Why this audit is important
The Oregon Medical Board (OMB) regulates doctors, physician assistants, podiatric physicians, and acupuncturists, with the mission to protect and promote the health, safety, and well-being of Oregonians.
In addition to licensing and education, OMB also investigates and disciplines licensees for violating Oregon’s Medical Practice Act. The board receives roughly 700 to 800 complaints a year.
To protect patients and maintain public trust, OMB’s role in investigating and disciplining licensees requires an assurance of consistency and equity in the resulting outcomes of these investigations.
If licensees are disciplined inconsistently or inequitably, especially as the result of racial bias or discrimination, it can have the effect of limiting the representation of people of color in medical professions. This can contribute to continued disparities in medical treatment and health outcomes for these communities.
What we found
Medical complaint cases can be complex, often containing specific circumstances within the case or the licensee’s history. In some instances, two complaint allegations can appear to be similar, but have completely different case details that may contribute to different board disciplinary outcomes. For example, the same procedure performed on two patients with different levels of overall health can have very different results.
While OMB’s investigation process includes many formal policies and procedures staff and managers are supposed to follow, its process for comparing disciplinary decisions is generally informal and intermittent. There is no formal process to help ensure these reviews are performed in a standardized way each time.
Many medical boards in other states, including Washington and California, utilize sanctioning guidelines or disciplinary matrices to ensure disciplinary decisions are consistent and equitable. Other types of health care boards, and other regulatory organizations, also use some form of disciplinary guidelines to help improve equity and consistency. While OMB utilizes a disciplinary matrix for two specific types of complaints, it does not do so for any other complaint types.
OMB’s current data system does not capture complaint information in a way that permits the agency to easily analyze its disciplinary decisions. While OMB has done qualitative reviews to try to ensure consistency, the database hinders OMB’s ability to conduct routine, systematic data analysis to help assure the public and licensees that similar cases result in consistent and equitable disciplinary outcomes.
What we recommend
We made four recommendations to OMB. The board agreed with all of our recommendations. The response can be found at the end of the report.