Public Citizen, a nonprofit consumer advocacy organization founded in 1971 with 1 million members and supporters throughout the United States that “champions the public interest in the halls of power,” defends democracy, resists corporate power, and fights to ensure that government works for the people, investigated the extent to which medical licensing boards are taking actions to protect the public from physicians who injure patients or behave inappropriately or illegally. Public Citizen issued its report on November 12, 2026 entitled “Ranking of the Rate of State Medical Boards’ Serious Disciplinary Actions, 2023-2025.”
Public Citizen reported that medical boards from all 50 states in the United States and the District of Columbia took 1,378 serious disciplinary actions (i.e., those that had a clear negative effect on a physician’s ability to practice) in 2023, 1,406 in 2024, and 1,447 in 2025, with an average annual rate of 1.76 serious disciplinary actions per 1,000 physicians. The analysis found that Alaska had the highest rate of disciplining physician misconduct for 2023-2025, with Ohio ranked second, Alabama third, Kentucky fourth, and North Dakota fifth.
Twenty-nine states and the District of Columbia had rates that were less than half of Alaska’s rate. Indiana, with a rate of 0.28 serious disciplinary actions per 1,000 physicians per year, ranked the lowest. Other low-ranking states included Georgia, Rhode Island, Idaho, Pennsylvania, and New Mexico and the District of Columbia.
If all states had taken serious disciplinary actions at the same rate as the highest-ranked board (Alaska) during the 2023-2025 period, there would have been 2,942 serious disciplinary actions taken during 2025, about double the number of serious actions that were taken that year.
In 2020 there were 1,387,360 medical board licensees, in 2022 there were 1,535,862 medical board licensees, and in 2024 there were 1,671,477 medical board licensees. Some physicians are licensed in more than one state.
Public Citizen reported that the overall annual rate of serious disciplinary actions per 1,000 licenses for 2023-2025 was 0.84. That rate is a 1.0% decrease from the annual rate of 0.86 serious actions per 1,000 licenses for 2021-2023 and a 14.2% decrease from the 0.98 annual rate for 2019-2021. Although the number of serious actions taken by medical-licensing boards has only decreased by 4.1% over the three study periods, the likelihood that any medical license will have a serious disciplinary action taken against it has decreased by over 16%.
The report concluded: “Our findings suggest that many licensing boards are inadequately enforcing their states’ medical practice acts. Low rates of serious disciplinary actions in comparison with other states, as well as with other boards in previous periods, suggest that the boards are taking insufficient actions to hold physicians accountable for negligent medical care or behavior that is unacceptably dangerous to patients.
The observed differences in the rates of state disciplinary action cannot be explained by differences in the competence or conduct of the physicians practicing in the various states. Nor is there any evidence that the rates of serious disciplinary actions taken by Alaska and other high-ranked states are sufficient to protect patients from dangerous doctors.
Implementing the state and federal reforms that we have suggested could improve the performance of state medical boards and help them better protect the public against the small minority of physicians who should not be practicing at all or should have their licenses restricted but are still fully licensed. These reforms are particularly urgent in states whose boards have the lowest rates of serious disciplinary actions against physicians. Physicians who provide appropriate medical services would also benefit from reforms that would improve the quality of medical care in their states.”
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