The primary mission of state medical boards in the United States is to protect the public and ensure that only persons who are qualified and fit to practice medicine do so. State boards generally view the practice of medicine as a privilege and not a natural right. In some respects, state boards serve as the ultimate gatekeeper for physicians by issuing medical licenses and authorizing disciplinary actions when professional misconduct occurs. In 2014, a total of 4043 physicians received disciplinary actions (eg, licensure limitation, suspension, or revocation), representing less than half of 1% of the 916 264 actively licensed physicians in the United States.1