Audit Shows State’s Board of Registration in Medicine Lacks Oversight of Health Services for Physicians

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In an audit released today, State Auditor Suzanne M. Bump strongly recommended that the Board of Registration in Medicine (BORIM) formalize its relationship with Physician Health Services (PHS), the commonwealth’s physician health program (PHP) provider.

PHS provides consultation, assessment, support, and referrals for treatment of physicians, residents, and medical students who have potentially impairing health conditions (e.g., substance use disorders, mental health issues, and physical illness) that may compromise their ability to practice medicine. PHS is also responsible for resolving cases where no patient harm is suspected but involve allegations that a physician has practiced while impaired. “BORIM owes it to both medical professionals and members of the public to be transparent, consistent, and performance-oriented in its PHP program. While it is typical for state medical licensing boards to refer potentially impaired medical professionals to an outside entity, it is highly unusual for boards to do so without a contract that addresses matters like due process, protocols and performance standards. While this audit should not be construed as implying any negative assessment of PHS’s operations, since this is an audit only of the state agency, BORIM’s board currently lacks solid information with which to ensure that the PHP program is attaining the goals of affording fair and effective treatment and of protecting the public,” Bump said. “The Board should enter into a formal contract that establishes quality benchmarks and periodic performance reviews.”
Bump’s audit, which examined the period of July 1, 2016 through June 30, 2018, calls on BORIM to enter into a formal contact with PHS that establishes the services it will deliver, processes for delivering them, quality standards it must meet, and periodic reviews of its performance.

Additionally, the audit revealed BORIM did not effectively monitor compliance reporting by PHS for some of the 27 physicians that had probation agreements. As a result, BORIM could not ensure these physicians did not return to active practice before their cases are resolved. Bump’s audit calls on BORIM to implement controls over monitoring activities to ensure policy compliance, timely submission of required reports, and prompt notification to PHS of physicians who require monitoring.

BORIM, which was established in 1894, is responsible for the licensing, regulation, and discipline of Massachusetts physicians and acupuncturists. In 2018, there were approximately 40,000 physicians and 1,800 acupuncturists licensed in the commonwealth.

 

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