The state Department of Safety and Professional Services receives about 500 complaints against Wisconsin doctors each year.
Half are from patients or family members. Some are from health care workers. Others are malpractice findings or hospital actions reported through a national data bank.
State investigators request medical records and ask doctors for a response.
A screening panel of the Wisconsin Medical Examining Board reviews cases each month. The panel closes about two-thirds of the cases, generally because the complaints are minor or can't be proven, said Dr. Gene Musser, a board member and former chairman.
For the other cases, formal investigations are launched. An investigator, attorney and lead board member gather more information and decide if the doctor should be disciplined and how. The full board has the final say.
Options are an administrative warning (which doesn't count as official discipline), required education, a reprimand, a license limitation, a suspension or a revocation. Many times a combination is used, such as a reprimand plus required education.
The board attorney generally negotiates with the doctor's attorney until they reach an agreement.
But sometimes doctors request a hearing before an administrative law judge. The judge recommends a type of discipline, which the board can adopt or not.
Doctors can appeal through the state court system.