to collect physician workforce data and if they currently collect workforce information from licensed physicians. To learn more, the FSMB sent surveys to the executive directors at state medical boards to determine their perceptions of collecting workforce data and current practices regarding their collection of such data. The purpose of this article is to convey results from this effort. Survey findings indicate that the vast majority of boards view physician workforce information as valuable in the determination of health care needs within their state, and that various boards are already collecting some data elements. Analysis of the data confirms the potential benefits of a physician minimum data set (MDS) and why state medical boards are in a unique position to collect MDS information from physicians.

scholarly journals Immune-mediated diseases and thromboembolic events: a modified Delphi panel

2021 ◽  
pp. 1-1
Author(s):  
Nassir Azimi ◽  
Freddy Caldera ◽  
Stan Cohen ◽  
James Conners ◽  
Timothy Fernandes ◽  
...  
Keyword(s):  
Delphi Panel ◽  
Thromboembolic Events ◽  
Modified Delphi ◽  
Immune Mediated

scholarly journals Sustainability of Biosimilars in Europe: A Delphi Panel Consensus with Systematic Literature Review

2020 ◽  
Vol 13 (11) ◽  
pp. 400
Author(s):  
Arnold G. Vulto ◽  
Jackie Vanderpuye-Orgle ◽  
Martin van der Graaff ◽  
Steven R. A. Simoens ◽  
Lorenzo Dagna ◽  
...  
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Health Care Systems ◽  
Delphi Panel ◽  
The European Union ◽  
Modified Delphi ◽  
Care Systems ◽  
Supply Risks ◽  
The Impact

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.

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