This month, Texas Gov. Greg Abbott signed a law that strengthens oversight of doctors by the state’s medical board — the same board that dragged its feet a decade ago in removing the license of neurosurgeon Christopher Duntsch, infamously known as “Dr. Death.”
The board’s shortcomings in the Duntsch case were extensively reported, but Texas lawmakers credited a subsequent investigation by KXAN News in Austin with finally spurring them to act.
One of those lawmakers, state Sen. Bob Hall, R-Edgewood, even went so far as to thank the TV journalists “for doing what we should have been doing” in uncovering the board’s repeated failures to block dangerous physicians from practicing and informing the public about doctors with out-of-state disciplinary actions.
It’s a dramatic case of journalists holding health care licensing bodies accountable and sparking policy changes after public officials fail to act.
Other prominent examples are a Los Angles Times’ exposé of the California nursing board’s delays in investigating complaints and a series by The Atlanta Journal-Constitution revealing that thousands of physicians around the country were permitted to practice after committing sexual abuse.
“I think we’ve seen time and again that medical boards are not going to fix some of their systemic problems unless they are brought out into the open,” said AHCJ board member Laura Beil, whose “Dr. Death” podcast about Duntch’s gross malpractice was among the most downloaded podcasts of 2018.
Pushing for accountability
State legislatures make laws that govern how licensing boards operate. But according to a report published in 2021 by Public Citizen: “Disturbingly, there is generally considerably more oversight over state medical boards by the news media than by state legislatures.”
The consumer advocacy group pointed to a lack of standards for measuring board performance. Its own analysis showed a nearly eightfold variation in how frequently boards discipline physicians.
By Public Citizen’s measure, Texas ranked fairly high among states in disciplining doctors, at No. 11.
Yet KXAN’s investigation, “Still Practicing,” showed that Duntsch’s lackadaisical treatment by the state medical board was no aberration. Journalists Matt Grant and Dalton Huey documented widespread lack of public transparency in cases of problem physicians, including at least 49 whom the board reported as having clean records even though licensing actions had been taken against them in other states.
The reporters sought answers from lawmakers.
Grant said he “sent our reporting to dozens of lawmakers across the state, from both parties, asking if this is an area they would be willing to look into to try to fix.”
“I think us pushing for accountability on a state level helped give this issue traction,” he added.
Grant and Beil spoke about the persistent problem of unsafe doctors at an AHCJ panel last year.
‘A major advance’
The new law requires the Texas Medical Board to continuously query the National Practitioner Data Bank, a confidential clearinghouse established by Congress, and promptly update physician records for the public. Physicians who have had their licenses revoked elsewhere cannot practice in the state, and applicants must undergo fingerprinting and criminal background checks. Lying on a license application will be a Class A misdemeanor.
Public Citizen’s Health Research Group Director Robert Steinbrook, M.D., said the new law marks “a major advance.”
“In general, state medical boards do not do a good job of protecting patients from physicians who have been disciplined in other states, including those who have had their licenses revoked,” Steinbrook said.
As USA TODAY reported in 2018, state medical boards are not required to query the National Practitioner Data Bank, and many do not. AHCJ also looked into this problem back in 2011.
Public Citizen has recommended that boards routinely look up records in the data bank, along with appointing more non-physician members to boards and providing boards with adequate resources. It endorsed closing malpractice settlement reporting loopholes and opening the National Practitioner Data Bank to the public.
‘Similar issues’ in every state
There’s more work to be done to expose the failures of licensing bodies. Just this month, Connecticut Public reported spotty disclosure of physician records in its state.
“I am confident that similar issues would be uncovered to some degree in every state across the country,” KXAN reporter Dalton Huey said. But he added that there is “no one consistent method to get the information you need. Every state varies in how they post/report disciplinary records.”
KXAN reporter Matt Grant had this advice for reporters: “Start by asking your state medical board if they do a ‘continuous query’ of the National Practitioner Data Bank for all physicians. How transparent is your medical board when it comes to making disciplinary actions public? Is it a one line sentence, or can you actually read the records?”
And don’t neglect boards that license other medical professionals such as chiropractors, dentists and nurses.
Another problem worth highlighting is that some states have handed over licensing board appointment powers to trade organizations that represent the very professionals who are being regulated.
Five states allow physician organizations to select members of medical boards, according to a report published in November 2022 by the Pacific Legal Foundation. It found similar conflicts of interest with licensing bodies for chiropractors, dentists, nurses, occupational therapists, pharmacists, therapists, physicians, podiatrists, psychologists and veterinarians.
Check out AHCJ’s tip sheet on covering professional licensing boards.
