Assembly OKs Bill to Alter Review Process for Doctors

A bill placing new restrictions on hospitals seeking to discipline doctors accused of incompetence sailed through the Assembly Monday on a 55-8 vote.

The bill, which would change hospital disciplinary proceedings and give accused doctors the right to be represented by attorneys at hearings, was sent back to the Senate for agreements on amendments added in the lower house.

Authored by Sen. Barry Keene (D-Benicia) and backed by the California Medical Assn., the bill was prompted by doctors’ complaints that the process for reviewing their performance was skewed against them and often motivated by competitors’ jealousy. The bill, which unanimously passed the Senate last week, addresses the peer review process in hospitals that comes into play when a complaint is filed or an unexpected patient death occurs.

A panel of the doctor’s colleagues reviews the circumstances of the complaint and, if the doctor is found guilty, he can be stripped of hospital privileges. All disciplinary actions must be reported to state medical authorities for further investigation that can ultimately bar a physician from practice.

Currently, doctors are notified of a pending disciplinary action and can request a hearing of their peers where they can bring in their own witnesses, submit documentary evidence and cross-examine their accusers. They can also appeal the result to a higher hospital board or to the Superior Court.

Under the proposed legislation, doctors would be entitled to have attorneys represent them at the hospital hearings. The burden of proof, currently on the accused doctor, would be shifted to the hospital. A timetable for carrying out the review, including a minimum 60-day notice before a hearing, would be imposed.

“This bill does not . . . complicate the process,” Assemblyman William J. Filante (R-Greenbrae) said. Filante, the Assembly’s only physician, praised the legislation and said it would “move the patients and public safety to the number-one priority.”

Backers of the legislation say that the peer review process has become an easy way for physicians to undermine competitors.

But critics maintain that the bill would make the current peer review process meaningless because its restrictions would make it too costly and time consuming for most hospitals.

Dr. Verner S. Waite, a general and vascular surgeon who in 1979 was the subject of a critical peer review at St. Francis Medical Center in Lynwood, charged Monday that the process had been prompted by “economic competition.”

Waite won a libel and slander suit against two fellow surgeons and the medical center after the review of his work. His case prompted the formation of the Semmelweis Society, a group of doctors, dentists and lawyers that lobbied for the passage of Keene’s bill.

“We want peer review very much,” Waite said of the 250-member society. “But we want it with clean hands.”