State May Cut CPR Ability Rule for MDs

California doctors would no longer be required to prove their ability to perform life-saving cardiopulmonary resuscitation (CPR) under a proposal being considered by the state board that licenses physicians.

The Board of Medical Quality Assurance wants to drop its five-year-old CPR requirement and will hold a hearing on the issue Jan. 25.

The board’s licensing division argues that the rule was an example of unnecessary government regulation and that most physicians are already required to learn the emergency technique by the hospitals where they practice.

“If they (physicians) need to know it, they do,” said the board’s assistant executive director, Stephen Wilford. “If they don’t, then requiring one test every two years isn’t going to give it to them.”

In fact, the Joint Commission on Accreditation of Hospitals, a nationally recognized nonprofit group that sets hospital standards, dropped its CPR requirement in 1981, a spokesman for the commission said.

Training Required

Current state hospital licensing rules require that each facility have a CPR training program, but the wording is vague and does not require that all staff physicians be trained.

When the medical board’s rule was adopted with a good deal of fanfare in 1980, the board argued that the public expected physicians to know the technique. Yet 39 of 104 license applicants tested failed a voluntary check of their CPR skills that year.

Since then, in renewing their medical licenses every two years, the state’s 100,000 physicians have had to sign sworn statements that they have a valid CPR certificate from the American Heart Assn., the American Red Cross or the California Society of Anesthesiologists.

Cardiopulmonary resuscitation was developed in the 1960s as a technique for keeping alive an individual whose heart has stopped until a trained emergency rescue team arrives.

The training courses teach methods for keeping oxygen and blood flowing through the victim’s body, by blowing air into the lungs and regularly compressing the chest. Without CPR, most individuals die within minutes of heart arrest.

To earn a CPR certificate from the Los Angeles affiliate of the American Heart Assn., for example, doctors must spend eight hours learning the technique and practicing it on specially constructed mannequins, which have been dubbed “Rususci-Annies.”

Certificates from the various programs are generally valid for one or two years, and then require a brush-up course for renewal.

But from the start, physicians have complained to the board about adding CPR to the continuing education requirements that must be fulfilled for license renewal.

One physician from the San Francisco Peninsula recently argued that requiring the use of the mannequins would expose doctors to the risk of acquired immune deficiency syndrome (AIDS), an often-fatal disorder that has been multiplying rapidly, especially among male homosexuals, intravenous drug users, hemophiliacs and Haitians.

But the medical board’s Wilford denied that AIDS was an issue in the board’s decision to drop the CPR rule. Researchers believe that the disease is probably spread through intimate contact, through blood, blood products or semen.

Wilford said that audits of licensing applications have shown that more than 90% of physicians have complied with the requirement.