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California’s Budget Woes Pose A Threat to Public Safety

Published: August 18, 2011

California is delinquent – yet again – on a promise to pay back “borrowed” money, and it may directly effect your health.

A recent report by the nonprofit organization Public Citizen shows that California’s Medical Board failed to enact disciplinary procedures on 710 medical doctors, even if the doctor’s own hospitals and/or medical organizations felt compelled to take actions against him or her. State budget woes (and sleight-of-hand by our governors) are making this situation worse.

Of the unpunished 710 physicians, 35% were repeatedly sued for malpractice. Now, it is important to recognize that being sued does NOT necessarily mean a doctor is bad. Many physicians who are willing to take on the toughest cases may find themselves sued in our litigious society. Tougher cases have bad outcomes more often, and with a bad outcome enters the lawyer from stage left. On the other hand, this stat does invite concern. Commenting on the California Medical Board’s inactivity as compared to other medical organizations Dr. Sidney Wolfe, Director of Public Citizen’s research group told the LA Times’: “Hospitals rarely discipline doctors. When they do, it is usually for very serious infractions”

How serious? The report by Public Citizen laid down many examples. In all cases these physician evaded discipline from the California Medical Board. To cite just three:

A surgeon (disciplined three times in 2007 and 2008) had eight malpractice payments from 1991 to 2008 totaling $2 million, including a misdiagnosis and failure to perform a procedure.

Another doctor (disciplined six times from 2005 to 2009) had privileges suspended for providing substandard care. He was judged “unable to practice safely” and had his privileges suspended in 2009 for posing an “immediate threat to health or safety”.

A third doctor (disciplined in 1991) subsequently had 15 medical malpractice payouts – totaling about $1.9 million – between 1993 and 2009. Two cases involved an object left behind after surgery.

Wolfe noted that in describing a doctor in California, you should not have to use the term “posing an immediate threat to health or safety” adding “The hospitals, HMOs, and peer reviews are all saying that these people are unfit to practice medicine, yet the State of California is doing nothing about it. Why are these physicians allowed to continue holding their licenses without an inquiry?” A partial, though definitely incomplete answer, is a lack of funds.

Jennifer Simones, a spokeswoman for the Medical Board, told the LA Times that state hiring freezes and budget cuts are taking their toll on the ability of the board to operate. Simones noted “we have a 20% vacancy rate and we’re trying to focus on our core functions.” Unaddressed by that response is what the Board imagines constitutes their core functions. Reigning in dubious docs seems high on the list to this correspondent.

Simones also pointed out that in 2008 Governor Schwarzenegger “borrowed” $6 million from the Medical Board’s $55 million dollar budget to spend elsewhere in the bureaucracy. That money was not repaid, as promised. Worse, Governor Brown is considering another episode of “borrowing”. Because the Board operates on fees paid by practitioners, its financial status is more secure than other state agencies.

Dr. Wolfe sent Governor Jerry Brown a letter encouraging him to investigate Pubic Citizen’s report, and fill the California Medical Board’s staffing vacancies. The Governor’s office said he will review the report, but as the LA Times previously reported Governor Jerry Brown plans on “borrowing” $9 million more from the Board.

Far and away my favorite part of this article was the comment from Brown spokeswoman Elizabeth Ashford about this potential move. She said, “It won’t contribute to the backlog because, in the event we did see an effect, we’d repay it.” This is great, if unintended comedy; better than “I haven’t done anything wrong and promise never to do it again”.

Ashford’s claim that what Brown is going to do will produce no harm because if it does (and pause a moment to enjoy that phrasing) Brown will then pay back amount that caused the harm. Never mind the fact that before the money is even removed there are 710 unresolved cases about physicians potentially posing a threat to public safety.

For its part the Board says it will tackle these matters when it has more resources to devote to them. Speaking as someone who has tried repeatedly (and failed repeatedly) to move the Board to act against a physician who is apparently mentally ill (and believe me, a potential threat to the public) I am not holding my breath.

Despite the Medical Board’s evident lack of zeal in acting in a timely and forceful manner, robbing Peter to pay Paul in our budgetary crisis is wrong. California’s physicians pay hefty fees to insure that proper supervision is made of practitioners in the state. Our governors can’t resist stealing that money (that’s what it’s called when you “borrow” money you have no intention of repaying, right?), and it only means that the Board will do a worse job than it is doing already.

Let us hope that you, dear reader, do not have an unhappy outcome with your physician on account of this financial debauchery.