Editorial: Put Non-Physicians In Charge Of The State Medical Board

Published on

Editorial by LOS ANGELES TIMES EDITORIAL BOARD

July 6, 2021

https://www.latimes.com/opinion/story/2021-07-06/california-medical-board-reform

It’s become a common scene at the quarterly meetings of the California Medical Board, the 15-member state panel that oversees physicians and other healthcare professionals: Witnesses tell heartrending stories about loved ones maimed or killed by a routine medical procedure, then blast the board for imposing little or no penalty on the doctor responsible. Even the board admits that the public has lost a lot of faith in its ability to protect consumers from bad doctors.

That’s why the board has joined a number of experts and advocates in urging the state Legislature to adopt several meaningful reforms, including one that’s rich in symbolism: Giving control of the board to people who aren’t doctors. Meanwhile, the board has burned through its budget and is in serious need of a cash infusion to keep investigating complaints and licensing doctors.

As it happens, the board’s statutory authority is up for its periodic renewal this year. So you might think that lawmakers would use the opportunity to make some badly needed changes in the board and try to restore the public’s confidence in its work.

But instead of taking a big swing at the problems, the state Senate bunted in late May, proposing no change in the board’s makeup, suggesting a small increase in funding and offering little in the way of concrete action to improve enforcement efforts. A Senate committee had proposed to go further, only to run into a buzzsaw of opposition from one of the state’s most influential lobbying forces, the California Medical Assn.

Specifically, the committee’s version of the bill (Senate Bill 806) endorsed the idea of adding two members from the general public to the board, giving non-physicians a slim majority of 9 to 8, and raising the biennial license renewal fee to $1,150 — a 46% hike. But before the Senate voted, the bill’s author, Sen. Richard Roth (D-Riverside), dropped the proposed change in the board’s makeup and cut the fee to $863 — a 9% bump. 

Granted, changing the board’s balance of power and boosting its budget won’t necessarily lead to more effective enforcement and fewer instances of bad doctors continuing to practice. They’re just two parts of a larger package of needed changes, many of which the board itself has identified and more of which need to be embraced by the Legislature. But they’re necessary parts.

One benefit of having a majority of non-physicians on the board is that it could give the public more confidence that the board is focused on protecting healthcare consumers, not healthcare providers. That’s what the law requires, but the public has to take it on faith that the board is complying because it does so much of its enforcement work in secret. 

Complaints about doctors are confidential, and unless some formal disciplinary action is taken — which happens in only about 3% of the cases — there is no disclosure to the public. And even when doctors are put on probation, reprimanded or hit with some other sanction, they don’t have to reveal much to the people they treat; they only have to disclose to new patients if they are currently on probation, and only if that penalty was imposed after January 2019. Otherwise, it’s up to patients to check the state’s database or ask the board for information about a doctor’s record. 

No matter who holds a majority on the board, it will still rely on medical experts to investigate complaints and on the state Attorney General’s Office to provide the legal guidance and muscle needed to impose sanctions. But it’s up to the board members to decide whether to accept the recommendations from their investigators and the AG. Astoundingly, the board doesn’t regularly track how often it accepts, modifies or rejects those recommendations, or how often the settlements reached with physicians adhere to its own guidelines. It did gather those data for fiscal year 2019-20, though, and found that the board approved 99% of the proposed settlements without changes, even though less than half of those settlements comported with all elements of the board’s guidelines. 

The numbers buttress the argument by patient advocates that the board and its experts are too lenient on doctors who give substandard care. Public board member Eserick “T.J.” Watkins, a life and fitness coach and former member of the state’s Physical Therapy Board, told a Senate committee that by his own estimation, the board deviated from its guidelines 90% of the time. According to Watkins, the board goes out of its way to protect physicians, not the public.

Bridget Fogarty Gramme, director of the Center for Public Interest Law at the University of San Diego School of Law, offered another compelling reason to give public members a majority on the board: to avoid the risk of antitrust lawsuits. The Supreme Court held six years ago that licensing boards run by people who work in the industry they regulate can be sued for antitrust violations if they’re not subject to “active supervision” by state officials. That’s arguably the case here, where the doctors on the medical board decide who can and cannot practice in California.

The center also has called for the state to appoint a temporary enforcement monitor to audit the board’s enforcement process, as the state did almost two decades ago. SB 806 declares the Legislature’s intent to appoint a temporary monitor, but it wouldn’t actually make it happen, and that’s a problem. 

A monitor could explore whether too many complaints are being dismissed without investigation (as more than 80% have been in recent years), why so many settlements aren’t hewing to the board’s guidelines, how the process could be made more transparent, and whether the board was gathering and analyzing data effectively.

One clear limit on the board’s ability to investigate complaints quickly and thoroughly is its shortage of funds. The board’s budget comes from licensing fees paid by doctors, which haven’t increased in 15 years; meanwhile, its costs have grown faster than its revenues, putting it on the path to insolvency. That’s why it sought a significant fee hike.

The medical association argued against the increase, contending that the board’s financial problems were caused by its own methods and inefficiencies. A 2020 consultants report to the board found, however, that most of those costs are outside the board’s control and that a fee increase of almost 50% was needed to get the board back to the level of funding and reserves required by law.

It’s easy to understand why the association would resist the higher fees, given the many costs their members have to bear. But they have a vested interest in a medical board that weeds out bad practices and bad doctors who damage their profession’s reputation. Consumers, too, need to tell legislators that they want a medical board they can trust. The current version of SB 806 falls short of that goal.


The Los Angeles Times’ editorial board determines the editorial positions of the organization. The editorial board opines on the important issues of the day – exhorting, explaining, deploring, mourning, applauding or championing, as the case may be. The board, which operates separately from the newsroom, proceeds on the presumption that serious, non-partisan, intellectually honest engagement with the world is a requirement of good citizenship. You can read more about the board’s mission and its members at the About The Times Editorial Board page.

Consumer Watchdog
Consumer Watchdoghttps://consumerwatchdog.org
Providing an effective voice for American consumers in an era when special interests dominate public discourse, government and politics. Non-partisan.

Latest Healthcare Videos

Video thumbnail
KFMB-SD (CBS) - San Diego, CA: Dental Visit Leads To Hospital Stay
02:51
Video thumbnail
KGET - Bakersfield, CA: California Medical Board Meets in Bakersfield to Address Maternal Mortality
02:52
Video thumbnail
KBAK (FOX58) - Bakersfield, CA: High Maternal Mortality Rate
02:59
Video thumbnail
KERO-BFL (23ABC) – Bakersfield, CA: Maternal Mortality Addressed By Medical Board
03:12
Video thumbnail
KERO-BFL (23ABC) – Bakersfield, CA: Pregnancy Care Mistreatment
02:22
Video thumbnail
CNBC - Last Call: Home Insurance Crisis
06:45
Video thumbnail
KOVR-SAC (CBS) - Sacramento, CA: Physician Under Fire For Sexual Battery
02:12
Video thumbnail
KERO-BFL (ABC) - Bakersfield, CA: Crystal Guijarro Rodriguez on the Negligence of Doctors
06:09
Video thumbnail
KERO-BFL (ABC) - Bakersfield, CA: "DO NO HARM: Loss and Liability in the Medical Field"
44:03
Video thumbnail
KFMB-SD (CBS) - San Diego, CA: Hundreds Wrongly Told They May Have Cancer
03:20
Video thumbnail
KERO-BFL (ABC) - Bakersfield, CA: Larcenia Taylor on the Loss of Her Husband James Taylor
05:13
Video thumbnail
KERO-BFL (ABC) - Bakersfield, CA: Monica De La Rosa Speaks About the Loss of her Daughter Sabrina
04:35
Video thumbnail
KERO-BFL (ABC) - Bakersfield, CA: Tracy Dominguez Speaks About The Loss of Her Daughter and Grandson
07:22
Video thumbnail
KERO-BFL (ABC) - Bakersfield, CA: Michele Ramos Speaks About Loss and Liability in the Medical Field
07:58
Video thumbnail
KGET - Consumer Watchdog Advocates Note The Importance of Making Change Within The Healthcare System
02:26
Video thumbnail
ABC - Bakersfield, CA; Consumer Watchdog Shows Support in Honor of the Latina Maternal Health Fair
02:53
Video thumbnail
KABC- Los Angeles, CA; Pathways Medical in Toluca Lake Owner Falsely Claims to be A Licensed Doctor
02:22
Video thumbnail
Spectrum News; CW Argues Senate Bill 815's Proposed Changes Aren't Enough To Protect Patients
02:39
Video thumbnail
WABI (CBS) - Bangor, ME; Consumer Watchdog's Jerry Flanagan Speaks Upon Medical Debt Reform
01:27
Video thumbnail
KBAK-TV; Bakersfield Report on EuroPhoria
03:00
Video thumbnail
KGO - San Francisco, CA; The Shortest, Most Expensive Ambulance Ride
05:20
Video thumbnail
23 (ABC); Tracy Dominguez and Selena Alvarez Seek Justice At The Osteopathic Medical Board Meeting
02:44
Video thumbnail
CBS 8: Chula Vista Plastic Surgeon Charged With Manslaughter Still In Practice
03:14
Video thumbnail
KTLA - Los Angeles, CA; Consumer Watchdog Group Members Calling For A Patient Bill of Rights
02:31
Video thumbnail
KNBC - Los Angeles, CA; Medical Board Member TJ Watkins Calls On Californians To Help
04:17
Video thumbnail
KGET NBC TV-17 Bakersfield, CA: Gov Newsom Signs Bill To Increase Med Mal Damages Cap
00:53
Video thumbnail
KGET NBC TV-17 Bakersfield, CA: Local Family Supports Passage of AB 35 To Raise Med Mal Cap in CA
01:13
Video thumbnail
KNSD NBC TV-7 San Diego, CA: CA Bill Seeks to Raise Medical Malpractice Damages Cap
03:35
Video thumbnail
KOVR CBS TV-13 Sacramento, CA: How Will State Raising Medical Malpractice Cap Affect Patients?
03:37
Video thumbnail
KERO ABC TV-23 Bakersfield, CA: Families of Malpractice Victims Push for Doctor Accountability
01:18
Video thumbnail
KABC TV-7 Los Angeles, CA: Victims of Medical Malpractice Demand Changes at California Medical Board
02:10
Video thumbnail
KCBS TV-2 Los Angeles, CA: COVD Testing Lab Defrauding Consumers in California
05:15
Video thumbnail
KCAL TV 9, CBS, Los Angeles: GOP healthcare plan may bring back the days of junk insurance
01:55
Video thumbnail
KCAL TV-9 Los Angeles, CA: What Consumers Should Know About Potential Obamacare Changes
02:18
Video thumbnail
Bernie Sanders speaks for Prop 61!
16:05
Video thumbnail
Exposed: Trump's Health Plan
02:02
Video thumbnail
AHF's Michael Weinstein speaks for Prop 61
04:12
Video thumbnail
CURES: How Far We Have Come
01:02
Video thumbnail
Who Does Your Doctor Care About Protecting?
01:42
Video thumbnail
Bernie Sanders at Prop 61 rally
11:30
Video thumbnail
"Your Money or Your Life" (Trailer #1)
00:43
Video thumbnail
"Your Money or Your Life" (Trailer #2)
00:43
Video thumbnail
KGET NBC TV-17 Bakersfield, CA: Push To Reform CA State Medical Board Advances
01:51
Video thumbnail
KGET NBC TV-17 Bakersfield, CA: Two Years Since Childbirth Tragedy By Alleged Medical Negligence
00:53
Video thumbnail
KGET NBC TV-17 Bakersfield, CA: Dominguez Family Testifies At Med Board Hearing To Get Justice
03:04

Latest Healthcare Releases

Healthcare In The News

Latest Healthcare Report

Support Consumer Watchdog

Subscribe to our newsletter

To be updated with all the latest news, press releases and special reports.

More Healthcare Releases