First Do No Harm: The Labor Market Consequences of a Physician Disciplinary Record

• In Event: Conflicts of Interest and Professional Misconduct in Health Care

Abstract

State medical boards enforce care quality standards by disciplining physicians via publicly-disclosed administrative actions. We use a novel dataset of 70,000 state medical board actions in more than 40 states over the years 2008-2023 to report the first estimates of the effect of these disciplinary actions on physicians' careers. We find that 2.2% of physicians ever receive a disciplinary action over this time period. After a disciplinary action, a physician's billings to Medicare fall substantially, even for those physicians who are not subject to Medicare exclusion. We find that the declines are smaller for mild disciplinary actions (e.g., fines, continuing medical education) and larger for more severe discipline (e.g., revocations). We also observe that physicians lose hospital affiliations and begin practicing in smaller organizations. Overall, we determine that most disciplined physicians remain in the profession, although generally in lower-productivity settings with less oversight.

Authors

• Gabrielle Sorresso, Cornell University
  Presenting Author

• Amanda Yvonne Agan, Cornell University
  Non-Presenting Co-Author

• Colleen M Carey, Cornell University
  Non-Presenting Co-Author