Assessing severity of physician misconduct and subsequent disciplinary actions: a cross-sectional survey and analysis of discipline summaries

There are growing efforts to identify the characteristics of physicians who face misconduct allegations. We aimed to analyze disciplinary actions in relation to violations and to identify variables that may influence outcomes, to determine the risk of bias in adjudication procedures. In Phase 1, we deployed a survey to patients, family members, and physicians in a healthcare network to develop a severity hierarchy for types of violations and disciplinary actions. In Phase 2, we analyzed a subset of discipline summaries published by the provincial regulatory college between 2010 and 2019 and characterized violations, disciplinary actions, and their associations. Phase 1: Seventeen physicians and 11 patients or family members completed the survey. Sexual misconduct was rated as the most severe type of violation (mean: 4.79, range: 1–5). License revocation was rated as the most severe disciplinary action (4.46). Phase 2: Overall, there were higher severity violations for men physicians relative to women (4.13 vs. 4.02, 95% CI: 0.03, 0.21). The corresponding disciplinary actions were rated as moderate, mean severity 3.19 (SD: 0.280), with no difference by gender, and these were disproportionate to the severity of violations. Our findings suggest that adjudication processes may have room for improvement.