Fiscal crisis affects California medical board actions

Public Citizen recently sent a letter to California Governor Jerry Brown, asking him to do something about the state medical board’s failure to stop potentially dangerous doctors from practicing.

Based on a report done earlier this year, the advocacy group claimed the Medical Board of California has not taken action against 710 physicians who had been disciplined for wrongdoing by healthcare institutions and organizations. More than 100 of the doctors were described by peer reviewers as an “immediate threat to health or safety of patients,” and more than a third were repeat offenders, according to the report.

Public Citizen’s letter and report got wide coverage in the news media, but most accounts failed to point out that the medical board may not have been the villain in this situation but a victim itself of California’s fiscal crisis.

A letter written to Public Citizen by the board’s legal counsel noted that the medical board was facing “fiscal uncertainty” and hiring restrictions, even with a 20% personnel vacancy rate.

Funding has gone the wrong way, with the California Medical Association recently asking the state Supreme Court to rule on the state government's authority to borrow $6 million from a special fund used to finance the operations of the Medical Board of California.

The board also hasn’t tried to hide the problem, commissioning an internal review last year that showed that the number of disciplinary complaints referred for investigation or prosecution declined from 1,443 in 2004 to 2005 to 1,123 in 2008 to 2009. The review also found that an investigation of a complaint about a doctor takes 400 days and then another year to bring the case to conclusion.

The information sent to Brown was based on Public Citizen’s analysis of the National Practitioner Data Bank, which tracks state disciplinary actions, medical malpractice payments, and clinical privilege actions taken against physicians.

While California’s rank in serious disciplinary action rates against doctors has been dropping for years-from 35 to 41 just from 2010 to 2011-other states are considered just as bad, if not worse, by Public Citizen.

The bottom 10 states with the lowest serious disciplinary action rates for 2007 to 2009 were Minnesota, South Carolina, Wisconsin, New Hampshire, Connecticut, Massachusetts, Mississippi, Florida, Maryland, and Vermont, according to the report.

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