By JW August, TIMES OF SAN DIEGO

In our state it’s the job of the Medical Board of California to investigate complaints against doctors. The board is facing a deadline now, mandated by state law, to determine if its work is still needed.

It’s called a “sunset review,” and while there is little opposition to continue the Medical Board, there is a great deal of interest in using this review to reform the board. A number of proposed changes are in Senate Bill 815, which is now headed to the Senate floor for a vote. This session ends on Sept. 14, and it’s anticipated the bill will pass. 

Supporters of the proposed legislation say it would allow the board to continue operating through 2028, while strengthening its ability to discipline physicians statewide. 

For years advocates like San Diegan Marian Hollingsworth have argued the board is ineffective because it is more concerned with protecting “the reputation and financial status of doctors rather than the safety of consumers.”   

Consumer Watchdog in Santa Monica has continually hammered the board on its practices. In a recent letter to the Senate Committee on Business, Professions and Economic Development, the consumer advocacy group said the Medical Board “dismisses most complaints without discipline or explanation, takes years to investigate and when it does act” it’s a slap on the hand, “even when the doctor is a repeat offender.”

The proposed legislation would make a total of 20 changes and give the board four more years before the next review. Critics say the reforms are a good start, but not a a solution to what they see as ineffective disciplining of poor medical practices by physicians.

One of the major changes is the Medical Board’s makeup. Currently the board consists of eight physicians and seven public members. SB 815 would would add two public members to the board, creating a public-member majority. Patient advocates say the rebalancing of the board should lead to immediate changes in the board’s actions.   

In a letter to the Legislature, the board said it “vigorously disagrees with those who assert that the board is not focused on its mission,” but recognizes changing the composition of the board to a public-member majority “would reassure the public that the board has the appropriate priorities.”

In another change, the board’s standards to discipline a doctor would be the same as followed by 41 other state medical boards. And the physicians and surgeons license fee would increase to “adequately fund the board’s operations,” according to Sen. Richard Roth, the Riverside County Democrat who introduced the bill. 

He said the board is essentially insolvent because of low license fees. He said it has been kept in operation by loans from other state agencies, such as the Bureau of Automotive Repair. “Frankly, it’s time we fund this important program,” he said

The current fee is $863 for doctors and surgeons to renew their license for two years. The proposed increase is to $1,350 to prevent insolvency and pay back the money the board borrowed. 

During the last sunset review, the California Medical Association, which lobbies for its 50,000 member doctors, killed an attempt to raise the license fee. This time the association is suggesting the fee increase by $150 per year, to a total $1,013 for a two-year license. As of April 24,the medical association opposed the bill unless changes were made.

The bill also would give more voice to a patient who has filed a complaint, The bill states that before a case is closed, the review of the complaint would require “an interview of the complainant, patient, or patient representative.”  

Consumer Watchdog noted in a letter to the Legislature that “it is inconceivable that the Medical Board would close a complaint involving potentially life-threatening negligence after a medical consultant gets only the doctor’s side of the story.”

The other role of the board is to provide information to the public about state-licensed physicians. And that, says Hollingsworth, will remain a major weakness in the board’s work.

While the bill does establish a “consumer liaison unit” to keep complainants informed on their cases, it still falls short, advocates say.

“The board insists that consumers take responsibility for their own care by checking the board’s website when choosing a doctor,” Hollingsworth said. “However, this same website doesn’t reveal whether a doctor is under investigation or has any previous complaints.”

The board has three years to investigate a doctor before posting an accusation so that means, said Hollingsworth, “by not revealing this information, it deprives consumers of full informed consent when agreeing to treatment.”

Both Consumber Watchdog and Hollingsworth cite an example of an ongoing case in San Diego that involved the death of a patient allegedly at the hands of her doctor. Dr. Carlos Chacón, a Bonita plastic surgeon, was charged last month with second degree murder in the 2018 death of patient Megan Espinoza but is still allowed to practice. 

Other women have been harmed by the doctor, according to criminal charges and civil lawsuits. Those patients were not warned about his history, until he was required to disclose the charge as a condition of bail.

In its letter in supporting the reform, Consumer Watchdog said, the “Medical Board Sunset Review legislation must guarantee patients’ voice in the enforcement process, increase transparency of physicians’ disciplinary histories, and ensure the board holds dangerous doctors accountable.”