The board receives between 700 and 800 complaints each year, all of them about any of the more than 25,000 doctors, physician assistants and acupuncturists licensed in Oregon. The board is responsible for investigating complaints and determining what, if any, sanction is needed. Sanctions can include a suspended medical license, a fine or combination. The board also can take non-disciplinary actions that help a medical professional correct shortcomings with an agreement that can include education or mentoring.
State auditors found that the board needs to standardize its disciplinary process so that different cases are handled equitably. For example, the Oregon Medical Board has no formal policies or procedures to examine the disciplinary outcomes of prior cases when making decisions about new cases with similar circumstances. The audit focused on the system of handling complaints and didn’t make a judgment call on the fairness of any specific cases.
Auditors found that sometimes the medical board requests information about past disciplinary outcomes, but not in a consistent way.
“Regulations are often talked about as rules to follow to protect people who receive services,” Audits Director Kip Memmott said in a statement. “But effective regulation also protects those providing the services. When it comes to regulations that affect public health, people need to have confidence those rules are being implemented equitably and effectively.”
Auditors also found that other states, including Washington and California, have a more thorough set of sanctioning guidelines that take into account different factors and ensure that discipline is consistently applied. Oregon’s medical board, however, has a more limited set of guidelines.
It’s also difficult to compare cases. Auditors found the medical board’s data system hinders the agency’s ability to make routine and systemic comparisons that ensure consistent and equitable discipline.
Auditors recommended the medical board put in place sanctioning guidelines to ensure fairness and a new data system to better categorize and compare cases, consistently review complaint data to monitor for equity and develop written policies and procedures to analyze disciplinary decisions for equity and consistency.
The medical board, in its response, agreed with the recommendations. The board’s executive director, Nicole Krishnaswami, told auditors in a letter the board plans to make changes in the coming years.
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