At its Quarterly Board meeting last week, multiple members of the state board that regulates doctors for the first time seriously acknowledged activists’ call for the state to respond to complaints of physician negligence by requiring patient interviews and mandating investigations of patient deaths. The Medical Board of California directed staff to investigate potential changes to the law and placed the issue on the agenda for its next meeting.
The action tracked reforms Consumer Watchdog and the volunteer team of advocates we work with have championed as key components of a Medical Board Patient Bill of Rights:
Consumer right to input at each stage of the enforcement process
- Interview a complainant before their quality of care complaint is dismissed.
Adequate discipline for serious offenses
- Full investigation of serious injury and death complaints (standing policy for other medical licensing Boards).
Brand new and seasoned advocates who have all experienced harm and loss in the health care system again came together and joined us to testify at the medical board meeting in support of those priorities.
Advocates also called on the Board to ensure patients know their doctors’ history by disclosing if a doctor is facing criminal charges when they make an appointment, and posting when a doctor has lost hospital privileges prominently on the physician profile on the medical board’s website.
Others asked the board to hold an in-person meeting to hear from families in the epicenter of California’s maternal mortality crisis, the Central Valley. Each spoke to how these improvements in transparency, accountability and patient participation in the board’s enforcement process would help protect future patients from the tragedies their families have suffered.
President Lawson noted that the law the Board follows when handling complaints is lopsided in favor of physicians:
“It mandates that relevant patient records be reviewed, it mandates that the statement or explanation of the care and treatment provided by the physician and surgeon be reviewed, it mandates that any additional expert testimony or literature provided by the physician and surgeon be reviewed, and then any additional facts that the medical expert thinks will be helpful. Under any additional facts …a patient interview could be authorized. The balance is already in favor of a physician both being interviewed, providing an explanation, and then also providing expert testimony, literature etc. without the patient involvement there.”
Dr. Hawkins said the Board should “dig deeper, to see if we can get closer to what we are being asked to do by the public.”
A patient interview should be included in the initial review process.
Why is this important? Well, currently, when you file a death or serious bodily injury complaint with the Medical Board of California your complaint is reviewed first by a Central Complaint unit analyst. You may be asked to sign an authorization form to release your or your family member’s medical records, but that is the end of your input into your complaint review process. At that time, your physician is notified that you have filed a complaint. While you have no other input, your physician does. Business & Professions code 2220.08 gives your physician rights that go far beyond the physician interview, as President Lawson stated. After this review, and armed with all of this information your physician provides, the medical consultant makes the decision as to whether your death or serious bodily injury complaint should be investigated — again, without any input from you. The typical outcome: 90 percent of complaints are closed at the Central Complaint Unit with no interview and no opportunity to provide additional information. I know this from personal experience. Like the majority of the families I work with, my death complaint was closed at the Central Complaint Unit and I was never interviewed. This motivated me to become a state and national advocate and work on legislative and policy changes to help other families. Now, I have the honor of leading a volunteer team of courageous advocates who want the same thing: to save other families from tragedies like ours.
Responding to public questions about why the Board does not investigate all death and serious injury complaints, as the Osteopathic Medical Board, Board of Registered Nursing and other health care boards are required to do, Doctor Tsai and Doctor Bholat urged discussion of the issue whether the Board should meet the same guidelines. Board President Lawson acknowledged that a change in the law (again B&P Sec. 2220.08) to bring Medical Board investigations on par with other health care boards could be necessary.
With the legislative sunset oversight review of the medical board coming this spring, the board will have one of their first interim meetings focused on legislation in March. With several physician board members in agreement, President Lawson placed this issue on the meeting agenda to further discuss what a potential legislative change request should look like.
Consumer Watchdog and its growing volunteer team of advocates will be present at the March meeting, focused on urging the Board to support the reforms in the Patient Bill of Rights during the Legislature’s review. We continue to bring these issues directly to lawmakers as well.