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Introduction

Introduction

This Guide to Medical Regulation in the United States, compiled by the Federation of State Medical Boards (FSMB), provides information to the public about the work of the nation’s state medical boards and their mission of public protection.

Included is general background information about medical regulation, as well as an overview of how physicians become licensed to practice medicine in the United States. In addition, the guide provides special resources for the public — ranging from how to access information about a physician’s disciplinary record to how and when to file a medical complaint.

More detailed data about physician licensure and discipline, along with demographic trends and information about licensed physicians, is available at Medical Licensing and Disciplinary Trends and Actions, 2019

More detailed information about the structure and operations of each of the nation’s 71 state and territorial medical boards is available at the FSMB’s Compendium of State Medical Boards.

For more specific information about the policies and activities of individual state medical boards please use the FSMB’s Directory of State Medical and Osteopathic Boards in the United States, which provides detailed contact information for each board. 

About the Federation of State Medical Boards

States are authorized under the United States Constitution to establish laws and regulations protecting the health, safety, and general welfare of their citizens.

To protect the public from the unprofessional, improper, unlawful or incompetent practice of medicine, each of the states and territories making up the United States has formally adopted a Medical Practice Act, which defines the requirements for the practice of medicine within their borders and gives authority to a medical board to enforce the act’s provisions.

The Federation of State Medical Boards (FSMB) represents the 71 medical boards within the United States, its territories, and the District of Columbia. It assists these boards as they go about their mandate of protecting the public’s health, safety and welfare through proper licensing and discipline of physicians and, in many jurisdictions, physician assistants and other health care professionals.

The FSMB offers relevant policy, programs, education, and services to state medical boards that result in improved patient care and safety through effective and fair medical regulation.

The FSMB also strives to enhance the role of state medical boards in an evolving health care environment by leading, anticipating, and responding to trends in medical regulation at the federal and state government level.

About State Medical Boards

The 10th Amendment of the United States Constitution authorizes states to establish laws and regulations protecting the health, safety, and general welfare of their citizens. The practice of medicine is not an inherent right of an individual, but a privilege granted by the people of a state acting through their elected representatives.

To protect the public from the unprofessional, improper and incompetent practice of medicine, each of the 50 states, the District of Columbia and the U.S. territories have enacted laws and regulations that govern the practice of medicine and outline the responsibility of state medical boards to regulate that practice. This guidance is outlined in a state statute, usually called a Medical Practice Act.

Seventy-one state and territorial medical boards are currently authorized to regulate physicians. All of the state medical boards issue licenses for the general practice of medicine, with medical licenses falling into two physician categories: allopathic (MD) and osteopathic (DO). The 71 boards in the United States include more than 50 allopathic (MD) and composite (MD and DO) licensing boards, 14 osteopathic (DO) boards and boards for the following jurisdictions: Guam, Puerto Rico, the U.S. Virgin Islands and the Commonwealth of the Northern Mariana Islands.

The medical licenses that state medical boards issue are undifferentiated, meaning that U.S. physicians are not licensed based upon their specialty or practice focus, and certification in a medical specialty is not absolutely required in order to obtain a license to practice medicine.

In many states, other health care professionals are also licensed and regulated by medical boards in addition to physicians. Examples include physician assistants and acupuncturists.

In addition to licensing physicians, state medical boards investigate complaints, discipline those who violate the law, conduct physician evaluations, and facilitate rehabilitation of physicians when appropriate.

State medical boards also adopt policies and guidelines related to the practice of medicine and designed to improve the overall quality of health care in the state.

Medical Board Structure

The structure and authority of medical boards vary from state to state. Some boards are independent and maintain all licensing and disciplinary powers, while others are part of a larger umbrella agency, such as a state department of health, exercising varied levels of responsibilities or functioning in an advisory capacity.

State medical boards are typically made up of volunteer physicians and members of the public who are, in most cases, appointed by the governor. In recent years, non-physician board members — often referred to as “public members” — have become common. The vast majority of boards in the United States now have public members.

The state legislature determines the financial resources of most boards. Funding for medical board activities comes from physician licensing and registration fees. Most boards employ an administrative staff that includes an executive officer, attorneys, investigators, and licensing specialists. Some boards share staff — such as investigators and attorneys — with other state regulatory agencies.

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