Other Disciplinary Actions

Only 29 State regulatory agencies indicate that adjudications other than normal revocations, fines, dismissals, suspensions, and probations are used as disciplinary tools. Though the overall mean number of adjudications was 4.93, large States had a significantly higher rate, at 8.9; while smaller States averaged 2.9. The largest group of respondents, 6 percent (8), were divided between 2 as a maximum, and 5 to 10 adjudications of "Other" actions. The majority of responses by the 10 largest States to "Other" actions adjudicated ranged from 5 to 10. (See Table 8.)

Although large numbers of adjudications were indicated, few disciplinary actions were actually taken.

In the areas of voluntary compliance and related activities affecting controlled substances abuse and drug-related diversion, the following topics constitute the major concerns:

• Present status of peer review and self-regulation • Sources and methods for controlled board and association linkages

• Effect on voluntary compliance.

(1) Present Status of Peer Review and Self-Regulation

The following results concern peer review and self-regulation by professional associations: • Role of Associations In Self-Regulation One-fourth (60) of the association representatives believed that the association should play a primary role in self-regulation, with MD responses indicating highest agreement, 58 percent (18). The number of responses noting that a peer review was being planned indicates a trend toward associations taking a more active role in self-regulation. (See Table 9.)

Association-sponsored self-regulation was felt to be most effective in curbing violations of professional ethics. Eighty-three percent (95) of respondents indicated this belief. Recordkeeping violations were also cited as areas of potential association effectiveness (by 42 percent or 48 of the respondents.) The least effective areas of self-regulation were believed to be felonies and drug-related crimes. (See Table 11.)

Status of Mandatory and Voluntary Peer Review Because 75 percent (146) of the State board representatives did not answer this question, no findings could be made concerning mandatory peer review as a method to increase accountability and influence prescribing practices relating to controlled substances. Of those that did answer, 10 percent (20) said that they are planning to establish a review process, while another 10 percent (19) said that mandatory review processes are already in effect. Responses on voluntary peer review indicated that 14 percent (28) of the State boards have a voluntary peer program and that 9 percent (17) are planning to establish such a program. But again, 72 percent (140) of the State board representatives did not respond to this question. (See Tables 12 A and B.)