States aren’t adequately protecting consumers from bad doctors, according to a new study from the advocacy group Public Citizen.

The group looked at state medical boards and found the rate at which doctors are disciplined has dropped during the past decade: In 2010, the boards took 2.97 serious actions per 1,000 physicians, down three percent from last year and 20 percent from 2004, a peak year when the rate was 3.72 per 1,000 physicians.

If the rate had stayed consistent from 2004, there would have been 745 more actions last year. (The rates are an average based on the past three years.)

Maryland’s board took 79 serious actions last year for a rate of 2.55 – for a rank among the states of 39th. That was an improvement in rank from previous years. It was 43rd in 2009, down from 48 in 2003, the group said.

The least active state last year was Minnesota, with a rate of 1.29. Others near the bottom were South Carolina, Wisconsin and Connecticut.

The most active state was Louisiana, with a rate of 5.98. Others near the top were Alaska, Ohio and Oklahoma.

“One reason for medical boards’ declining rate of discipline is likely tighter state budgets,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, in a statement. “The ability of certain states to rapidly increase or decrease their rankings, even when calculated based on three-year averages, can only be due to changes in practices at the board level.”

So, is it possible that fewer doctors acted improperly?