CMA Testifies on Medical Board Audit at Sacramento Hearing
[Posted 01/27/05]

CMA President Robert Hertzka, M.D., testified Tuesday at a joint legislative hearing on the recent audit of the Medical Board of California’s enforcement program. The 300-page audit, released in November, makes sweeping recommendations for changing the board’s procedures and operations. It was written by Julie D’Angelo Fellmeth from the Center for Public Interest Law and calls for funding the recommendations through a $200 increase in physician license fees. The legislature ordered the audit two years ago.

Numerous news reports have sensationalized the audit’s findings, and Fellmeth and others have been quoted accusing CMA of impeding the medical board’s efforts to discipline dangerous physicians by refusing to support fee increases.

At Tuesday’s hearing, Dr. Hertzka sharply disputed that view, emphasizing CMA’s historic support for a strong and effective medical board. Dr. Hertzka testified that CMA has always supported licensing fee increases when there is a demonstrated need for additional funds and assured the committee that the current proposal is no exception.

Dr. Hertzka backed some of the report’s findings, including a call for improved expert review in cases alleging substandard care. He also agreed that the medical board could benefit from upgrading its electronic information systems, updating its internal policy and procedure guidelines, and increasing efforts to educate other organizations (courts, malpractice carriers, coroners, and hospitals) about mandated reporting requirements.

The report condemned the medical board for delays at almost every level of case processing and suggested that the recent mandate requiring specialty (rather than generalist) expert review at the outset of investigation sometimes causes delays when a specialist is not readily available. Dr. Hertzka, however, called early specialty physician input essential because it helps investigators identify at the beginning of the process which cases should be pursued or dropped.

Dr. Hertzka explained that physicians more than anyone are angered and impacted when it takes the medical board 2.5 years to clear the average case. These delays leave many innocent, competent doctors with unwarranted complaints hanging over their lives and their practices. Dr. Hertzka encouraged the board to expedite the investigation process, including making better use of its power to fine physicians $1,000/day when they fail to promptly turn over medical records to investigators.

The report sharply criticized the board’s Diversion Program, which monitors physicians with chemical dependencies or mental health problems. The audit found serious record-keeping failures that made it difficult to determine how closely participants are monitored. The report recommended the program be overhauled or eliminated. Dr. Hertzka, however, gave strong backing to the program, suggesting that better management and staffing could resolve its problems. The diversion program—which offers physicians the opportunity to voluntarily accept practice restrictions and monitoring while they are rehabilitated instead of hiding the problem and practicing impaired—is a worthwhile program that prevents patient harm, Dr. Hertzka testified.

Click here for a copy of CMA’s written testimony.

Contact: Sandra Bressler, 415/882-5171 or sbressler@cmanet.org.