THE STATE BOARD of Medical Examiners is to be commended for proposing changes to state law that would give it more power to investigate physicians, make it more likely that its disciplinary actions won’t be overturned by courts and open more of those activities to the public.

The proposals would make physicians’ self-policing system as thorough and open to public scrutiny as any professional disciplinary system in South Carolina, and superior to most such systems.

Public attention has focused on the criminal background checks to which new physicians could be subjected and on a new rule that would allow the board to open cases to public review once it formally charges a doctor with a violation.

But other changes are potentially more significant: A second non-physician would be added to the board, and the board’s Medical Disciplinary Commission, now composed entirely of doctors, would have one lay person added for every three physicians. In addition, judges would no longer be able to close records that the board has opened to the public, and more precise definitions and procedures should keep judges from overturning the board’s disciplinary actions, as has happened in two notorious cases in the past year.

The public would be better served if such reforms were approved for all of the professions that are licensed by the state, from accountants to veterinarians.

But while these proposals are a step in the right direction, they don’t go as far as they should.

For one thing, the public still would be kept in the dark about most complaints that are filed against physicians, learning only about that small minority that the board determines to be worth pursuing.

Defenders in the medical, legal and other professions say such secrecy provisions are necessary to protect the reputation of innocent people who are targeted by illegitimate complaints. But as long as most complaints are kept secret, the public will never know whether most are indeed without merit or whether the boards are dismissing legitimate complaints in order to protect their professions. Involving such a large number of non-physicians in the discipline system should allay some of those concerns, but it won’t do as much as simply opening the entire process to public scrutiny.

What is most disappointing about the proposals is that they do little, if anything, to make sure the Board of Medical Examiners does a better job of protecting the public from careless or incompetent doctors. While the board would have more and better tools to police physicians, the new procedures still seem focused primarily on doctors who abuse drugs or run pill mills or otherwise engage in “misconduct.” The board is right to take those problems seriously, but it should focus at least as much on physicians’ competence and diligence.

Many physicians acknowledge that their profession has not done enough to reduce medical errors. They argue, correctly, that lawsuits are not the best way to solve the problem: Most lawsuits against doctors are over bad outcomes, not malpractice; and most cases of actual malpractice don’t result in lawsuits, or in any other punitive action. But simply supporting new procedures aimed at systemic errors or wishing the lawsuits would go away isn’t a sufficient answer to the problem. As long as the state operates a self-policing system for physicians, its primary goal should be to discipline that tiny minority of doctors whose carelessness or incompetence truly poses a risk to patients.