Medical boards and PHPs violate ADA protections because they can get away with it and it benefits the system to discipline physicians at the highest rate feasible. IMO licensing boards should require licensees to possess the minimal qualifications to practice not the "almost perfect" standards that they enforce through coercion. If a physician has the necessary medical training and certification, no criminal record, no formal complaints and no reports to the National Providers Data Bank, the default should be the issuing or reissuing of a medical license. If there are health issues or adverse actions against the physician, the board should be required to demonstrate clearly in what way those issues or actions impair his ability to practice with reasonable skill and safety. In other words, the granting of a license for any profession to an otherwise qualified applicant should be the default which would make ADA violations a rarity. I know this sounds aspirational but what's the North Star for, anyway?