Information For Consumers
How State Medical Boards Serve the Public
As they fulfill their role of overseeing the practice of medicine in a state, medical boards provide value for both patients and physicians. By following up on complaints and disciplining physicians when needed, medical boards ensure public trust in the basic standards of competence and ethical behavior in their physicians. By striving to ensure that physicians have been properly trained and are maintaining their professional skills, medical boards help protect the integrity of the medical profession.
By defining the practice of medicine in a state, boards play an influential role in how medical care is delivered. A state’s Medical Practice Act may contain many important regulations on the use of medical devices, the administering of certain kinds of drugs and the conditions under which medical care can be provided.
One of the most important roles state medical boards play is serving as a repository of publicly available information about physicians. This information can be useful to consumers in helping them choose a physician when they need medical care. Boards provide a valuable service to consumers who are seeking information about physicians by disclosing if a physician is currently licensed in good standing, if disciplinary action has ever been imposed, or if formal disciplinary charges are pending.
The public can also inquire if the board has other public information in a physician’s record, such as criminal convictions, sanctions taken by hospitals, and malpractice judgments and settlements.
Consumers who believe that a physician has engaged in unprofessional conduct or that the quality of medical care they received is substandard should contact their state medical board. (For more information, see “How and When to File a Complaint Against a Physician,” below.)
The Consumer’s Role
With the rise of consumer empowerment in recent years, and the expanding influence of the internet, patients have begun to play a much more proactive role in learning about physicians’ credentials and background. Patients are increasingly likely to verify their physician’s credentials and ask questions about their training and qualifications to perform certain procedures.
One simple way state medical boards can help is by providing information about physicians’ training in certain specialties or modes of practice. While the vast majority of licensed physicians practice within their areas of training, if a physician operates outside of his or her scope of expertise and provides substandard care that harms a patient, he or she will be held accountable by a state medical board for failing to meet standards.
Other mechanisms are built into the health care system to prevent physicians from practicing in areas of training in which they may not be able to practice safely. For example, hospitals often require physicians to be board certified in a medical specialty before they will grant privileges to practice in the hospital.
But a good first step for consumers to learn more about a physician is to check a physician’s credentials and training through a state medical board.
How to Check a Physician’s Qualifications
State medical boards have responded to the growing trend toward consumer empowerment in recent years by greatly improving access to meaningful information about the physicians licensed in their respective states.
Once a patient has identified a physician that he or she is interested in seeing, it is wise to invest some time and energy in learning more about their skills and training, as well as the quality of care they provide. Here are some resources to help find out more about a physician’s qualifications:
State Medical Board Physician Profiles
State medical boards make available a variety of physician information on their individual state websites through online “physician profiles.” At a minimum, medical board profiles include licensure status and disciplinary history. More comprehensive profile systems may include full board orders of disciplinary actions, malpractice judgments and criminal convictions.
Some also provide information that creates important context to help consumers make decisions about their health care providers. For example, a profile including data on physician medical malpractice may include details about the length of a physician’s time in practice, the nature of his or her specialty, the types of patients treated and geographic location — all of which can significantly influence the number and size of malpractice judgments, settlements and awards.
Much of this information may be available at your state medical board’s website. The types of information available from your state board may include:
- Medical licenses (active or inactive)
- Final disciplinary orders or actions by regulatory boards or agencies, including state medical boards, the U.S. Drug Enforcement Administration and Medicare
- Final suspensions or revocations of hospital privileges
- Criminal convictions
- Malpractice payment information
- Medical schools attended and graduation dates
- Graduate medical training (residency and fellowship) programs attended and completion dates
- Specialty board certifications
- Area(s) of practice
For consumers, the FSMB has made available its national database of consolidated physician licensure and disciplinary information through a service called DocInfo. This is the same database used by state medical boards and various U.S. and international health care entities during the licensure and credentialing process.
DocInfo is free to the public and offers the nation’s most up-to-date, publicly available repository of core information about physicians, including details important to patients and families, including:
- Disciplinary actions
- License history
- Medical school
- Type of degree
- American Board of Medical Specialties (ABMS) specialty
- American Osteopathic Association (AOA) specialty
How and When to File a Complaint Against a Physician
Many consumers are unaware of where they should turn when they encounter an issue of competence or ethics with a physician. State medical boards are the designated state agencies to investigate complaints about physicians and, when warranted, take action against them.
Depending on the size of a state’s physician population, medical boards typically will receive hundreds to thousands of complaints annually, each of which must be investigated by board staff. Complaints are prioritized according to the potential for patient harm; cases in which an investigator determines imminent patient harm is possible are typically “fast-tracked” to ensure swift action by the medical board. Examples of complaints receiving high priority by investigators may include a physician engaging in sexual misconduct, practicing medicine while under the influence of alcohol or drugs, and providing substandard care.
The most common complaint received by medical boards is an allegation that a physician has deviated from the accepted standard of medical care in a state. Some of the most common standard-of-care complaints include:
- Overprescribing or prescribing the wrong medicine
- Failure to diagnose a medical problem that is found later
- Failure to provide a patient with medical test results in a timely manner, which can lead to harm
- Failure to provide appropriate post-operative care
- Failure to respond to a call from a hospital to help a patient in a traumatic situation
To file a complaint against a physician, please contact the state medical board in your state. A directory of state boards is available at the FSMB’s website.
How the Complaint Process Works
While the details, terminology and order of events vary from state to state, once a complaint is received by a state medical board the complaint process commonly includes the following steps:
1. The complaint is assessed for jurisdiction. When a complaint arrives at the medical board, the first step is to determine whether the board has the authority to investigate it under the state’s Medical Practice Act.
If yes: Go to Step 2.
If no: The complaint may be referred to another agency with jurisdiction. If that isn’t possible, the person who lodged the complaint is sent a letter stating that the board has no jurisdiction.
2. The case is prioritized and an investigation begun. Before taking any action, the board determines if there is an imminent threat to the public. If this is the case, it typically has the power to immediately suspend a physician’s license and order the physician to cease seeing patients. Other restrictions may also be applied if there is an imminent threat.
3. The investigation proceeds; all parties involved are contacted. After the case is prioritized, the board begins a comprehensive investigation, identifying all the individuals and facilities that may have pertinent information. Individuals involved in the case are asked to describe the events that took place and provide any information they may have.
4. The physician and complainant receive formal notification. At this stage a letter is typically sent to the physician, stating the allegation, seeking a response to the complaint and requesting any relevant records. The complainant is also notified.
5. The case is given medical review. Investigators for the board determine whether a patient’s medical care has been impacted as a result of the complaint or whether the complaint involves other issues, such as fraud or behavioral/ethical problems. During this stage, an expert with professional credentials in the same specialty as the physician in question may be called in to provide an additional opinion about the care provided.
6. The board decides what action to take. A wide variety of disciplinary measures or other actions in response to the original complaint are available to boards. For the most serious cases, especially those that impact patient safety, the board may opt to file a formal complaint against the physician, leading to disciplinary action that may include suspension or revocation of a license or imposition of fines. For less serious offenses, options may include, but are not limited to, a letter of concern; an appearance before the board; or the requirement of a physical, medical, or psychiatric competency evaluation.
For serious infractions or issues, which warrant filing of a formal complaint: Go to Step 7.
For lesser infractions or issues: Board may consider imposing lower-level options or closing the case without formal action.
7. The case is set for a hearing. For serious infractions or issues, state medical boards schedule a hearing – a formal review of the case in which physicians have an additional opportunity to respond to the complaint. As sometimes happens in the U.S. legal system, some cases may be settled before the hearing date. When that happens, the settlement offer goes before the full board at a regularly scheduled board meeting, where a decision is made about whether to accept the settlement agreement. If accepted, it is placed into effect. If not, the matter proceeds to a hearing before the board.
If no settlement: Go to Step 8.
If settlement: Board closes case.
8. Adjudication. Cases that are not settled are adjudicated, meaning they go to a full hearing, similar to a court trial. There is a formal proceeding, with presentation of evidence and witnesses. Afterward, the board deliberates and makes findings on whether one or more violations of a state’s Medical Practice Act have been proven. If a violation has been proven, the board determines the appropriate disciplinary actions to impose on the physician, which can include a reprimand; conditions or restrictions placed on the physician’s license; or suspension or revocation of the license.
9. Public notice. If a board finds that a violation of the Medical Practice Act has taken place, and disciplinary action has been taken, this information is entered into the public record. The information becomes part of the physician’s permanent professional record and is shared with other state medical boards via the FSMB’s Physician Data Center. Patients have access to this information directly from their state medical board or by accessing the FSMB’s DocInfo online service (www.docinfo.org).
STEPS IN THE COMPLAINT PROCESS
Contacting Your State Medical Board
If you are searching for information about a physician’s qualifications, or if you want to file a complaint against a physician, you should contact your state medical board.
A directory of all boards in the Federation of State Medical Boards is maintained at the FSMB’s website. You can access it here.
For More Information
Please note these additional sources of information about medical regulation and state medical boards:
NOTE: Information in this guide was provided by state and territorial medical boards during 2020. For the most up-to-date information about specific state or territorial boards, readers should contact individual state boards directly.