A national advocacy group has declared South Carolina as worst in the nation at reprimanding physicians, but the leader of the state Board of Medical Examiners refutes those findings.

South Carolina has consistently been among the bottom 10 states at disciplining doctors for each of the past nine annual rankings by Public Citizen’s Health Research Group. The study found South Carolina has taken serious disciplinary actions – defined as revocations, surrenders, suspensions or probations – against only 1.33 doctors per 1,000 annually in the past three years. The only others with fewer than two disciplinary actions per 1,000 annually over the past three years were the District of Columbia (1.47), Minnesota (1.49), Massachusetts (1.66), Connecticut (1.82) and Wisconsin (1.9). The state with the best record, according to Public Citizen, is Wyoming with 6.79 serious disciplinary actions per 1,000 physicians.

The national average was 3.06 based on Public Citizen’s analysis of medical board data from all states and the District of Columbia. That’s up 3 percent from last year but still down 18 percent from the peak rate of discipline in 2004 of 3.72 per 1,000 physicians.

“There is considerable evidence that most boards are inadequately disciplining physicians,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group. “Action must be taken, legislatively and through public pressure on medical boards themselves, to increase the amount of discipline, and thus, the amount of patient protection.”

Dr. Louis E. Costa II, president of the S.C. Board of Medical Examiners, said the study is flawed in many ways.

“According to Wolfe’s model, a state with a perfect score would be the one that revoked all of its doctors,” he said.

Costa explained that each state has different regulations, making it difficult to compare them. South Carolina’s regulations are more punitive that most state’s for physicians found guilty of misconduct.

“In South Carolina, if a doctor’s license is revoked for misconduct or failure to meet the expected standards, the revoked licensee can never practice again in this state,” Costa said. “There are no provisions for re-licensure, ever.”

Doctors sanctioned in some states can apply for reactivation. Those states might have higher serious sanction rates than South Carolina, but their sanctioned doctors might be back working already.

Costa praised the current leaders of the S.C. Department of Labor Licensing and Regulation for giving the Board of Medical Examiners a level of autonomy and control related to licensure and compliance. And he is proud of the work the board does to protect the public.