The California court stated that it was difficult to "compartmentalize dishonesty in such a way that a person who is willing to cheat his government out of $65,000 in taxes may yet be considered honest in his dealings with his patients."
Likewise, the Washington Supreme Court upheld the suspension of a doctor’s license following his conviction for tax fraud (In Re Kindschi (52 Wn.2d 8 [1958]). In taking a broad view of the requirement that improper conduct relates to the practice of medicine, the court held that conviction for tax fraud, which goes to the issue of trustworthiness, is a valid reason for taking disciplinary action against a physician.
Who gets into trouble with medical disciplinary boards? In a California study (Arch. Intern. Med. 2004;164:653-8) of the characteristics associated with physician discipline (for all manner of misconduct, not just dishonesty), the authors concluded that male physicians were nearly three times as likely as women physicians, and those who were non–board-certified were twice as likely as their board-certified counterparts, to be disciplined.
Obstetricians, gynecologists, family physicians, general practitioners, and psychiatrists were more likely than internists, whereas pediatricians and radiologists were the least likely. Age had a smaller influence (elevated risk with increasing age), and foreign medical graduates also had an increased risk. In another study, medical students with professional misbehavior were found to be more likely to display similar behavior after graduation.
In 2011, there were a total of 6,034 disciplinary actions of all types taken against doctors, with the highest number in Wyoming (6.79 per 1,000 doctors), Louisiana (5.58), and Ohio (5.52). The lowest rates were in South Carolina (1.33 per 1,000 doctors), Washington, D.C. (1.47), and Minnesota (1.49).
Many believe these numbers vastly underestimate the prevalence of physician misconduct, and that the widely disparate statistics do not indicate any state having more or fewer bad doctors. Instead, the numbers reflect the suboptimal functioning of medical disciplinary boards.
Dr. Tan is emeritus professor of medicine at the University of Hawaii. This article is meant to be educational and does not constitute medical, ethical, or legal advice. It is adapted from the author’s book, "Medical Malpractice: Understanding the Law, Managing the Risk" (2006). For additional information, readers may contact the author at siang@hawaii.edu.