HARRISBURG - At a time when most government agencies are going begging for funding, the state board that regulates doctors and other medical professionals in Pennsylvania has amassed a $30 million surplus.
The board is so flush that 50,000 licensed physicians are getting a pass this year on license fees they pay every other year.
The decision last summer to waive the fee - $360 for doctors of medicine, or M.D.s - has raised the hackles of critics who ask why not spend the money for its intended use - policing doctors - rather than giving those same professionals a two-year holiday from their license fee?
They contend the state has a weak record of taking enforcement action against rogue doctors - such as Philadelphia abortionist Kermit Gosnell.
"Pennsylvania's is not a very good board," said physician Sidney Wolfe, director of Public Citizen's Health Research Group, a health advocacy organization that releases periodic rankings of state medical boards based on the number of disciplinary actions.
In 2011, the Public Citizen group ranked Pennsylvania 29th in the nation based on the number of serious disciplinary actions per 1,000 physicians.
"Maybe if it spent money on doing investigations, more people of Pennsylvania would be better served," Wolfe said.
Board Chairman James Freeman, who proposed the fee suspension, declined to comment and directed questions to the Department of State public information office.
Rabbi Solomon Isaacson, the board's citizen member and one of three who voted against the fee waiving, also declined to comment, citing board policy.
"The medical board felt they had sufficient funds to operate for the next two years," said Ron Ruman, spokesman for the Department of State, which oversees medical and professional licensing boards.
Fees from the state's licensed doctors, along with smaller levies on 25,000 other medical professionals, bring in $18 million to support Bureau of Professional and Occupational Affairs staff members who oversee the medical profession in Pennsylvania.
All medical-license fees are deposited in a restricted account and used solely to support medical board activities, including investigation, enforcement, and prosecution of cases involving doctors.
The medical board has a $7 million annual budget.
In 2003, the board was projected to have a $6.6 million deficit when the legislature passed new malpractice legislation that was expected to trigger more litigation against doctors. With the medical board required to investigate each lawsuit, a fee increase was approved to cover the anticipated costs. As it turned out, the costs were overestimated and the surplus grew to the current $30 million.
At the same time, the number of professional licenses issued grew with the addition of other medical-related fields, such as athletic trainers.
With that as a backdrop, the board voted in July to suspend the fees.
Bureau Commissioner Katie True, who abstained in favor of letting professional members make the decision, said she felt the fee waiver would help family-practice doctors and other medical professionals whose incomes are not as large as those of physician specialists.
"In hard economic times, with a sufficient amount of money, it was a one-time-only waiver to help out," True said.
Wolfe said Pennsylvania ought to use its surplus to hire more investigators, particularly given the national controversy over the Gosnell clinic case.
A grand jury report released in 2011 found the medical board had failed to follow up on numerous complaints that could have shut down the West Philadelphia clinic a decade ago.
Between 2002 and 2009, the grand jury learned, seven attorneys for the state's medical licensing board knew of problems at the clinic and did nothing.
The lawyers reviewed five cases against Gosnell and closed three without investigating. The last two were investigated and closed without action - including the death of a 22-year-old whose family sued Gosnell and received a $400,000 settlement.
Gosnell is in jail, awaiting trial after being charged with the deaths of seven babies born alive and of one adult patient.
Travis Gery, the bureau's executive deputy chief counsel, whom Gov. Corbett hired after the Gosnell clinic was closed, said that the bureau was adequately staffed and that complaints in the past likely fell through bureaucratic cracks that now have been filled.
"There was a lack of system in place for multiple agencies to share information," Gery said. "It was the biggest failure out there. But many of things we have put in place are a result of that, such as a much closer relationship with the Department of Health."
Wolfe maintains that statistics - including that Pennsylvania is one of eight states with 70 percent or more of its doctors having received hospital sanctions but no state-licensure action - are evidence the board is not aggressive enough and indicate a need for better enforcement.
"A free pass for everyone is more important than having adequate staff to protect the people of Pennsylvania from a small percent of doctors who should have licenses revoked," Wolfe said.
But Mark Talbot, director of enforcement and investigation for the Bureau of Professional and Occupational Affairs, said it was unfair to compare Pennsylvania to other states when details of all investigations are not available.
"I don't think Public Citizen did a very good job at all," Talbot said. "A more fair question is: 'Are you doing the right thing when it comes to egregious conduct by health-care professionals?' I think we are."