{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:03:34Z","timestamp":1762297414423,"version":"3.40.5"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,2,1]]},"abstract":"<jats:p>OBJECTIVE. The purpose of this research was to explore state physician licensing board policies and regulation of active, inactive, and retired licenses.<\/jats:p>\n               <jats:p>METHODS. We conducted structured telephone interviews from January to March 2007 with representatives of all 64 state allopathic and osteopathic medical licensing boards in the United States. All of the licensing boards participated.<\/jats:p>\n               <jats:p>RESULTS. Only 34% of state licensing boards query physicians regarding clinical activity at both initial licensure and renewal. The majority of boards allow physicians to hold or renew an unrestricted active license to practice medicine, although they may not have cared for a patient in years. Only 1 board requires a minimum number of patient visits to maintain an active license. Five boards allow physicians with inactive licenses to practice some form of medicine, whereas 7 boards allow physicians with retired licenses to practice. Few states have any mechanism to assess the competency of clinically inactive physicians who return to active practice.<\/jats:p>\n               <jats:p>CONCLUSIONS. The number of inactive physicians in the United States is growing. Currently, state medical board policies do not address the issue of continuing competence in license renewal. Greater medical safety concerns on the part of the public will likely lead to calls for greater accountability by state licensing authorities.<\/jats:p>","DOI":"10.1542\/peds.2008-1017","type":"journal-article","created":{"date-parts":[[2009,1,26]],"date-time":"2009-01-26T12:23:44Z","timestamp":1232972624000},"page":"643-652","source":"Crossref","is-referenced-by-count":9,"title":["Protecting the Public: State Medical Board Licensure Policies for Active and Inactive Physicians"],"prefix":"10.1542","volume":"123","author":[{"given":"Gary L.","family":"Freed","sequence":"first","affiliation":[{"name":"Child Health Evaluation and Research Unit"},{"name":"Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly M.","family":"Dunham","sequence":"additional","affiliation":[{"name":"Child Health Evaluation and Research Unit"},{"name":"Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Abraham","sequence":"additional","affiliation":[{"name":"Child Health Evaluation and Research Unit"},{"name":"Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Research Advisory Committee of the American Board of Pediatrics","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,2,1]]},"reference":[{"key":"2021120822561814000_R1","doi-asserted-by":"crossref","unstructured":"Freed GL, Abraham LM, Brzoznowski KF. Inactive physicians: the state of our understanding. J Pediatr.\u20082007;151(4):431\u2013434","DOI":"10.1016\/j.jpeds.2007.04.066"},{"key":"2021120822561814000_R2","unstructured":"American Medical Association. Physician Characteristics and Distribution in the US: 2006 Edition. Chicago, IL: American Medical Association; 2006"},{"key":"2021120822561814000_R3","unstructured":"Mulvey H, Jewett E. Physician reentry into the workforce. In: Physician Reentry Into the Workforce Project. Elk Grove Village, IL: American Academy of Pediatrics, Division of Workforce and Medical Education Policy; 2008"},{"key":"2021120822561814000_R4","doi-asserted-by":"crossref","unstructured":"Hannan EL, Kilburn H Jr, Bernard H, O'Donnell JF, Lukacik G, Shields EP. Coronary artery bypass surgery: the relationship between inhospital mortality rate and surgical volume after controlling for clinical risk factors. Med Care.\u20081991;29(11):1094\u20131107","DOI":"10.1097\/00005650-199111000-00003"},{"key":"2021120822561814000_R5","doi-asserted-by":"crossref","unstructured":"Kimmel SE, Berlin JA, Laskey WK. The relationship between coronary angioplasty procedure volume and major complications. JAMA.\u20081995;274(14):1137\u20131142","DOI":"10.1001\/jama.274.14.1137"},{"key":"2021120822561814000_R6","doi-asserted-by":"crossref","unstructured":"Kitahata MM, Koepsell TD, Deyo RA, Maxwell CL, Dodge WT, Wagner EH. Physicians' experience with the acquired immunodeficiency syndrome as a factor in patients' survival. N Engl J Med.\u20081996;334(11):701\u2013706","DOI":"10.1056\/NEJM199603143341106"},{"key":"2021120822561814000_R7","unstructured":"Federation of State Medical Boards. Essentials of a Modern Medical Practice Act. 11th ed. Dallas, TX: Federation of State Medical Boards; 2006"},{"key":"2021120822561814000_R8","doi-asserted-by":"crossref","unstructured":"Nash IS, Corrato RR, Dlutowski MJ, O'Connor JP, Nash DB. Generalist versus specialist care for acute myocardial infarction. Am J Cardiol.\u20081999;83(5):650\u2013654","DOI":"10.1016\/S0002-9149(98)00961-8"},{"key":"2021120822561814000_R9","doi-asserted-by":"crossref","unstructured":"Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol.\u20082000;18(11):2327\u20132340","DOI":"10.1200\/JCO.2000.18.11.2327"},{"key":"2021120822561814000_R10","doi-asserted-by":"crossref","unstructured":"Tu JV, Austin PC, Chan BT. Relationship between annual volume of patients treated by admitting physician and mortality after acute myocardial infarction. JAMA.\u20082001;285(24):3116\u20133122","DOI":"10.1001\/jama.285.24.3116"},{"key":"2021120822561814000_R11","doi-asserted-by":"crossref","unstructured":"Billingsley KG, Morris AM, Dominitz JA, et al. Surgeon and hospital characteristics as predictors of major adverse outcomes following colon cancer surgery: understanding the volume-outcome relationship. Arch Surg.\u20082007;142(1):23\u201331; discussion 32","DOI":"10.1001\/archsurg.142.1.23"},{"key":"2021120822561814000_R12","doi-asserted-by":"crossref","unstructured":"Schull MJ, Vermeulen MJ, Stukel TA. The risk of missed diagnosis of acute myocardial infarction associated with emergency department volume. Ann Emerg Med.\u20082006;48(6):647\u2013655","DOI":"10.1016\/j.annemergmed.2006.03.025"},{"key":"2021120822561814000_R13","doi-asserted-by":"crossref","unstructured":"Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg.\u20081998;228(3):320\u2013330","DOI":"10.1097\/00000658-199809000-00005"},{"key":"2021120822561814000_R14","doi-asserted-by":"crossref","unstructured":"Finlayson SR. The volume-outcome debate revisited. Am Surg.\u20082006;72(11):1038\u20131042, discussion 1061\u20131069, 1133\u20131148","DOI":"10.1177\/000313480607201110"},{"key":"2021120822561814000_R15","unstructured":"Freeman ML. Training and competence in gastrointestinal endoscopy. Rev Gastroenterol Disord.\u20082001;1(2):73\u201386"},{"key":"2021120822561814000_R16","doi-asserted-by":"crossref","unstructured":"Boyajian-O'Neill LA, Gronewold LM, Glaros AG, Elmore AM. Physician licensure during disasters: a National Survey of State Medical Boards. JAMA.\u20082008;299(2):169\u2013171","DOI":"10.1001\/jama.2007.39"},{"key":"2021120822561814000_R17","unstructured":"Uniform Law Commission. Uniform Emergency Volunteer Health Practitioners Act.\u20082007"},{"key":"2021120822561814000_R18","unstructured":"Council on Graduate Medical Education. Fifth Report: Women and Medicine. Washington, DC: Council on Graduate Medical Education; 1995. Report HRSA-P-DM-95-1"},{"key":"2021120822561814000_R19","doi-asserted-by":"crossref","unstructured":"Escovitz GH, Woodside NB. Retraining inactive physicians. A seven-year experience. JAMA.\u20081978;239(20):2139\u20132142","DOI":"10.1001\/jama.239.20.2139"},{"key":"2021120822561814000_R20","unstructured":"Frank E, Rothenberg R, Brown WV, Maibach H. Basic demographic and professional characteristics of US women physicians. West J Med.\u20081997;166(3):179\u2013184"},{"key":"2021120822561814000_R21","doi-asserted-by":"crossref","unstructured":"Frank E, Singh SR. Personal and practice-related characteristics of a subsample of US women dermatologists: data from the Women Physicians' Health Study. Int J Dermatol.\u20082001;40(6):393\u2013400","DOI":"10.1046\/j.1365-4362.2001.01213.x"},{"key":"2021120822561814000_R22","unstructured":"Lowes R. How unhappy are women doctors?Med Econ.\u20082000;77(13):80\u201382, 89\u201390, 95 passim"},{"key":"2021120822561814000_R23","unstructured":"Pfifferling J. Things I wish they taught me in medical school. Resid Staff Physician.\u20081990;36(2):85\u201392"},{"key":"2021120822561814000_R24","doi-asserted-by":"crossref","unstructured":"Powell PT, Nakata DA. Can earnings decline cause a retirement flight of physicians? Financial compensation and the decision to stay in practice. Med Care Res Rev.\u20082001;58(3):361\u2013378","DOI":"10.1177\/107755870105800304"},{"key":"2021120822561814000_R25","doi-asserted-by":"crossref","unstructured":"Silberger AB, Marder WD, Willke RJ. Practice characteristics of male and female physicians. Health Aff (Millwood).\u20081987;6(4):104\u2013109","DOI":"10.1377\/hlthaff.6.4.104"},{"key":"2021120822561814000_R26","doi-asserted-by":"crossref","unstructured":"Tesch BJ, Osborne J, Simpson DE, Murray SF, Spiro J. Women physicians in dual-physician relationships compared with those in other dual-career relationships. Acad Med.\u20081992;67(8):542\u2013544","DOI":"10.1097\/00001888-199208000-00014"},{"key":"2021120822561814000_R27","doi-asserted-by":"crossref","unstructured":"Warde C, Allen W, Gelberg L. Physician role conflict and resulting career changes: gender and generational differences. J Gen Intern Med.\u20081996;11(12):729\u2013735","DOI":"10.1007\/BF02598986"},{"key":"2021120822561814000_R28","doi-asserted-by":"crossref","unstructured":"Weisman C. Hours worked by female physicians. Health Aff (Millwood).\u20081988;7(2):189\u2013191","DOI":"10.1377\/hlthaff.7.2.189"},{"key":"2021120822561814000_R29","doi-asserted-by":"crossref","unstructured":"American College of Emergency Physicians. Policy statements: physician impairment. Ann Emerg Med.\u20081995;25(2):306\u2013309","DOI":"10.1016\/S0196-0644(95)70344-6"},{"key":"2021120822561814000_R30","doi-asserted-by":"crossref","unstructured":"Mark S, Gupta J. Reentry into clinical practice: challenges and strategies. JAMA.\u20082002;288(9):1091\u20131096","DOI":"10.1001\/jama.288.9.1091"},{"key":"2021120822561814000_R31","doi-asserted-by":"crossref","unstructured":"Jacoby I, Gary NE, Meyer GS, et al. Retraining physicians for primary care: a study of physician perspectives and program development. JAMA.\u20081997;277(19):1569\u20131573","DOI":"10.1001\/jama.277.19.1569"},{"key":"2021120822561814000_R32","unstructured":"Redfern L. Returning to practice. NT Learn Curve.\u20081999;15:134\u2013146"},{"key":"2021120822561814000_R33","unstructured":"National Institute on Drug Abuse. Prescription Drugs: Abuse and Addiction. Bethesda, MD: National Institute on Drug Abuse; 2005: Report No. NIH 05\u20134881"},{"key":"2021120822561814000_R34","unstructured":"Pfifferling JH. Managing the unmanageable: the disruptive physician. Fam Pract Manag.\u20081997;4(10):76\u201378, 83, 87\u201392"},{"key":"2021120822561814000_R35","unstructured":"US Department of Health and Human Services, Office of Women's Health. Physician Retraining Compendium. Washington, DC: US Department of Health and Human Services, Office of Women's Health; 2001"},{"key":"2021120822561814000_R36","unstructured":"Federation of State Medical Boards. Report of the Board of Directors: Report on Special Commitee on Maintenance of Licensure. Dallas, TX: Federation of State Medical Boards; 2004"},{"key":"2021120822561814000_R37","unstructured":"Stowell-Ritter A. Strategies to Improve Health Care Quality in Virginia: Survey of Residents Age 50+. Washington, DC: AARP; 2007"},{"key":"2021120822561814000_R38","doi-asserted-by":"crossref","unstructured":"Thompson JN. The future of medical licensure in the United States. Acad Med.\u20082006;81(12 suppl):S36\u2013S39","DOI":"10.1097\/01.ACM.0000243351.57047.2e"},{"key":"2021120822561814000_R39","unstructured":"Federation of State Medical Boards, Special Committee on Maintenance of Licensure. Draft Report on Maintenance of Licensure. Dallas, TX: Federation of State Medical Boards; 2008"},{"key":"2021120822561814000_R40","unstructured":"Federation of State Medical Boards. Licensure by Endorsement: Final Report of the Ad Hoc Committee on Licensure by Endorsement. Dallas, TX: Federation of State Medical Boards; 1995"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/123\/2\/643\/1124657\/zpe00209000643.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/123\/2\/643\/1124657\/zpe00209000643.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T02:52:20Z","timestamp":1639018340000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/123\/2\/643\/69359\/Protecting-the-Public-State-Medical-Board"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,2,1]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2009,2,1]]},"published-print":{"date-parts":[[2009,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2008-1017","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2009,2,1]]}}}