For some time now, physicians in California have been hearing rumors that the California Medical Board is getting tougher on its licensees, and that more physicians have been under state investigation for wrongdoing than ever before. This has not always been the case.
The California Medical Board has previously come under scrutiny for reportedly lax enforcement as previously reported in news articles from Orange County and through statements made by state legislators. According to the Orange County Register:
“In the past 10 years, the California Medical Board has reinstated the licenses of doctors who were convicted of sexually assaulting patients, defrauding insurance companies of millions and hiring hit men to kill their wives. Although some doctors spent as much time in prison as they did in medical school, they were most often able to show rehabilitation and given a second chance to treat patients.”
The Orange County Register examined records of 123 doctors who sought reinstatement in the past decade after they had their California medical license revoked misconduct or negligence. More than half were able to satisfy a judge and the medical board that they were fit to practice. Among the 66 who were reinstated, 16 got into trouble again.
“The Medical Board of California seldom disciplines physicians or revokes their medical licenses, and its enforcement time often exceeds state standards. . .”, theAP/Ventura County Star reports.
Out of the 6,539 complaints that the board received in fiscal year 2009, regulators issued 276 formal charges against physicians, according to the board's latest annual report. Less than 2 percent of the complaints led to the loss of medical licenses, the report found. According to the consumer advocacy group Public Citizen, the state ranks 43rd among states in taking serious disciplinary action against doctors such as California medical license suspensions .
Studies of the Medical Board’s disciplinary procedures were initiated in the Legislature and reported by Senator Liz Figueroa who then authored legislation, SB 231, which is intended to enhance enforcement.
"There are some things that people have done, and I don't care how remorseful you are, you shouldn't get your license back," said Julie D'Angelo Fellmeth, a San Diego attorney, in a previous article. She was hired by the state in 2003 to report on the board's enforcement practices.
Some in the medical community have wondered whether this sort of political heat would in turn result in increased scrutiny of physicians’ practices.
Knowledgeable sources say that the Medical Board caseload in the in the Medical Board’s Sacramento district office alone has nearly doubled over the past year, from 80 referrals for prosecution to over 150. The Sacramento office handles a geographic area from Bakersfield to Redding (the Central Valley).
Most of the increase in investigative workload has been in increased numbers of DUI’s, Substance Abuse and Sexual Misconduct allegations against physicians.
But why the increase? What is driving the uptick in prosecutorial numbers for the Medical Board? Are doctors committing more violations or is the Board simply investigating more cases than before?
The answer is unclear. It could be due to greater diligence in reporting by hospitals with respect to Peer Review actions as required by Business and Professions Code section 805. Or, there may be an increase in reported judgments or settlements of medical negligence insurance matters under section 801 (which would probably indicate greater litigiousness by patients seeking monetary compensation from doctors). Or, it could be the result of an increase in patient complaints directly to the Medical Board, a factor that can be influenced by the Board’s efforts to publicize its regulatory role and the access of patients to the Board’s complaint process.
Patient complaints can be filed with the Board anonymously or with the patient named, and each case receives review by Board headquarters staff for possible referral to investigation. When the latter occurs, a medical consultant physician reviews the matter for possible referral to a field office where Medical Board investigators take over the matter under direction from the Attorney General’s Office.
Whatever the reason for the increase in Medical Board enforcement cases, physicians should be particularly aware that DUI’s, Substance Abuse, and Sexual Misconduct will likely result in a Board investigation and possible Accusation. The Board has also been known to subpoena blood samples from DUI screens at the local level and conduct more thorough toxicology screens than are conducted by local law enforcement, resulting in substance abuse charges against a physician that might have otherwise slipped through a simple DUI matter.
All of this should be a word of caution to physicians to avoid putting themselves at risk of disciplinary action, which can have dire professional consequences such as a California medical license suspensions or revocation.
CALIFORNIA MEDICAL BOARD DISCIPLINARY CASES ON THE RISE