Audit of the Board of Registration in Medicine
April 7, 2020 · Board of Registration in Medicine · Read the full official report on mass.gov ↗
Published April 7, 2020 Audit covers July 1, 2016 – June 30, 2018 Under Suzanne M. Bump · 2011–2023
source
“BORIM had inadequate oversight controls, including monitoring, over PHS.”
Read the plain-English breakdown
This is a state performance audit of the Massachusetts Board of Registration in Medicine, covering July 1, 2016 through June 30, 2018.
“In accordance with Section 12 of Chapter 11 of the Massachusetts General Laws, the Office of the State Auditor has conducted a performance audit of the Board of Registration in Medicine (BORIM) for the period July 1, 2016 through June 30, 2018.”
The audit looked at whether the board was properly overseeing services for doctors whose health conditions could affect their ability to safely practice medicine.
“The objective of our audit was to assess how effectively BORIM administered the provision of PHP services to physicians through PHS.”
For ordinary patients, the point is safer medical care: the board is supposed to make sure licensed doctors are qualified, competent, and providing high-standard care.
“The Board of Registration in Medicine’s mission is to ensure that only qualified and competent physicians of good moral character are licensed to practice in the Commonwealth of Massachusetts and that those physicians and health care institutions in which they practice provide to their patients a high standard of care, and support an environment that maximizes the high quality of health care in Massachusetts.”
The auditor concluded that the board did not have enough controls over Physician Health Services and also did not effectively track required compliance reports for doctors on probation agreements.
“BORIM did not effectively monitor and control PHS’s compliance reporting related to physicians with BORIM probation agreements.”
The auditor recommended that the board create stronger oversight, including a formal contract, policies, reviews, dispute resolution, documented meetings, and better tracking of monitoring reports.
“BORIM should establish oversight and monitoring controls over PHS, including the following:”
What the Auditor checked
- Did not comply Do BORIM’s oversight and monitoring of controls over Physician Health Services’ (PHS’s) operation ensure due process and quality treatment of substance use disorders for physicians who have been reported as practicing medicine while impaired?
What the Auditor found
Why it matters: Without effective oversight of PHS, BORIM cannot ensure that physicians receive proper treatment for each alleged impairment.
Standard: BORIM is responsible for oversight of organizations that contribute to its mission, including PHS, and FSMB guidelines identify contracts, rules, reviews, and approval of PHP providers as best practices. ( Section 1 of Title 243 of the Code of Massachusetts Regulations; Section II(g) of the PHC Unit’s procedures )
6 recommendations
- BORIM should establish a formal contract with PHS documenting PHS’s responsibilities as the PHP provider.agency: disagreed
- BORIM’s board of directors should formally approve PHS as the Commonwealth’s PHP provider.agency: disagreed
- BORIM should establish policies and procedures that PHS, its vendors, and other providers must follow to ensure that impairment cases are properly and consistently handled.agency: disagreed
- BORIM should implement a requirement of PHS program reviews to determine whether PHS meets BORIM’s expectations.agency: disagreed
- BORIM should ensure that a fair disposition process for dispute resolution is provided to physicians under PHS care.agency: disagreed
- BORIM should document monthly meetings between the PHC Unit and PHS.agency: disagreed
Agency response & Auditor reply
Agency: "The Board disagrees "best practices" under the Federation of State Medical Boards' (FSMB) Guidelines for the Structure and Function of a State Medical and Osteopathic Board, requires the Board to have oversight of Physician Health Services."
Auditor: "The Office of the State Auditor (OSA) can appreciate BORIM’s position regarding the establishment of a contract with PHS."
Why it matters: BORIM could not ensure the public’s safety related to physicians returning to active practice.
Standard: Section II(f) of the PHC Unit’s procedures requires the unit to ensure monitoring reports are filed on time and tracked. ( Section II(f) of the PHC Unit’s procedures )
2 recommendations
- BORIM should implement controls over monitoring activities to ensure policy compliance, timely submission of complete required reports, and prompt notification to PHS of physicians who require monitoring reports.agency: already implemented
- BORIM should maintain records of all data for all years on the monthly and quarterly monitoring spreadsheet.agency: already implemented
Agency response & Auditor reply
Agency: "The recommendations referenced in this finding were adopted prior to the commencement of OSA Audit."
Auditor: "Despite this, we still found problems with PHS’s submission of quarterly monitoring reports to BORIM during the audit period."
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Other Office of the State Auditor reports on Board of Registration in Medicine .
- Board of Registration in MedicineAuthority / Commission