Los Angeles, CA – Initial findings of the Medical Board Enforcement Monitor, released this week, confirm that the Medical Board’s investigations of doctors are hamstrung by funding shortfalls and that prosecutions are undermined by a crippling division between investigators and attorneys housed in different agencies. Lawmakers meet in Sacramento today for an oversight hearing to discuss the Medical Board’s performance.
“The report confirms what injured patients have been shouting from the rooftops: The Medical Board is failing to protect the public from doctors who cause harm,” said Carmen Balber, executive director of Consumer Watchdog. “Divorcing the investigators who obtain evidence from the attorneys who use it means meritorious cases, with real public safety implications, are not moving forward.”
Consumer Watchdog called on lawmakers today to move complaint investigators and prosecutors under the same roof, and to increase Board funding to reduce investigator workloads and retain staff. The group also called for reforms to ensure patients have a voice in the enforcement process, improve transparency of doctors’ histories and strengthen accountability for serious harm.
The Enforcement Monitor Initial Report finds:
- “Inadequate investigator workforce staffing, resulting in case delays, disruptions, and inconsistent investigations”
- “Lack of structured collaboration between HQIU and HQE during investigation and administrative action phases …The elimination of a formal collaboration process has decreased investigator and prosecutor productivity and efficiency.”
*HQIU houses Board investigators in the Department of Consumer Affairs; HQE houses Board prosecutors in the Attorney General’s Office
Data presented in the Monitor’s initial report show that the end of collaboration between investigators and prosecutors, known as vertical enforcement or “VE,” in 2018 precipitated an increase in case delays and in the number of cases rejected. According to the report, some of this increase in case rejections can be attributed to investigations being forwarded to the Attorney General’s office without needed evidence, and without enough time for additional investigation. Cases must be filed before a statute of limitations expires.
Between 2017/18 when VE existed and 2021/22 when it was over, the number of cases rejected by the Attorney General’s Office (HQE) increased 1300%: from 1.4% to 19.4%. The return of cases by HQE for additional investigation went up 450%: from 3.7% to 15.6%.
Vertical enforcement was implemented most recently after the last Medical Board Enforcement Monitor’s recommendations were published in 2004-05.
Consumer Watchdog and patient advocates will call on lawmakers to enact additional reforms at today’s oversight hearing, including a change in the law to mandate the Board interview patients before their complaint is closed. Last year, the Board closed 83% (8254) of pending cases at its triage unit without investigation or an interview of the complainant. Most complaints are submitted by members of the public.
The stories of patients seeking greater transparency and accountability at the Board, after it failed to hold doctors accountable for harm to themselves and their loved ones, can be found here: https://consumerwatchdog.org/meet-the-advocates/
“Most public complaints to the Board about serious injury or deaths are closed without a single conversation with the patient or family member who submitted the complaint. That means the person who may know most about the care they received is shut out of the investigation completely. Patients must have the right to an interview before a case is closed,” said Balber.
More information on the Joint Sunset Review Hearing of the Senate Business, Professions & Economic Development and Assembly Business & Professions Committees, beginning at 1:30PM on Thursday March 16th, is here: https://sbp.senate.ca.gov/sunsetreviewhearings
The Enforcement Monitor report was mandated as part of the last Sunset Review legislation in 2021. The Monitor’s final report is due July 5th.