Learning from Leading Peers: An Interview Study with Seven SMBs that Recently Implemented Policies to Protect Patients

Background: State medical boards (SMBs) are tasked with protecting the public but vary in rates of severe disciplinary actions taken against physicians who harm patients. Prior work yielded a SMB-informed list of 56 policy recommendations for protecting the public from egregious wrongdoing by physicians. However, these recommendations have not seen widespread adoption by boards. Objective: The purpose of this study was to identify lessons learned from SMBs who recently successfully implemented innovative policies that protect the public. Methods: We conducted in-depth semi-structured interviews with executive directors and board members from 7 SMBs across the United States and its territories. Results: A total of 13 themes were identified reflecting lessons learned that other boards could adopt when implementing new policies. Advice emerging from interviews included both people-focused and process-focused lessons, spanning domains such as proactively anticipating and acting on barriers to policy implementation, leveraging networks of different stakeholders, using data to inform policy change and case investigations, and attending carefully to board composition and capacity building. Conclusions: The lessons identified provide valuable guidance and a helpful starting point for SMBs seeking to cultivate change in their board’s policies and practices.