Md. getting better at disciplining bad doctors, researchers say Study's credibility called into question


Maryland's performance in the discipline of bad doctors has improved in the last two years, according to a national health research organization.

The Public Citizen Health Research Group says Maryland ranks 27th nationally in dealing with incompetent and negligent doctors. In previous ratings by the organization, Maryland always ranked among the bottom 15 states.

"It is a sign for optimism," said Dr. Sidney Wolfe, director of the research group, which was founded by consumer advocate Ralph Nader. "They have for too long been one of the worst states. They must be doing something right, thereby protecting more patients in Maryland."

J. Michael Compton, executive director of the Maryland Board of Physician Quality Assurance, said the Public Citizen report lacks credence.

"It was flawed when they said we ranked 43rd [in 1991], and it's flawed now," Mr. Compton said yesterday. "I don't put much stock in it."

As it has in the past, Public Citizen is attempting to draw attention to what it sees as the lenient treatment of the nation's criminal, incompetent and negligent doctors. It says, for example, that 70 percent of doctors found guilty of negligent, substandard or incompetent care are never forced out of practice, even temporarily.

"Government agencies catch too few bad doctors, and too many of the ones they do catch are getting away with slaps on the wrist," Dr. Wolfe said.

That is no longer true in Maryland, Mr. Compton said, thanks to bigger budgets for his agency and more teeth in the laws governing the discipline of doctors.

In 1989, its first year of operation, the Board of Physician Quality Assurance took action against physicians 29 times, Mr. Compton said. Last year, it did so 113 times.

The report ranks states by the number of "serious disciplinary actions" they take per 1,000 doctors. In 1992, the report said, Maryland's disciplinary rate was 3.67. Oklahoma had the best rate at 12, and Delaware the worst at .65.

But Mr. Compton said Public Citizen based its conclusions on a total physician population in Maryland of 17,977. "I don't know where in the world they got that number," he said. He said his board has issued licenses to about 21,000 doctors but that only 9,000 of them actively practice medicine here. The rest either live elsewhere, are retired or are part of the especially large number of researchers working in Maryland.

The numbers used by Public Citizen, Mr. Compton said, always unfairly detract from Maryland's ranking.

He also said that states with higher licensing standards are punished in the Public Citizen survey. For example, he said, Maryland licenses only doctors who score 75 or higher on the national licensing examination. West Virginia uses 70 as the cutoff.

"If you weed out the problem at the front end, they penalize you because you have fewer problems at the back end," Mr. Compton said.

Dr. Wolfe agreed that Mr. Compton's points were valid but he dismissed them as having little overall effect on the rankings. "He's nitpicking," Dr. Wolfe said.

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