scholarly journals State Medical Board Responses to an Inquiry on Physician Researcher Misconduct

2008 ◽  
Vol 94 (1) ◽  
pp. 16-22
Author(s):  
Stefan P. Kruszewski ◽  
Richard P Paczynski ◽  
Marzana Bialy
Keyword(s):  
Clinical Research ◽  
Medical Science ◽  
Research Misconduct ◽  
Clinical Problem ◽  
Relevant Information ◽  
Disciplinary Action ◽  
Regulatory Agencies ◽  
Access To Data ◽  
State Medical Boards ◽  
State Medical Board

ABSTRACT Misconduct in clinical research jeopardizes the integrity of medical science. Physician researcher misconduct that produces flawed results has consequences, including the subsequent inability of other physicians who rely on erroneous data to provide informed consent and/or accurate assessment of pharmaceutical and medical device efficacy and safety. This deviation from acceptable medical practice can directly harm patients. How state medical boards address this clinical problem is uncertain. To examine this issue, we asked 51 U.S. medical boards to search their databases for disciplinary action in response to physician researcher misconduct (PRM) from 1996 thru early 2007. We compared their responses with data from federal agencies responsible for disciplinary actions against clinical researchers. Our results demonstrated: i) a high percentage (45 percent) of U.S. medical boards indicated that they did not have or could not provide access to data adequate to address whether or not disciplinary action for PRM had been levied in their states and ii) of respondents able to make relevant information available, we identified only 13 cases of physician disciplinary action for PRM. In contrast, several dozen examples of disciplinary action against physicians for serious clinical research misconduct could be readily documented in publicly accessible data from federal regulatory agencies.

Effectiveness of Written and Oral Specialty Certification Examinations to Predict Actions against the Medical Licenses of Anesthesiologists

2017 ◽  
Vol 126 (6) ◽  
pp. 1171-1179 ◽  
Author(s):  
Yan Zhou ◽  
Huaping Sun ◽  
Deborah J. Culley ◽  
Aaron Young ◽  
Ann E. Harman ◽  
...  
Keyword(s):  
Hazard Ratio ◽  
Disciplinary Action ◽  
Certification Examination ◽  
Medical Graduates ◽  
Written Examination ◽  
Increased Risk ◽  
Specialty Certification ◽  
Medical License ◽  
State Medical Boards ◽  
State Medical Board

Abstract Background The American Board of Anesthesiology administers written and oral examinations for its primary certification. This retrospective cohort study tested the hypothesis that the risk of a disciplinary action against a physician’s medical license is lower in those who pass both examinations than those who pass only the written examination. Methods Physicians who entered anesthesiology training from 1971 to 2011 were followed up to 2014. License actions were ascertained via the Disciplinary Action Notification Service of the Federation of State Medical Boards. Results The incidence rate of license actions was relatively stable over the study period, with approximately 2 to 3 new cases per 1,000 person-years. In multivariable models, the risk of license actions was higher in men (hazard ratio = 1.88 [95% CI, 1.66 to 2.13]) and lower in international medical graduates (hazard ratio = 0.73 [95% CI, 0.66 to 0.81]). Compared with those passing both examinations on the first attempt, those passing neither examination (hazard ratio = 3.60 [95% CI, 3.14 to 4.13]) and those passing only the written examination (hazard ratio = 3.51 [95% CI, 2.87 to 4.29]) had an increased risk of receiving an action from a state medical board. The risk was no different between the latter two groups (P = 0.81), showing that passing the oral but not the written primary certification examination is associated with a decreased risk of subsequent license actions. For those with residency performance information available, having at least one unsatisfactory training record independently increased the risk of license actions. Conclusions These findings support the concept that an oral examination assesses domains important to physician performance that are not fully captured in a written examination.

Determining the Most Valuable Clinical Variables : a Stepwise Multiple Logistic Regression Program

1980 ◽  
Vol 19 (01) ◽  
pp. 42-49 ◽  
Author(s):  
B. W. Brown ◽  
C. Engelhard ◽  
J. Haipern ◽  
J. F. Fries ◽  
L. S. Coles
Keyword(s):  
Logistic Regression ◽  
Predictor Variable ◽  
Clinical Problem ◽  
Relevant Information ◽  
Stepwise Logistic Regression ◽  
Multiple Logistic Regression ◽  
Binary Outcome ◽  
Medical Problems ◽  
Valuable Predictor ◽  
Data Banks

In solving a clinical problem of diagnosis, prognosis, or treatment choice, a physician must select from among a large group of possible tests. In general, an ordering exists specifying which tests are most valuable in providing relevant information concerning the problem on hand. The computer program package to be described (MW) extracts appropriate data from the ARAMIS data banks and then analyzes the data by stepwise logistic regression. A binary outcome (diagnosis, prognostic event, or treatment response) is sequentially associated with possible tests, and the most powerful combination of tests is identified. For example, the most valuable predictor variable of early mortality in SLE is proteinuria, followed sequentially by anemia and absence of arthritis. Experience with these techniques suggests : 1. optimal certainty is usually reached after only three or four tests; 2. several different test sequences may lead to the same level of certainty; 3. diagnosis may usually be ascertained with greater certainty than prognosis; 4. many medical problems contain considerable non-reducible uncertainty; 5. a relatively small group of tests are typically found among the most powerful; 6. results are consistent across several patient populations; 7. results are largely independent of the particular statistic employed. These observations suggest strategies for maximizing information while minimizing risk and expense.

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 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.

scholarly journals Broad concepts and messy realities: optimising the application of mental capacity criteria

2021 ◽  
pp. medethics-2021-107571
Author(s):  
Scott Y H Kim ◽  
Nuala B Kane ◽  
Alexander Ruck Keene ◽  
Gareth S Owen
Keyword(s):  
Decision Making ◽  
Clinical Research ◽  
Functional Capacity ◽  
Functional Model ◽  
Relevant Information ◽  
Mental Capacity ◽  
Capacity Assessment ◽  
Diverse Range ◽  
England And Wales ◽  
Mental Capacity Act

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of capacity, we previously developed a descriptive typology of justifications (rationales) used in the application of the Mental Capacity Act (MCA) criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA.

scholarly journals Eyes wide open: reader and author responsibility in understanding the limits of peer review

2015 ◽  
Vol 97 (7) ◽  
pp. 487-489 ◽  
Author(s):  
PJ Benson
Keyword(s):  
Stem Cell ◽  
Peer Review ◽  
Electronic Publishing ◽  
Scientific Journal ◽  
Medical Science ◽  
Research Misconduct ◽  
Public Library ◽  
Third Party ◽  
Review Journal ◽  
Peer Review Journal

‘Medical science can only flourish in a free society and dies under totalitarian repression.’ 1 Peer review post-publication is relatively easy to define: when the world decides the importance of publication. Peer review pre-publication is what the scientific community frequently means when using the term ‘peer review’. But what it is it? Few will agree on an exact definition; generally speaking, it refers to an independent, third party scrutiny of a manuscript by scientific experts (called peers) who advise on its suitability for publication. Peer review is expensive; although reviewers are unpaid, the cost in time is enormous and it is slow. There is often little agreement among reviewers about whether an article should be published and peer review can be a lottery. Often referred to as a quality assurance process, there are many examples of when peer review failed. Many will be aware of Woo-Suk Hwang’s shocking stem cell research misconduct at Seoul National University. 2 Science famously published two breakthrough articles that were found subsequently to be completely fabricated and this happened in spite of peer review. Science is not unique in making this error. However, love it or hate it, peer review, for the present time at least, is here to stay. In this article, Philippa Benson, Managing Editor of Science Advances (the first open access journal of the American Association for the Advancement of Science), discusses the merits of peer review. Dr Benson has extensive experience in the publishing world and was Executive Director of PJB Consulting, a not-for-profit organisation supporting clients on issues related to converting to full electronic publishing workflows as well as challenges working with international authors and publishers. Her clients included the Public Library of Science journals, the American Society for Nutrition and the de Beaumont Foundation. She recently co-authored a book, What Editors Want: An Author’s Guide to Scientific Journal Publishing (University of Chicago Press), which helps readers understand and navigate the publishing process in high impact science and technical journals. Her master’s and doctorate degrees are from Carnegie Mellon University. JYOTI SHAH Commissioning Editor References 1. Eaton KK . Editorial: when is a peer review journal not a peer review journal? J Nutr Environ Med 1997 ; 7 : 139 – 144 . 2. van der Heyden MA , van de Ven T , Opthof T . Fraud and misconduct in science: the stem cell seduction . Neth Heart J 2009 ; 17 : 25 – 29 .

In Search of a New Ethic for Treating Patients with Chronic Pain: What Can Medical Boards Do?

1998 ◽  
Vol 26 (4) ◽  
pp. 332-349 ◽  
Author(s):  
Ann M. Martino
Keyword(s):  
Chronic Pain ◽  
Opioid Analgesics ◽  
Conventional Wisdom ◽  
High Profile ◽  
Medical Board ◽  
Medical Establishment ◽  
The Press ◽  
Substantial Risk ◽  
State Medical Boards ◽  
State Medical Board

A decade ago, conventional wisdom in the medical establishment was that physicians treating chronic pain with opioid analgesics were at a substantial risk of being sanctioned for overprescribing by state medical regulatory boards. Dozens of articles written since have alluded to this risk as an obstacle to effective pain re1ief. In the early 1990s, a number of high profile cases in which physicians were disciplined by regulatory boards for overprescribing to patients with chronic pain were reported in the press. Although the board actions in many of these cases were eventually overturned by state judiciaries, the publicity heightened practitioners’. sensitivity to the regulatory risks associated with prescribing opioids.A review of the available data on state medical board actions nationwide for the period from 1990 to 1996 reveals that the perception of regulatory risk far exceeds the reality. Indeed, relatively few (less than 5 percent) of the disciplinary actions taken for overprescribing by state medical boards in any given year directly concern the treatment of chronic pain—malignant or nonmalignant—in patients.

scholarly journals 3143 DIAMOND: A Digital Platform for Workforce Development

2019 ◽  
Vol 3 (s1) ◽  
pp. 67-67
Author(s):  
Brenda Eakin ◽  
Elias M. Samuels ◽  
Vicki Ellingrod ◽  
Carolynn Jones ◽  
Camille Anne Martina ◽  
...  
Keyword(s):  
Clinical Research ◽  
Workforce Development ◽  
Research Training ◽  
Relevant Information ◽  
Lessons Learned ◽  
Training Methods ◽  
Digital Learning ◽  
Learning Space ◽  
Digital Platform ◽  
Competency Domains

OBJECTIVES/SPECIFIC AIMS: The DIAMOND project encourages study team workforce development through the creation of a digital learning space that brings together resources from across the CTSA consortium. This allows for widespread access to and dissemination of training and assessment materials. DIAMOND also includes access to an ePortfolio that encourages CRPs to define career goals and document professional skills and training. METHODS/STUDY POPULATION: Four CTSA institutions (the University of Michigan, the Ohio State University, University of Rochester, and Tufts CTSI) collaborated to develop and implement the DIAMOND portal. The platform is structured around eight competency domains, making it easy for users to search for research training and assessment materials. Contributors can upload links to (and meta-data about) training and assessment materials from their institutions, allowing resources to be widely disseminated through the DIAMOND platform. Detailed information about materials included in DIAMOND is collected through an easy to use submission form. DIAMOND also includes an ePortfolio designed for CRPs. This encourages workforce development by providing a tool for self-assessment of clinical research skills, allowing users to showcase evidence of experience, training and education, and fosters professional connections. RESULTS/ANTICIPATED RESULTS: To date, more than 100 items have been posted to DIAMOND from nine contributors. In the first 30 days there were 229 active users with more than 500 page views from across the U.S. as well as China and India. Training materials were viewed most often from four competency domains: 1) Scientific Concepts & Research Design, 2) Clinical Study Operations, 3) Ethical & Participant Safety, and 4) Leadership & Professionalism. Additionally, over 100 CRPs have created a DIAMOND ePortfolio account, using the platform to document skills, connect with each other, and search for internships and job opportunities. DISCUSSION/SIGNIFICANCE OF IMPACT: Lessons learned during development of the DIAMOND digital platform include defining relevant information to collect for the best user experience; selection of a standardized, user-friendly digital platform; and integration of the digital network and ePortfolio. Combined, the DIAMOND portal and ePortfolio provide a professional development platform for clinical research professionals to contribute, access, and benefit from training and assessment opportunities relevant to workforce development and their individual career development needs.

Pain Management and Disciplinary Action: How Medical Boards Can Remove Barriers to Effective Treatment

1996 ◽  
Vol 24 (4) ◽  
pp. 338-343 ◽  
Author(s):  
Chris Stern Hyman
Keyword(s):  
Pain Management ◽  
Assisted Suicide ◽  
Pain Treatment ◽  
Chronically Ill ◽  
The Elderly ◽  
Disciplinary Action ◽  
Current Debate ◽  
Physician Assisted Suicide ◽  
Patients With Cancer ◽  
State Medical Boards

The current debate about physician-assisted suicide and the question of whether patients would ask for such help if their pain were adequately controlled place in sharp focus the issue of undertreated pain. Studies have repeatedly documented the scope of the problem. A 1993 study of 897 physicians caring for cancer patients found that 86 percent of the physicians reported that most patients with cancer are undermedicated for their pain. A 1994 study found that noncancer patients receive even less adequate pain treatment than patients with cancer-related pain, and that minority patients, the elderly, and women were more likely than others to receive inadequate pain treatment. Although the problem of undertreatment of pain is multifaceted, I only address how state medical boards contribute to the problem and suggest possible remedies.The literature on palliative care describes the numerous barriers that impede effective pain management and that result in the inadequate prescribing of pain-relieving drugs for terminally and chronically ill patients.

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