Assembly OKs Measure Making It Easier to Discipline Doctors

The California Assembly voted Thursday to give regulators strong new tools to stop substandard doctors from practicing medicine as it approved legislation to beef up the state’s physician discipline system.

The measure by Sen. Robert Presley (D-Riverside) and Assemblywoman Jackie Speier (D-South San Francisco) won 75-1 approval in the Assembly. The vote margin belied the tough bargaining that had taken place behind the scenes between professional physician organizations, citizen groups and legislative staff before the bill reached the floor.

It now goes back to the Senate for approval of a series of technical changes and then on to Gov. George Deukmejian, who had asked for some of the changes and is expected to sign it into law.

Referring to the state’s doctor disciplinary system as “comatose now for about a decade,” Speier told the Assembly that the legislation would “bring it back to life.”

The lone vote of opposition came from Assemblyman Pat Nolan (R-Glendale), who said later that some doctors in his district had expressed concerns about it. The legislation gives the Medical Board of California, the state agency that licenses, regulates and disciplines physicians, stronger prosecutorial backing, better access to information and more authority to immediately suspend physician licenses in egregious cases.

It does that by establishing a unit within the attorney general’s office to prosecute physician cases and provide legal advice to board investigators, by requiring coroners to report any deaths suspected of being caused by physician negligence and by directing prosecutors to notify the board when doctors are charged with felonies.

Under the measure, the board, which has often been criticized for failing to move quickly against doctors considered a danger to their patients, is also empowered either through its own actions or those of administrative law judges to temporarily suspend physician licenses.

The move to overhaul the state’s doctor discipline system was started by Robert C. Fellmeth, director of the University of San Diego’s Center for Public Interest Law, whose 1989 report found the system so laden with procedural hurdles and so plagued by staff shortages that it was “effectively moribund.”

But efforts to strengthen the system gained real momentum when a Los Angeles County jury convicted Dr. Milos Klvana of second-degree murder in the deaths of eight newborns and a fetus. At Klvana’s sentencing, the judge in the case blamed the medical board for failing over the years to either investigate the doctor properly or stop him from practicing medicine.

Presley’s measure was opposed initially by the California Medical Assn., a professional doctor organization and a powerful force in the Legislature by virtue of the millions of dollars in campaign contributions it doles out each year. It contended that the bill erased too many of the protections afforded doctors in the disciplinary system.

Presley and Fellmeth finally won the support of the CMA when they agreed to give up some provisions in the bill, particularly those that would streamline the appeal process for doctors who have been the subject of discipline. Both men acknowledged that the removal of that section weakened the measure, but they vowed to come back next year with another bill that will propose additional reforms in the process.

“I won’t be drinking champagne after this passes,” Fellmeth said following one bargaining session. “But I will be finding a very high-quality beer.”