Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003–2013

AbuDagga, Azza; Wolfe, Sidney M.; Carome, Michael A.; Oshel, Robert E.

doi:10.1371/journal.pone.0147800

Cited by 36 publications

(33 citation statements)

References 17 publications

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“…Interestingly, 82.73% of all guilty verdicts led to the removal of the doctor from practice, in the form of a suspension or complete erasure from the GMC register. Below we confirm the contributory four a priori risk factors associated with medical misconduct, also supported in the wider literature1–8 13:…”

Section: Resultssupporting

confidence: 87%

“…Medical misconduct is defined here as any act leading to a medical doctor (hereafter referred to as ‘doctor’) being deemed unfit to practice. Common patient safety measures worldwide aim to improve reporting and management of complaints about medical misconduct 1–6. However, legislative guidance pertaining to medical misconduct differs across countries.…”

Section: Introductionmentioning

confidence: 99%

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A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

et al. 2019

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BackgroundMedical misconduct is an international problem. It is judged according to whether a doctor has endangered the health of the public. Little is known about the risk factors associated with medical misconduct. To inform patient safety, we undertook a focused mapping review and synthesis (FMRS) of tribunal reports retrieved from the Medical Practitioners Tribunal Service (MPTS).MethodsA four-phase FMRS was undertaken: (1) identification and retrieval of 1-year tribunal transcripts from the MPTS (focus), (2) analysis of transcripts to identify patterns mapped to ‘a priori’ risk factors (mapping), (3) peer review of the data (calibration) and (4) creation of a risk profile (synthesis).ResultsOut of the 351 investigative tribunals, 249 (70.94%) resulted in a guilty verdict. 82.73% of all guilty verdicts led to the removal of the doctor from practice. Through the identification of four a priori risk factors, we developed a model of risk associated with medical misconduct: (1) being male, (2) primary medical qualification (PMQ) outside of the UK, (3) working within general practice and surgical specialties, and (4) having passed PMQ more than 20 years ago. Notable ‘unconfirmed’ factors, such as locum work, PMQ achieved outside of the European Union, increasing age and lack of clinical guidance are also relevant to what is deemed professional behaviour and what is not.ConclusionsThe findings can inform debates about patient safety and lay the groundwork for further research into medical misconduct. Prospective studies should focus on confirming the contributory factors and relationship between these four a priori risk factors for medical misconduct: being male, PMQ outside of the UK, increasing age and working in general practice or surgical settings.

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Section: Resultssupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

et al. 2019

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“…Similar to a recent study of physician reports in the NPDB (AbuDagga, Wolfe, Carome, & Oshel, ), this study showed that only a small fraction, 0.6%, of the nurses who were reported to the NPDB due to licensure actions taken against them or malpractice payments paid on their behalf during the study period had licensure or malpractice‐payment reports related to sexual misconduct. In comparison, 1.0% of all physicians reported to the NPDB had licensure actions or malpractice payments related to sexual misconduct (AbuDagga et al, ).…”

Section: Discussionsupporting

confidence: 84%

“…Thus, any nurse licensing board could have initiated a licensing action against these nurses. This problematic finding also has been noted in prior research for sexual misconduct and other types of offenses involving physicians (AbuDagga et al, ; Levine, Oshel, & Wolfe, ).…”

Section: Discussionsupporting

confidence: 63%

Crossing the line: Sexual misconduct by nurses reported to the National Practitioner Data Bank

AbuDagga

Wolfe

Carome

et al. 2018

Public Health Nursing

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Objective The objective of this study was to examine nurse sexual‐misconduct–related reports in the National Practitioner Data Bank (NPDB) and to compare them with reports for other types of offenses. Design and Population We analyzed NPDB’s reports of adverse state nursing board licensure actions and malpractice payments for all nurses from January 1, 2003, to June 30, 2016. Results Overall, 882 nurses had sexual‐misconduct–related reports. Most were aged 35–54 (63.2%), male (63.2%), and registered or advanced practice nurses (61.5%). The disciplinary actions noted in the 988 nurse sexual‐misconduct–related licensure reports were more frequently serious than those noted in the 207,023 reports for other offenses committed by nurses (90.8% vs. 74.8%, respectively; p < 0.001). Of the 33 nurses with sexual‐misconduct–related malpractice‐payment reports, 48.5% were not disciplined by any state board of nursing for these offenses. Three‐quarters of the victims in the 47 sexual‐misconduct–related malpractice‐payment reports were female, with “emotional injury only” reported as the severity of injury in 91.5% of these reports. Conclusions Very few nurses have been reported to the NPDB due to sexual misconduct. We welcome a zero‐tolerance standard against sexual misconduct involving patients by all types of health care professionals, including nurses.

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“…Another study found that most sexual misconduct cases reported to the NDPB were handled by state licensing boards. Of those cases handled by malpractice or the clinical privilege system, only 30 percent were also disciplined by state licensing boards (AbuDagga et al ).…”

Section: Literature Reviewmentioning

confidence: 99%

Targeting Bad Doctors: Lessons from Indiana, 1975–2015

Liu¹,

Hyman²

2019

J Empirical Legal Studies

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For physicians, quality of care is regulated through the medical malpractice and professional licensing/disciplinary systems. The medical malpractice (med mal) system acts through ex post private litigation; the licensing system acts through ex ante permission to practice (i.e., licensure), coupled with ex post disciplinary action against physicians who engage in "bad" behavior. How often do these separate mechanisms for ensuring quality control take action against the same doctors? With what result? We study these questions using 41 years of data from Indiana, covering almost 30,000 physicians. Disciplinary sanctions are much less common than med mal claims-whether paid or unpaid. Only a small number of physicians are "tagged" by both systems. Disciplinary risk increases with the number of past med mal claims. Paid claims have a greater impact than unpaid claims, and large payouts (100 k, 2015$) have a slightly greater impact than small payouts on disciplinary risk. The risk of a paid claim increases with more severe disciplinary sanctions (i.e., revocation and suspension). Our findings suggest an obvious model for the interaction of these two systems. I. IntroductionThe medical malpractice (med mal) and state licensure/disciplinary systems are distinct but related regulatory strategies. The med mal system targets injury that is the result of negligence, and provides monetary damages. Professional discipline, on the other hand, deals with issues ranging from substance abuse and sexual misconduct to fraud, incompetence, and unlicensed practice.In theory, the two systems can (but need not) work together to promote the delivery of high-quality care. Repeat med mal claims could act as a signal to the disciplinary system. Conversely, disciplinary sanctions could trigger patients to file med mal complaints, and

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Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003–2013

Cited by 36 publications

References 17 publications

A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

Crossing the line: Sexual misconduct by nurses reported to the National Practitioner Data Bank

Targeting Bad Doctors: Lessons from Indiana, 1975–2015

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