At Janssen Malloy LLP, we represent all manner of health care providers in licensing and disciplinary actions. Anecdotally, we’ve noticed a recent increase in investigations and disciplinary actions by licensing boards, particularly for physicians and nurses. When we began to look at statistics of the licensing agencies, our suspicions were confirmed.
There are approximately 100,000 licensed physicians who actively practice in California. Interestingly, about thirty percent of those are over the age of 60. Last year, California’s population increased by about 330,000 people, for a total population of 38.2 million. With an increasing State population and what have been generally flat graduation rates from medical schools, the number of physicians available to population in California has decreased in the last few years.
The Medical Board of California (Board) is the licensing agency for California physicians. The Board categorizes complaints as those by the public, those made as required under the Business & Professions Code section 805, those that are self-reported by the physicians or their practice groups, those made by other governmental agencies, and those that are anonymous. The total numbers of complaints against physicians have generally held steady in the last ten years. For example, complaints to the Board by the public against physicians are between 4,000 to 5,000 each year. The largest complaint by the public concerns a physician’s gross negligence or competency. The next largest concerns complaints of unprofessional conduct.
Although complaints have remained the same, administrative actions against physicians and physician’s assistants by the Board, such as license revocations, surrender, suspension and probation, have recently increased. In the last two fiscal years, administrative actions were just under 400 total actions, whereas in years prior they hovered in the low 300s. And, in the last four years, cases the Board refers to the Attorney General for prosecution has increased by approximately 100 over the prior few years. Board statistics also tell us that the largest categories driving licensing actions are gross negligence, unprofessional conduct, self-abuse of drugs or alcohol, and inappropriate prescribing practices.
Why the increase in licensing actions if complaints have remained relatively stable? The Board reports that it continues to fill vacant staff positions, including investigators and attorneys, and it is now at its lowest vacancy rate in years. As a result, enforcement actions against physicians may continue to rise.