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Characteristics Associated With Physician Discipline
A Case-Control Study
Neal D. Kohatsu, MD, MPH;
Dawn Gould, RN, MSN;
Leslie K. Ross, PhD;
Patrick J. Fox, PhD
Arch Intern Med. 2004;164:653-658.
Background There has been increasing attention devoted to patient safety. However, the focus has been on system improvements rather than individual physician performance issues. The purpose of this study was to determine if there is an association between certain physician characteristics and the likelihood of medical board–imposed discipline.
Methods Unmatched, case-control study of 890 physicians disciplined by the Medical Board of California between July 1, 1998, and June 30, 2001, compared with 2981 randomly selected, nondisciplined controls. Odds ratios (ORs) were calculated for physician discipline with respect to age, sex, board certification, international medical school education, and specialty.
Results Male sex (OR, 2.76; P<.001), lack of board certification (OR, 2.22; P<.001), increasing age (OR, 1.64; P<.001), and international medical school education (OR, 1.36; P<.001) were associated with an elevated risk for disciplinary action that included license revocation, practice suspension, probation, and public reprimand. The following specialties had an increased risk for discipline compared with internal medicine: family practice (OR, 1.68; P = .002); general practice (OR, 1.97, P = .001); obstetrics and gynecology (OR, 2.25; P<.001); and psychiatry (OR, 1.87; P<.001). Physicians in pediatrics (OR, 0.62; P = .001) and radiology (OR, 0.36; P<.001) were less likely to receive discipline compared with those in internal medicine.
Conclusion Certain physician characteristics and medical specialties are associated with an increased likelihood of discipline.
From the Medical Board of California (Dr Kohatsu) and the Institute for Health & Aging, School of Nursing, University of California, San Francisco (Ms Gould and Drs Ross and Fox). Dr Kohatsu is now with the College of Public Health, University of Iowa, Iowa City. The authors have no relevant financial interest in this article.
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