State Medical Boards: Future Challenges for Regulation and Quality Enhancement of Medical Care

Thompson and Robin review of the origins of and future challenges facing the proactive oversight of medical licensure. They detail the history of physician licensure as a public safety mechanism, noting how the enactment of Health Care Quality Improvement Act of 1986 significantly stepped up provider oversight. With an eye toward the necessary next steps in quality improvement related to provider monitoring, they consider the limitations of the medical licensure and oversight system, including: its reactive nature; the increasing complexities of medical practice and, therefore, the regulation thereof; and the finite resources dedicated to this public safety function.