Findings

What a disciplinary action is, and why it gets counted

When a state medical board investigates a complaint and decides that a physician broke the rules, it can take a formal step on the record. That step is a disciplinary action. It can range from a public reprimand, which is a written rebuke that leaves the doctor free to practice, to probation, which lets the doctor keep working under conditions and monitoring, to a license suspension, which removes the doctor for a set period, to a full revocation, which ends the license entirely. A board can also accept a voluntary surrender, where a physician gives up the license while under investigation, or attach a monetary fine. Because a single case can produce more than one of these steps at once, the total number of actions in a year is usually higher than the number of cases behind them.

Counting these actions matters because they are one of the few public signals of how active a state's oversight system is. A board that takes very few actions might have a healthier physician population, or it might simply have a smaller staff, a narrower legal definition of what gets recorded, or a slower complaint pipeline. To read the numbers honestly, you have to look at the action type and at the rate, not just the headline count. The sections below walk through both.

6,444 disciplinary actions nationally in 2023, a rate of 5.97 per 1,000 licensees

According to the Federation of State Medical Boards, the United States recorded 6,444 disciplinary actions in 2023, drawn from 6,266 separate cases. FSMB U.S. Medical Regulatory Trends and Actions, 2023 Set against roughly 1,080,000 licensed physicians nationwide, that works out to a national rate of 5.97 actions per 1,000 licensees. In plain terms, about six actions were taken for every thousand licensed doctors that year. The small gap between the 6,444 actions and the 6,266 cases is the stacking effect described above, where one case can carry, for instance, both a suspension and a fine.

Reporting actions per 1,000 licensees, rather than the raw total, is what makes a fair comparison possible. A large state will almost always record more actions than a small one simply because it licenses more physicians, so a raw count tells you more about a state's size than about its enforcement. Dividing by the number of licensees strips out that size effect and leaves a figure that can be lined up side by side across states of very different scale. The national rate of 5.97 is the yardstick the rest of this analysis measures against.

Probation was the most common action type, with 1,247 actions

The single most common type of action nationally in 2023 was probation, with 1,247 actions. FSMB U.S. Medical Regulatory Trends and Actions, 2023 Probation lets a physician continue to practice while meeting conditions the board sets, such as supervision, additional training, or limits on certain procedures. Its prominence reflects a regulatory preference, where the facts allow it, for keeping qualified doctors in service under oversight rather than removing them outright. The harsher steps of suspension and revocation are less frequent and are reserved for the more serious findings.

The mix of action types matters as much as the total, because each step carries a different meaning for patients and for the physician. A revocation permanently invalidates a license. A suspension removes the doctor for a defined window. Probation keeps the doctor in practice under conditions. A voluntary surrender ends the license at the doctor's own initiative while under scrutiny, and a public reprimand records the misconduct without restricting practice. Two states can post similar overall rates while leaning toward very different ends of this severity range, so the type breakdown is essential context for any single number.

Florida led the 10 covered states at 6.40 per 1,000; Massachusetts was lowest at 2.11

Among the 10 state medical boards in this analysis, Florida had the highest disciplinary action rate at 6.40 per 1,000 licensees, the product of 480 actions against roughly 75,000 licensees. Florida Department of Health Annual Report, 2023 Florida's rate sits slightly above the national figure of 5.97. Behind it came Texas at 4.47 per 1,000, California at 3.84, Ohio at 3.29, New York at 3.12, Michigan at 3.00, Pennsylvania at 2.96, and Washington at 2.59. At the lower end, Illinois recorded 2.52 and Massachusetts the lowest of the group at 2.11. The spread from Florida to Massachusetts is roughly threefold, even though both are large, well established boards.

That spread should not be read as a verdict on physician quality. A higher rate can just as easily reflect a board with more staff, broader legal definitions of what counts as a recordable action, or a more aggressive posture toward enforcement, as it can reflect anything about the doctors themselves. The data describes how busy and how strict each board is, not how safe its physicians are. For the detail behind any one state, including the breakdown by action type, see the disciplinary trends pages for Florida and Massachusetts, and the full PlainDoctor data methodology.