Cheryl W. Thompson of The Washington Post studied medical board records from the District of Columbia, Maryland and Virginia, finding that "scores of physicians in the area and across the country have been given repeated chances to practice, despite well-documented drug and alcohol problems." In addition, sanctions in such cases can take months or years and rarely result in a loss of the license to practice. "The District and Maryland boards do not permanently revoke doctors' licenses. In Virginia, where a license can be permanently taken away only with a doctor's agreement, just one was revoked for substance abuse from 1999 to 2004, records show." Maryland and Virginia punish their physicians nearly twice as often as D.C. does.