CMA Gives Its Support to Tougher Discipline : Health: Doctors group, which had opposed a bill cracking down on substandard physicians, agrees to back it after changes are made.

Backing off from its initial opposition, the politically powerful California Medical Assn. agreed Thursday to support legislation that would strengthen the state’s much-criticized disciplinary system for doctors.

Supporters said backing of the influential doctors’ group, which contributes millions of dollars to lawmakers’ campaigns, now virtually assures that the bill by Sen. Robert Presley (D-Riverside) will win legislative approval.

Indeed, hours later the bill was approved unanimously by the Senate Judiciary Committee.

“The chances of the bill going all the way to the governor are excellent,” said Martin Pinon, a special assistant to Presley. “With this new partnership, so to speak, it’s a done deal.”

The change in the association’s position came after a round of compromising that consumer advocates said weakened some reforms in the measure but left enough of them intact so that the bill would still make significant changes in the way the state disciplines substandard doctors.

The measure establishes a unit in the attorney general’s office to prosecute physician cases and provide legal advice to state investigators; empowers the California Medical Board or administrative law judges to temporarily suspend physician licenses in egregious cases, and requires physicians to notify affected patients when their licenses have been restricted.

It gives the Medical Board, which oversees the disciplinary system, more access to information by requiring coroners to report any deaths they suspect may have been caused by doctor negligence and by requiring prosecutors to report to the board when physicians are charged with felonies. It increases the fines that can be assessed against hospital chiefs of staff who fail to report action taken by hospital review committees against doctors.

Robert Fellmuth, director of the University of San Diego’s Center for Public Interest Law and the author of a critical 1989 report, said the reforms would streamline the disciplinary process and give the medical board better tools to get rid of dangerous doctors.

In his report--”Physician Discipline in California: A Code Blue Emergency”--Fellmuth labeled the state’s physician-disciplinary system “moribund,” complaining that it was so laden with procedures that substandard doctors usually escaped serious punishment.

“This bill is not Utopia, but it’s an improvement,” Fellmuth said. “I won’t be drinking champagne after it passes, but I will be finding a very high quality beer.”

To win the CMA’s support, he said consumer advocates had to give up provisions that would have streamlined the appeal process for doctors who have been disciplined. But in an election year when lawmakers are actively seeking campaign contributions, he said it probably would have been “politically impossible” to pass the bill without the CMA’s endorsement.

Charles M. McFadden, director of the CMA’s division of communications, said the organization had originally opposed the measure believing it removed too many protections that are now afforded physicians in the disciplinary process.

“We think the bill as it now stands after intense negotiations with Sen. Presley preserves due process for physicians,” he said. “From our perspective we feel we have achieved a consensus on a bill which provides increased protections for the public and preserves the rights of accused physicians.”

Steve Barrow, a lobbyist for the Center for Public Interest Law, said he will push again next year for additional reforms.

“It’s no secret that there are a lot of major reforms that are not in this bill, but we’re happy we got as far as we did. These are significant changes,” he said.