If you’re looking for information about your doctor, you may find yourself searching the website of your state’s medical board. Those are the agencies that license physicians and also discipline them for offenses including sexual misconduct, substance abuse, and negligent care. But the accuracy and completeness of the information you find, and even how often doctors are punished, can depend on your state. That’s according to two new reports, one from Consumer Reports and the other from researchers at the University of Michigan.

Consumer Reports Safe Patient Project partnered with the nonprofit Informed Patient Institute to evaluate the websites of state medical boards in all 50 states. They found that most are difficult to navigate and the information on them varies widely.

“Consumers living in every state should have easy access to complete information about their doctors’ histories,” says Lisa McGiffert, director of the Safe Patient Project. “But we found that most medical board websites don’t make it easy to find profiles on individual doctors and when you get there, you don’t get easy-to-understand explanations of what, when, and why the board took disciplinary actions.”

Different States, Different Actions

The University of Michigan study, published in BMJ Quality and Safety, found a similar lack of consistency among state medical boards—this time regarding the disciplinary actions the boards take against doctors. The researchers calculated a fourfold variation in disciplinary rates across the country.

“I don't think it's intentional, but there are states where you get off easier, and there are states where you get firmly dealt with,” says study co-author John A. Harris, M.D., an obstetrician-gynecologist and a Robert Wood Johnson Foundation clinical scholar at the University of Michigan Medical School.

Harris and his University of Michigan colleague, Elena Byhoff, M.D., used data from the American Medical Association and the National Practitioner Data Bank, a federal repository that collects physician disciplinary actions and medical malpractice payouts. They focused on disciplinary actions (not malpractice cases) from 2010 through 2014.

They found that each year state boards took 3.8 disciplinary actions for every 1,000 practicing physicians, on average. But there was a four-fold variation among the states, from just 2.1 actions per 1,000 doctors in Massachusetts to 7.9 actions per 1,000 in Delaware.

Why the wide variation? It’s probably not that Delaware doctors are actually prone to more misconduct, Harris says. “We're kind of all assuming that physicians in every state are essentially as ethical as physicians in another state,” he says.

Instead, he hypothesizes that it stems from factors such as different regulatory procedures and standards, the amount of funding each medical board receives to investigate claims, and how many non-physicians there are on the board. As a result, a physician could get a major disciplinary action in one state from the medical board for a particular offense and a minor disciplinary action for the same offense in another state, Harris says.

Read our full report on state medical boards and get links to your state board's website.

The Federation of State Medical Boards, which represents the boards and facilitates communication among them, acknowledges that variation is a potential issue. “Consistency is certainly a worthy goal,” says Lisa Robin, chief advocacy officer for the organization. “Looking at the disciplinary trends to make improvements in the system … we would always encourage that.” Still, she also says that, “the rate of discipline alone is probably not a good picture of really what the boards do and how well they’re able to protect patients in their state.”

Where Medical Boards Fall Short

But, as Consumer Reports’ analysis found, those state boards fall short in other measures, too. In fact, in many instances, physicians who have been severely disciplined continue to practice while their offenses remain relatively hidden, buried deep on the boards' websites or unavailable entirely online. (See the Ratings chart, below, to see how state medical board websites compared.)

“People are generally not aware that doctors on probation for serious issues such as sexual misconduct, drug abuse, and gross negligence continue to practice,” McGiffert says. “These doctors should be required to inform their patients of their probationary status.”

Harris, at the University of Michigan, hopes that his analysis will make medical boards more accountable—and, ultimately, make patients safer. “More specific information [should] be made available at the individual board level about their own activities,” he says. “I don’t quite understand the need to protect people that have been disciplined.”

A chart showing how state medical board websites compare.