California Medical Board reforms needed
Monday, March 11, 2013
Consumers Union Urges California to Adopt Medical Board Reforms
to Improve Oversight of Centers and Problem Physicians
State Lawmakers Begin Sunset Review of the Medical Board of California
SACRAMENTO, CA – Consumers Union, the policy and advocacy arm of Consumer Reports, urged state lawmakers today to implement a number of reforms to improve patient safety and physician accountability as part of the legislature’s sunset review of the Medical Board of California.
“The Medical Board is dragging its feet when it comes to implementing recent reforms that aim to strengthen state oversight of outpatient surgery centers and substance abusing physicians who harm patients,” said Lisa McGiffert, director of Consumers Union’s Safe Patient project (www.safepatientproject.org). “State lawmakers should use the sunset review process to ensure the Medical Board is held accountable for enforcing current law and takes further steps to improve patient safety and physician accountability.”
Consumers Union’s Safe Patient Project is a national campaign that has organized patient safety advocates from across California on issues relating to hospital safety, including hospital acquired infections and medical errors, and physician accountability.
As part of the Sunset Review of the Medical Board of California, Consumers Union urged state lawmakers to adopt a number of provisions to strengthen oversight of ambulatory surgery centers and problem physicians, including:
- Public Disclosure of Outpatient Surgery Center Accreditation History: The medical Board should be required to post on its website the history of physician-owned outpatient surgery centers, including any disciplinary actions taken by accreditation agencies or the Medical Board. The Medical Board is already supposed to post some information under a state law (SB 100) enacted in 2011. But a Consumers Union review of the Medical Board website found that only about 21 percent of the outpatient surgery centers that could be identified had even the basic information of the doctor owners’ names and clear evidence that their accreditation was up to date.
- Adverse Event Reporting for Outpatient Surgery Centers: Under the same 2011 law, outpatient centers are required to report medical errors to the state within specific timeframes. If they do not, they are subject to daily fines. This information is also supposed to be available to the public. Since outpatient centers are regulated both by the Medical Board and the Department of Public Health, implementation of this law has been slow and it remains unclear how the reports will be collected, fines assessed and information disclosed. The number and type of these adverse event reports should be disclosed to the public on the Medical Board’s website under the entry for each physician owned outpatient surgery center and any fines against centers that fail to report them should be included.
- Notice of Complaint Procedures at Outpatient Surgery Centers: Outpatient surgery centers should be required to post notices indicating where patients should file a complaint. Currently there is no notification on the premises of surgical centers about where patients can go to learn about the accreditation status or licensing of centers or about where they can go to make complaints.
- Uniform Standards for Substance Abusing Physicians: The Medical Board should be required to adopt the full uniform standards for discipline and oversight of substance-abusing physicians. These standards were spelled out in SB 1441 and have been in place since April 2011, but have not been implemented by the Medical Board. Consumers Union also urged lawmakers not to accept any recommendations that would lead to the creation of another Medical Board diversion program. The Board’s former diversion program failed audits five times and was eventually discontinued. Despite the diversion program’s failed record, there have been a number of legislative attempts to resurrect it.
- Statute of Limitations for Filing Complaints: The current law governing how long a patient has to file a complaint against a doctor is confusing and difficult for the public to interpret. It is tied to the date the Medical Board files an accusation (following its investigation) and patients have no way of knowing how long that will take. Because of this, some serious violations have been dropped without action. Lawmakers should create a statute of limitations that articulates clearly how long a patient has to file a complaint. It should link the deadline for filing a complaint to the date that a violation occurred – separating it from the Medical Board’s investigation and accusation process.
- Improved Disclosure of Malpractice Settlements: The medical Board should be required to include all malpractice settlements over $30,000 in the physician profiles posted on its website. Malpractice settlements resolved after January 1, 2003, currently are posted only after a physician has accumulated three or four settlements over a ten year period.
- Physician Disclosure of Disciplinary Orders to Patients: Physicians who continue to see patients while under a Medical Board disciplinary order (such as probation or restrictions on licenses) should be required to inform their patients of the order. Physicians who are disciplined currently are required to provide a copy of disciplinary decisions to hospital officials where they practice. But there is no current requirement to notify patients.