More than 250 doctors who surrendered their medical license in one state are practicing in another state, according to a November 30, 2018, article in USA Today. Doctors often surrender their licenses in the face of overwhelming evidence of misconduct, such as repeated surgical mistakes, excessive and improper opioid prescribing, or sexual misconduct. Such surrender can, the authors said, save the doctor the time and reputational harm that comes from facing a state's medical review board, and it often comes with no restriction to practice elsewhere. In fact, one-third of these doctors practice in another state with no limitations or public disclosure at all, the authors said. The article told of a doctor who surrendered his license in Louisiana for removing a healthy kidney during colon surgery; in California for removing a fallopian tube that he thought was an appendix, which had already been removed; and in New York when state regulators discovered what he did in those other states. However, he is still practicing in Ohio, where he has an "unblemished" medical license. Surrendering a license should be a tip-off to another state that a doctor has done something wrong, the authors said; instead it sometimes ends up as a "get-of-jail free card."

HRC Recommends: Risk managers should confirm that mechanisms are in place to ensure that individuals who are excluded from federal and state healthcare programs are not hired, retained, contracted with, appointed to the medical staff, or given clinical privileges and that the list of excluded and reinstated individuals and entities is checked routinely. Processes should be in place to check nearby state registries to see whether physicians have any issues with their licenses. Applications for privileges should include a question about whether a physician has had their license suspended or revoked in another state.