Op-Ed Commentary: Do No Harm: Kill The Medical Board

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A former meth user who was convicted on federal criminal charges for drug dealing will be treating California patients again within a year under an agreement recently announced by the California Medical Board. Pilots, lawyers or professional athletes would have lost their jobs for life. California's physician-controlled medical board, however, has become a political protection racket for the state's worst physicians.

With sunset review hearings beginning Monday, three decades of failures by the medical board are too vivid for the governor and Legislature to ignore. It's time to let the sun set on the board and start over with new medicine for doctor discipline in California.

At Monday's hearing, parents of children who died from prescription overdoses because the medical board dithered in investigating drug-dealing physicians will testify about how the board failed their families. The federal Drug Enforcement Administration and local police had to arrest doctors before the medical board acted on repeated complaints.

Consider the case of Dr. Carlos Estiandan, as uncovered in the Los Angeles Times' investigation. Estiandan was a reckless prescriber, who made $1 million per year writing prescriptions and whose prescriptions caused or contributed to the overdose deaths of eight patients. Those eight patients died while the medical board investigated his case, despite clear evidence of his drug dealing.

For decades, the medical board has failed to identify dangerous practice patterns, such as over-prescribing, which should trigger investigation. In fact, the board only acts on complaints by consumers, and then rarely. Once an investigation is begun, it takes years to resolve, too long for patients who may be at imminent risk of harm.

When prosecuted, an enforcement case can stagnate in five layers of review. Sadly, little other deterrence exists to medical negligence.

In 1975 the medical lobby promised the Legislature that, in return for severe restrictions on patients' legal rights to hold dangerous doctors accountable, a strong regulatory system under the medical board would protect patients from harm. But at every sunset marker, the medical board has proven to be little more than a tool of the physician majority that controls it.

A 2011 analysis of the National Practitioner Data Bank by the nonprofit Public Citizen found that 710 California physicians had their privileges restricted in hospital or other settings. The medical board had taken not a single disciplinary action against them.

It's time to pull the plug.

The medical board recently rejected a proposal to raise physician license fees modestly to identify physicians who are reckless prescribers of narcotics. That position parrots the line of the entity that controls the board: the California Medical Association.

The powerful doctors lobby was willing to spend $40 extra per year in licensing fees last year to create a private "diversion program" for drug-using doctors that never passed the Legislature, but this year it refuses to pay $9 to data-mine overprescribing data to detect drug-abusing doctors and patients.

A true overhaul of physician discipline would move complaint investigators into the attorney general's office to work hand in hand with prosecutors and would create a public-member majority on the medical board.

Real reform should also include mandatory random drug testing of high-risk surgeons and physicians – as is mandated now for bus drivers, college athletes and pilots. Finally, the state's 38-year-old limits on the rights of injured patients need to be revisited, too. It's time for the public to take the power back for itself.


Jamie Court and Carmen Balber are president and executive director of Consumer Watchdog.

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