Weak Laws and Lenient Enforcement Plague Missouri’s Oversight of Dangerous Doctors

Patients in Missouri face a double whammy of the state’s faulty oversight of dangerous doctors — Missouri law limits the state medical board’s authority to disciple them, and the board doesn’t fully exercise the rights it does have.


These are latest findings in the St. Louis Post-Dispatch’s series looking at the lack of information available to patients about the doctors and hospitals that treat them. “Leniency and secrecy are the rule when it comes to policing Missouri’s 22,000 doctors,” the paper wrote.

The state’s Board of Registration for the Healing Arts makes public little information on doctors. The board doesn’t release information on its own warning letters, on malpractice cases, on restrictions by hospitals or even where a doctor went to medical school. It seldom researches cases that challenge the quality of care, and it never uses its power to immediately suspend doctors, the paper found.

State laws also hamper the board’s oversight. It’s hard to discipline a doctor for one negligent incident, and unlike in most states, Missouri law does not give the board absolute authority over discipline. Instead, it must reach a settlement with a doctor or bring the case before commission in a litigious process that can drag on for years. Meanwhile, doctors continue to practice. Because the process is so long, the board often settles, the paper said.

This isn’t a new problem for Missouri. The paper wrote:

A Post-Dispatch investigation 30 years ago found Missouri was lax in its policing of doctors. Soon after, the legislature changed the board’s makeup to include one non-physician — a “public” member — to represent patients’ interests.

For a time, the board became more stringent, but the trend seems to have reversed, and the board is among the least active in the nation.

No board members would comment to the Post-Dispatch, though board staff told the paper that it hands were generally tied by the state’s laws.

The problematic oversight of doctors echoes much of what ProPublica found in our series looking at the lack of discipline of nurses around the country.

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