CMA Urges Physicians to Oppose Medical Board Fee Bill
[Posted 07/28/05]

The Medical Board of California reauthorization bill (SB 231) will be heard in the Assembly Appropriations Committee August 17. CMA opposes the bill as currently written because it contains language that would sunset the diversion program in 2008, limit physicians’ ability to appeal a medical board disciplinary action, and hand off to the attorney general all cases involving alleged physician misconduct, not just those that warrant further investigation.

CMA urges physicians to contact the author of the bill (Senator Liz Figueroa) and the appropriations committee members and tell them that physicians oppose these onerous provisions.

CMA believes the diversion program, which monitors physicians with chemical dependencies or mental health problems, is worthwhile and essential to public safety. The program offers physicians the opportunity to voluntarily accept practice restrictions and monitoring while they are rehabilitated, instead of hiding the problem and practicing impaired. Although the program’s record keeping has been criticized, CMA believes that any such problems can be solved through better management and staffing. CMA’s House of Delegates in 2005 called the program “vital in the rehabilitation of impaired physicians” (Resolution 618a-05) and directed CMA to ensure the program’s continuation.

The bill would also eliminate the medical board investigation unit, and give the Attorney General the authority to investigate and prosecute cases of alleged physician misconduct. CMA opposes this “vertical prosecution” model, which focuses on developing a case for prosecution, rather than simply searching for the truth. Under the current model, medical board investigators perform preliminary investigations and hand off to the attorney general’s office only those cases that warrant prosecution. The vast majority of medical board investigations do not require the attorney general’s involvement.

“No one has a stronger interest in disciplining low performing doctors than other members of the profession,” says CMA CEO Jack Lewin, M.D. “The vertical model set forth in this bill creates a prosecutorial mentality in which an investigation is considered ‘successful’ only when formal charges are filed. The fact of the matter is that 75 percent of medical board investigations are closed without any disciplinary action at all, and those are successes, too.”

The bill also contains a provision that would prevent most physicians from appealing a disciplinary action in a Sacramento court. Physicians would only be allowed to file an appeal in their local court, where judges can be less well informed about regulatory issues and deference to state agencies is common. “Any case against a state agency must be allowed to be heard in Sacramento—the seat of government,” says Sandra Bressler, vice president of CMA’s Center for Medical and Regulatory Policy. “Unlike some judges in other jurisdictions, Sacramento judges are not afraid to rule against a state agency if such an action is warranted.”

CMA has always supported licensing fee increases when there is a demonstrated need for additional funds. This bill would increase the two-year licensing fee 35 percent, from $600 to $824. CMA has submitted multiple requests for evidence justifying the need for this fee increase and has yet to receive an adequate response. Until such evidence is received, CMA will continue to oppose the fee increase. It is likely that the medical board can justify some fee increase based on increases in fixed costs over which it has no control.

Contact: Dustin Corcoran, 916/444-5532 or dcorcoran@cmanet.org.