There aren't too many great days for patient safety in state capitols, where the medical establishment tends to rule the roost through the power of its political giving and tentacles. But Monday was a great day for patient safety in Sacramento, when powerful testimony reminded legislators of the human cost of inaction.
The families of victims of overprescribing spent an hour and half in the Senate and Assembly Business and Professions Committees and presented some of the most compelling testimony ever heard there. Their stories and faces were felt around the Capitol Tuesday from huge photographs on the front pages of the Sacramento Bee and Los Angeles Times to TV news stories echoing legislative sympathy for reform.
The medical establishment is now on the defensive. A Medical Board overhaul is in the air. Debate is turning to the government not protecting patients enough.
Will the clarity these courageous families brought to the failure of California's laws to protect patient safety grow or wither in the coming days? It's up to us, but I think it will grow.
Carmen Balber and I asked in an oped in Monday morning's San Francisco Chronicle whether it wasn't time to pull the plug on the current physician-run medical board. We wrote:
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.
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.
