Indian State Medical Board Members Discuss Physician Discipline

The American Association of Physicians of Indian Origin and the Association of Telugu Medical Graduates in USA hosted a videoconference that gathered many of the Indian state medical board members.

It was a who’s who of the most successful Indian physicians throughout the country: those who rose to eminence in their state’s medical profession and now regulate the practice of medicine within its boundaries.

The presentation was an informal roundtable discussion where various board members provided insights on topics ranging from board presentations to disciplinary measures.

The conversation was surprisingly nuanced and offered a rare glimpse into the inner workings of medical licensing boards. Most would have expected a conversation rife with generic platitudes. And to be sure, there were a fair amount of generalities evoked and disseminated.

“be nice to your patients and they’ll be less likely to file complaints”

“make sure you properly document everything”

But beneath this veneer lies the heart of the matter and likely why such a presentation was orchestrated in the first place: what makes the Indian physician unique so as to warrant an entire conversation discussing medical licensing board matters?

At first blush, it might appear that the sheer number of Indian physicians has to be taken into consideration in order to answer this question. Indians constitute 1.35 percent of the American population, but make up at least 8.5 percent of the physicians practicing in America. Moreover, Indians are the largest number of International Medical Graduates (IMGs) in this country.

But the overrepresentation of Indian physicians isn’t the issue. It’s the uniqueness of the Indian physician that matters. Throughout the presentation, Indian board members noted specific attributes of Indian physicians that placed them at higher risk of disciplinary actions and board specific sanctions.

“Indian physicians are more entrepreneurial”

“They are more likely to own a medical practice”

“They are more likely to work as an independent practitioner”

These are assumptions most in medicine assume to be true but there’s no data available – at least not publicly – to verify this. But for many Indian physicians, there’s an undercurrent of paranoia. Many believe that they’re greater targets for regulators and overly ambitious prosecutors and attorney generals.

Whatever scant data available is largely inconclusive. There’s no study or body of data to verify this. It’s mere speculation.

But speculative thinking is a funny thing. It’s often the suggestion that proves more powerful than any fact or line of logic. Just look at how rapidly healthcare misinformation and disinformation spreads throughout the internet. Facts walk. Speculation sprints.

And the entire presentation – truly the entire undertone among most, if not all board members, was this: Indian physicians tend to practice medicine in a way that places them at higher risk relative to other physicians. And, as is the case with speculative thinking, all that’s needed is one match to ignite the flame of faith. It came as an innocuous statement close to the end of the presentation.

“Indian physicians are often overconfident”

That statement was uttered by one of the board members. It might as well have encapsulated the entire subtext of the presentation.

Remember, healthcare is a regulated market. In such markets, the regulations define market behavior. Every state has a medical board that oversees the practice of medicine and warrants disciplinary actions when deemed appropriate. This process is fundamentally legal and subjective in nature. There are no clinical studies or established standards of care to guide what happens. Sure, something clinical might be referenced, but ultimately you have a body of individuals making subjective appraisals of individual cases and specific behaviors.

In such a scenario, words matter. And the words uttered during the presentation demonstrate a coherent belief across multiple state board members that Indian physicians are viewed as unique among the physician community: And not in a good way. Remember, the words spoken reflect the thoughts held. Indian physicians are overconfident. They take risks. Sometimes those risks need to be regulated. Indian physicians are unique like that – whether right or wrong, that’s the perception.

This perceived uniqueness puts Indian physicians at greater risk. This much was consistently insinuated and at times openly acknowledged and discussed. For Indian physicians, leery of believing that they would be at greater risk simply for the way they practice medicine, this presentation was a wake-up call.

You are at greater risk of regulatory sanctions because of how you are perceived. The board members have spoken.