In 1976, between three percent and five percent of physicians in the USA (over 10,000) were estimated to be incompetent, whether because of debilitating illness, addiction, or lack of proper training. Yet fewer than one hundred physicians were deprived of their licenses each year. When patients bring suits for malpractice, a "conspiracy of silence" puts immense pressure on physicians not to testify against their peers, increased by the substantial risk that by testifying on behalf of a plaintiff they may have their malpractice insurance policies cancelled. Lies and cover-ups keep others from acquiring information which might lead to exposure.
An example of extreme incompetence was a Californian orthopaedist with millions of dollars in malpractice judgements against him, including those from patients left crippled or paralyzed, and who had admitted under oath that he performed complicated and dangerous spinal surgery when it was unnecessary. Several news reports confirm that colleagues lied for him, intervened at the operating table to keep him from botching delicate procedures, and, on occasion performed follow-up operations to repair damage that he caused, all without taking action to restrict his further practice. When eventually they did restrict his hospital privileges, they did it so quietly that he simply continued to work at another hospital in the same town.