The current rate of serious disciplinary actions is a dangerously small drop in the bucket of adequate, consumer-protective doctor discipline. All states, especially those with the worst records, need to strengthen the structure and functions of their licensing boards. The increase in the total number of disciplinary actions in a given state may not indicate that more doctors are being caught. Much of the disciplinary activity, in states such as New York, involves insuring that doctors, once caught by one state, are disciplined when they move to another. There has also been a noticeable increase in sanctioning doctors for administrative purposes.
Questionable doctors can still cross state borders, though with less impunity than before.
The extent to which one board shares information with another still varies widely by state. In many instances discipline is still too slow although the case backlogs in some states have been greatly reduced. Wisconsin sanctioned a number of doctors only after they had already retired from practice. The vast majority of states continue to require reporting of hospital disciplinary actions and malpractice claims or payments to the medical board, but few check whether the required reports have actually been filed. And some still fail to act promptly, if at all, on the information they receive.