Physician license actions declining for substance use, psychological, physical impairments

Actions against physician licenses for substance use, and psychological and physical impairments, all declined from 2004 to 2020 in the United States.

But among 5,032 physician license actions, those related to substance use “remain markedly higher than those related to physical health,” according to the research letter, “Patterns in Actions Against Physician Licenses Related to Substance Use and Psychological or Physical Impairment in the U.S. From 2004 to 2020,” published in JAMA Health Forum.

The results were based on an analysis of the National Practitioner Databank, a government database of adverse action reports and malpractice payments submitted by health care institutions and state licensing boards.

“Substance use, burnout, and depressive symptoms are prevalent among physicians, with potential consequences for patient outcomes and safety,” the study said.

Increased awareness of those issues has led to more efforts to support physicians, but it was unclear if those issues are reflected in actions taken by hospitals or licensing boards.

From 2004 to 2020, there were 3,841 actions against the licenses of physicians related to substance use, the study said.

There were bumps up in 2006, 2011 and 2018, but generally the actions due to substance use declined in the study period from 5.6 to 1.6 actions per 10,000 physicians.

Psychological impairment accounted for 577 actions, with that figure decreasing from 0.8 to 0.2 per 10,000 physicians from 2004 to 2020. There were 614 actions dealing with physical impairment, decreasing from 0.7 to 0.2 actions per 10,000 physicians, the study said.

Compared with license actions related to physical impairment, physicians with license actions dealing with substance use or psychological impairment were more likely:

• To have an indefinite rather than permanent penalty length
• To have an emergency action taken against their license
• To have a greater number of lifetime license actions

The databank did not have detailed information on license actions, which represented “only the most severe cases of impairment.”

“Nevertheless, these findings suggest continued areas to improve mental health and support offerings for physicians, particularly interventions that may preclude the need for license actions in the first place,” said the study, with corresponding author Lisa S. Rotenstein, MD, MBA, of Brigham and Women’s Hospital in Boston.