In the Public Interest: Medical Licensing and the Disciplinary Process

Notes

197 Notes Introduction 1. See Held (1996: 298–299). 2. OIG (1990). 3. Allsop and Mulcahy (1996); Becker et al. (1961); Bosk (1979); Freidson (1975); Rosenthal (1995); Stacey (1992). 4. In most states malpractice settlements must be reported to the boards, but each state has its own ways of handling these settlements. Many states have a system that triggers a review process once a practitioner has more than a specific number of formal complaints during a set period and with a particular settlement amount. 5. For a good description of several important aspects of how medical boards worked in general in the mid-1990s, see Jost (1997). 6. I did not include Guam, the Virgin Islands, or Puerto Rico, which are members of the Federation of State Medical Boards. Washington, DC, has its own board, and it is included in the statistics I provide in this book as a state. Doctor of Osteopathy refers to a physician who graduated from an osteopathic medical school. 7. One study of 2,013 households was commissioned by the FSMB (1997a). 8. This Consumer Reports survey was based on a national probability telephone survey of 1,026 adults, January 28–31, 2011 (Consumer Reports 2011). 9. In Britain the equivalent regulatory agency, the General Medical Council (GMC), created by the 1858 National Medical Act, has faced many of the same criticisms as the licensing boards in the United States (Allsop 2002; Moran 2002, 2004; Stacey 1992). 10. Researchers have argued over the origin of the decline in trust. Imber (2008) points out that the decline is embedded in the weakness of religion and growth of technical competence, while others insist that it derives from the structure and commercialization of the professions (Freidson 1986: 28; Larson 1977; Wolinsky 1993). 11. Schlesinger (2002) provides data that assess attitudes of elites and the general population toward medicine and questioning of medical authority in the mid-1990s, concluding that elites are less supportive of physician authority. The lack of support is related to belief in lack of medical efficacy, lack of altruism, lack of trust in the political involvements of the profession, and physicians’ failures to act as agents for patients. Pescosolido et. al. (2001) argue that there has been some erosion of the public ’s positive view of physicians and those where the erosion is greatest are those who have the greatest stake in medical treatment. 12. See, for example, Saks (1995), especially chapter 1, for discussion of altruism and the public interest and Millenson (1997) for his discussion of the lack of scientific basis for many medical treatments. 13. Stewart (1999); Kohn, Corrigan, and Donaldson (2000). Many of Gawande’s New Yorker essays were compiled in Gawande (2002, 2007). 14. More than fifty articles appeared in the Boston Globe and Boston Herald concerning the case. The two books were Obsession: The Bizarre Relationship between a Prominent Harvard Psychiatrist and Her Suicidal Patient (Chafetz and Chafetz 1994) and Sex, Suicide, and the Harvard Psychiatrist (McNamara 1994). 15. It is not my intent to define what is in the public interest but instead to examine how it is decided. See Saks (1995) for an analysis of the process by which he thinks that it is possible to arrive at what is in the public interest. 16. Ethnographers often change details of people’s lives, construct composite accounts, and leave out the details that might identify participants, yet they present accurate depictions. This book is not about particular individuals or boards; it is about the different ways boards talk about and organize disciplinary processes. I heard repeatedly about every type of discussion I have developed here to illustrate variations. 17. Readers who wish to check the status of local physicians and how their state boards work can access individual board websites, which are listed on the FSMB website (http://www.fsmb.org/). 18. For a discussion of the importance of history to understand the present, see Garland (2001). 19. Stevens (1998: xix). 20. Black (1984) argues that we need to explain different forms of social control, which is a dependent variable with at least four formal styles: (1) punitive, which focuses on conduct; (2) conciliatory, which focuses on the relationship between the offender and the offended; (3) therapeutic, which focuses on the actor; and (4) compensatory. While Black sees them as separate, I found them all used within one organization and often articulated simultaneously. Most boards used either (in Black’s terms) “punitive” forms, focusing...