Legislators seek medical board reform

This article from the Los Angeles Times dated 4/26/2013 discusses the issue of the inability of the California Medical Board to investigate doctors whose actions are questionable and discipline those doctors who harm patients.

The State of California may turn over the process to the State Attorney General. The California Medical Board’s function would mainly deal with licensing doctors.

Legislators seek medical board reform

Bill would shift job of investigating doctors to the attorney general’s office.

BY SCOTT GLOVER AND LISA GIRION

The Medical Board of California would be stripped of its power to investigate physician misconduct under a sweeping reform plan by legislators who say the agency has struggled to hold problem doctors accountable.

The medical board has come under fire for failing to discipline doctors accused of harming patients, particularly those suspected of recklessly prescribing drugs.

Under the proposed legislation, amended Thursday, investigations of doctors would be handled by the California attorney general, leaving the board to deal mostly with licensing doctors.

“I’ve heard repeated stories of difficulty in sanctioning physicians. It’s cumbersome and takes a long period of time,” said Sen. Curren Price (D-Los Angeles), who co-wrote the proposal with Assemblyman Richard Gordon (D-Menlo Park). “I don’t want anybody else to die.”

The proposed changes come a month after Price and Gordon wrote a letter to the board president threatening to “dissolve” the board unless it made significant progress in overseeing the state’s more than 100,000 doctors.

The letter cited a Los Angeles Times investigative report that detailed cases in which doctors continued to practice despite having prescribed drugs to multiple patients who fatally overdosed. In some instances, the deaths occurred as the doctor was under investigation by the board and the inquiry dragged on for months or years.

Medical board President Sharon Levine, who was participating in a board hearing in Los Angeles, said she had been anticipating the move, but could not comment before the full board discussed the matter Friday.

Lynda Gledhill, a spokeswoman for Atty. Gen. Kamala Harris, said the attorney general was still evaluating the proposal.

The idea of placing investigators in the attorney general’s office is not a new one.

A similar plan was proposed in 2004 by a public interest lawyer who was appointed by the Legislature to examine the medical board’s oversight of physicians.

The lawyer, Julianne D’Angelo Fellmeth, wrote a report recommending that investigators be transferred to the attorney general’s office, where they would work more closely with deputy attorney generals who prosecute cases of physician misconduct. The proposed move was intended to foster cooperation and streamline the process.

The plan was supported by then-Attorney Gen. Bill Lockyer, the medical board, the California Medical Assn. and other key players. Ultimately, however, there was political opposition to the idea and it was dropped from proposed legislation, Fellmeth said.

Gordon said he hoped this time would be different. He said shifting investigative responsibilities away from the medical board would not only improve investigations, it would enhance public confidence in the oversight process.

If the investigators answered to another agency, he said, “it would provide far greater assurance to the public that the medical profession is being regulated in California.”

“The way it is now, you could almost look at it and ask: Is this a situation of the fox guarding the henhouse,” Gordon said. “Some say they’re too cozy.”

Price and Gordon’s desire to reform the medical board seemed to grow more urgent after a public hearing in March that was part of a review process to renew the medical board’s legislative authority.

Much of the hearing focused on issues raised in a series of Times articles that found that drugs prescribed by doctors played a role in nearly half of the prescription drug overdose deaths in Southern California from 2006 through 2011. The Times reported that 71 physicians prescribed drugs to three or more patients who later fatally overdosed and several had a dozen or more patients who died. In most cases, the board was unaware of the patients’ deaths.

At the hearing, lawmakers heard emotional testimony from parents who criticized the medical board for doing little or nothing to stop doctors from harming patients with their prescription pads.

After the hearing, Price and Gordon wrote the letter to Levine urging the board to “be more responsive” and “show significant progress.” The lawmakers were critical of the board’s hiring record, pace of investigations and failure to more often seek immediate suspensions of doctors in the most egregious cases.

Levine said Thursday that the board “took very seriously” the lawmakers’ letter and had responded point by point. She said board officials planned to meet with them May 7 to discuss matters further.

Earlier this month, a broad package of bills aimed at reducing prescription drug abuse and overdose deaths won approval from a key state Senate committee. The package included a bill that would require coroners to report prescription-involved deaths to the Medical Board of California and one that would upgrade the state’s prescription drug monitoring program, known as CURES, to help officials improve tracking of overprescribing doctors and drug abusing patients. scott.glover@latimes.com   lisa.girion@latimes.com

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