Along with the tremendously high ethical and professional standards placed upon physicians comes the need to monitor physician adherence to medical board rules. Although physicians rarely require disciplinary action, when they do, the results can be devastating. Disciplinary action is warranted for only the most serious violations and manifests in many forms, including reputational damage, fines, and losing one’s medical license. According to a Federation of State Medical Boards (FSMB) report, approximately 8,000 disciplinary actions are annually brought to state medical boards. Of these, around one-half involve physician discipline.

According to the FSMB’s president and CEO Humayun J. Chaudhry, DO—whose viewpoint was published in JAMA—sexual misconduct and sexual boundary issues have been a major source of physician discipline, especially following the #MeToo movement’s arrival in 2017. Sexual misconduct and sexual boundary issues ranked among the top three causes for state medical board’s imposing disciplinary action upon physicians for acting unprofessionally.

However, it is not only the acting physician who is responsible and subject to disciplinary action. Dr. Chaudhry notes that fellow medical professionals have a duty to report any known actual or suspected sexual misconduct of a fellow physician. Otherwise, their silence is comparable to approval and could lead them to disciplinary action for unprofessionalism as well, resulting in potential licensure suspension or monetary fines as high as $100,000.

According to Dr. Chaudhry, unprofessional conduct was the most common cause for physician disciplinary action in 2019. The definition of unprofessional conduct may vary among each state’s Medical Practice Act. However, actions often included as “unprofessional” include sexual misconduct, failure to meet accepted standards of care, excessive drug prescription, prescribing drugs without valid justification, dishonesty during the license application process, felony or fraud conviction, and poor record-keeping.

A review published in an American Journal of Bioethics reported that 28% of physician disciplinary action cases were due to substance abuse disorders, 27% were due to controlled-substance violations, 21% were due to negligence or incompetence, and 19% were due to fraud or misrepresentation. Authors of the review noted the broad nature of their categories and urged physicians, in an effort to both decrease the number of disciplinary cases and improve patient care, to educate themselves on the various subcategories that might exist within the broader categories warranting disciplinary action. Self-education would also help to prevent potential financial and professional damage that can accompany disciplinary action.