Medical Lobby Dooms Bill to Stiffen Disciplining of Doctors

Heavy lobbying pressure from the California Medical Assn. prompted a state senator to withdraw a bill Thursday that would have strengthened procedures for disciplining doctors.

Sen. Robert Presley (D-Riverside), the bill’s author, said he will file a new version of the legislation in the next few weeks. But he conceded that it will be weaker than the tough proposal that was scheduled to be considered by the Senate this week.

Presley said he decided to alter his strategy after it became apparent that much of his support in the Senate was being eroded by intense lobbying from the powerful association of physicians.

“I may have had the votes still,” he said. “But I didn’t want to take a chance and give them (doctors) some sort of a psychological victory.”

Although the medical association wields considerable influence in the Legislature because it is a major contributor to legislative campaigns, Presley’s efforts to reform the disciplinary process got a boost late last year when a Valencia obstetrician was convicted of second-degree murder in the deaths of eight infants.

Prosecutors in the widely publicized trial said Dr. Milos Klvana had been investigated by the state Board of Medical Quality Assurance in some of the cases but his license to practice had never been revoked. They said state authorities had been slow to take action and then allowed themselves to be manipulated by the physician.

Presley’s legislation would have speeded up the disciplinary process, provided better access to information for board investigators and allowed the state to take quick action to stop doctors involved in particularly egregious cases from practicing.

But as his bill was about to be scheduled for Senate action, Presley said the medical association stepped up its lobbying efforts, offsetting any advantage he may have achieved as a result of the publicity surrounding the Klvana case.

To win medical association support, or at least its neutrality on the legislation, Presley said, would have required him to make such substantial revisions to the legislation that he decided it would be “tidier” to propose a new bill.

For example, Presley said missing from the new measure will be a provision that would have required court clerks to report to the Medical Board, the state agency that disciplines physicians, whenever a malpractice suit is filed against a doctor.

Marjorie Swartz, assistant director of government relations for the California Medical Assn., said the malpractice provision was one of her group’s prime objections to the bill.

“Some 75% of malpractice suits are frivolous so physicians felt it was a matter of unsubstantiated accusations going on their record,” she said.

Other medical association objections, she said, focused on Presley’s efforts to speed up the disciplinary process by removing some of the avenues of appeal now available to doctors accused of negligence or malpractice.

When a physician’s license “to earn a living is at stake,” she said, the association takes the position that there should be ample provision for independent review of various disciplinary actions.

Swartz said the medical association would work with Presley and would support any provision designed to correct “a legitimate flaw in the system.”

Presley predicted that he will be able to pass the new version of his legislation later this year.

“We won’t be able to get whatever we want,” he said. “But what we don’t get this year we’ll come back with next year.”