Character, Competence, and the Principles of Medical Discipline

This Article presents a first-of-its-kind analysis of the disciplinary functions of state medical licensing boards-the frequently overlooked administrative agencies designed to serve as the "gatekeepers" of the medical profession. It concludes that medical boards may have lost sight of their primary goal of patient protection and suggests that a renewed focus on professional licensing boards may go a long way towards addressing some of the quality of care problems plaguing the American medical system.

This Article identifies three fundamental legal principles underlying medical boards' authority to discipline physicians: the goal of public protection, substantive due process limitations based on fitness to practice medicine, and the concept of disciplinary minimalism. It demonstrates that boards, which frequently sanction physicians who engage in criminal conduct and other forms of "unprofessional conduct" outside the clinical sphere, often exercise their disciplinary discretion in a manner inconsistent with these fundamental principles. A more effective use of medical boards' scarce resources would involve a focus on physicians whose misconduct is more clearly linked to clinical practice. Accordingly, this Article suggests that boards return their focus to the principles of professional discipline, prioritizing disciplinary actions taken on the basis of competence, rather than character.