Licensure Actions Against Psychiatric Clinicians: A Cohort Analysis of National Practitioner Database Reports

Abstract

Objective: To examine trends and predictors of administrative actions against psychiatric clinicians' licenses between 2002 and 2022.

Methods: Data from the National Practitioner Data Bank (NPDB) identified 6400 disciplinary actions against psychiatric clinicians' licenses. Linear trend models assessed the trends of disciplinary actions across mental/physical health, licensing/legal issues, and unprofessional conduct. A first-order autoregressive model with a time indicator interaction term evaluated structural breaks (ie, a sudden or gradual change in the characteristics of data in a time series). Predictors of claims were assessed using logistic regression.

Results: Since 2002, disciplinary actions related to clinicians' mental/physical health (P=0.004) and licensure/legal issues (P=0.018) have decreased, while actions related to unprofessional conduct remained unchanged (P=0.358). Declines emerged in 2012 for mental/physical health (break coefficient -0.367; P=0.026) and in 2009 for unprofessional conduct (break coefficient -0.199; P=0.013). Clinicians facing disciplinary actions related to physical/mental health were significantly younger than those with legal/licensure issues (P<0.001). While the average age remained stable for mental/physical health-related actions, the average age increased for actions related to licensure/legal claims and unprofessional conduct.

Conclusions: The decrease in disciplinary actions related to physical/mental health may reflect better access and acceptance of treatment of clinicians, while the reduction in licensure/legal actions may indicate policy shifts. Findings regarding age underscore the need for enhanced support for mid and late-career clinicians to promote lifelong learning and practice.

FIGURE 1

Administrative actions among psychiatric clinicians from 2002 through 2022. Physical and mental health-related administrative actions (A); legal and licensure-related administrative actions (B); and administrative actions related to unprofessional conduct (C). Shaded regions represent the 95% credible interval for the estimate, and solid lines represent the autoregressive model line of best fit. The average age of practitioners receiving administrative actions has remained stable for physical and mental health (D). It has increased for actions related to licensure and legal (E) and unprofessional conduct (F).

FIGURE 2

First-order autoregressive model of administrative action bases.