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Editor's note: This story originally ran March 23, 2014.

Complaints against physicians in South Dakota are handled in secrecy, but there is nothing unusual about that, according to a national organization for state medical boards.

"It is common for complaint and investigatory information to be nonpublic in medical boards across the country," said Drew Carlson, the spokesman for the Federation of State Medical Boards. "Whatever the complaint, physicians are afforded the right of due process as the board investigates an allegation of professional misconduct."

The goal of that process is to ensure that physicians are treated fairly, and in instances where a physician is accused of behavior that threatens patients with immediate harm, licensing boards have the power to suspend a license while an investigation takes place, Carlson said.

"Information on a case usually becomes public when a medical board has completed its investigation and filed formal charges against a physician," Carlson said. "Final disciplinary actions taken against physicians also are public record."

But critics of that process say it should be more transparent. Without transparency, patients and consumers don't have assurances that licensing boards are protecting them from bad doctors.

Tim James, a Yankton lawyer who is representing several clients against Dr. Allen Sossan in malpractice lawsuits, said licensing boards in Nebraska and South Dakota had an opportunity to protect patients from Sossan, but did not. Neither state lists disciplinary action against Sossan, and South Dakota's simply lists his license status as "inactive."

"This backroom approach to peer review does not protect patients or enhance quality of care," James said. "Transparency, not secrecy, is the best protection for patients when it comes to the extremely lucrative business of medicine."

Nationally, there were more than 878,000 actively licensed physicians in the United States in 2012, but according to statistics compiled by the Federation of State Medical Boards, just one-half of 1 percent of those doctors were disciplined. That number is consistent with the discipline of doctors in South Dakota, said board spokeswoman Kristi Golden.

The medical boards typically have state employees who handle investigations, licensing and other administrative functions, while a volunteer board of physicians and lay people make disciplinary decisions, Carlson said. Typically, the volunteers are appointed by the governor.

That's true in South Dakota, where a nine-member board makes disciplinary decisions. The board's membership consists of six medical doctors, one doctor of osteopathy and two nonmedical appointees. They serve three-year terms, and they are permitted three consecutive terms.

Although the structure of the boards is similar nationwide, states have their own laws and requirements when it comes to licensing. For example, South Dakota is the only state in the nation that will only grant licenses to doctors who have finished at least three years of a residency program, Golden said. Some states will grant a license with only one year of residency training.

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