Medical Board Head Calls for End to Doctors’ Funding

As part of ongoing efforts to make the California Medical Board more consumer oriented, the board’s executive director said Friday that he would prefer to have its work funded by state taxpayers instead of physician licensing fees.

“I don’t like that surgeons and physicians pay fees to support us,” said Dixon Arnett, who was one of several participants in a panel discussion at the California Medical Assn.’s annual Western Scientific Assembly here. The panel discussed whether the Medical Board of California is doing its job of disciplining physicians. Arnett said it is important for the board, which both licenses and disciplines the state’s 70,000 practicing physicians, to distance itself from the CMA to avoid any seeming conflict of interest.

“The medical board by law is a consumer protection organization and not an auxiliary of the CMA,” Arnett said.

Arnett said, however, that the board’s decisions are not influenced by its source of funding.

He made his comments Friday during the weeklong gathering at the Disneyland Hotel that will culminate Wednesday with a satellite conference between President Clinton and CMA delegates on the topic of health-care reform.

Arnett took over leadership in January, 1993, about the same time the California Highway Patrol released a report harshly criticizing the board for misconduct and mismanagement, including the wholesale dismissal of complaints against physicians.

Since then, Arnett said, the board has enacted “the most extensive set of reforms in the history of any regulatory agency in the United States.”

But Robert C. Fellmeth, a lawyer representing the Center for Public Interest Law, said Friday he believes the board’s enforcement record is still “pathetic,” noting “no more than five or 10 (physician) licenses are removed each year because of incompetence.” He said that complaints are “clogging the system” because “there are not enough district attorneys working the cases.”

Instead of eliminating physician financial support of the board, Fellmeth recommended increasing physician licensing fees from $600 every two years to $800 a year to beef up enforcement. He also proposed that the board take responsibility to provide continuing education and retesting of physicians as part of its licensing function.

Paul J. Pfingst, representing attorneys who defend physicians in medical board cases, decried the emphasis on punishment. “We need a system that looks at salvaging the physician,” he said. “Good doctors can make a mistake.”

Too often, Pfingst said, doctors who have been disciplined by the board for relatively minor offenses have had their careers destroyed. He said any disciplinary action becomes magnified because information about it is shared by numerous regulatory agencies.

Arnett, however, said the medical board this year will go to the state Legislature for authorization to share information with consumers about doctors who have been disciplined by the staffs of hospitals where they have practiced. Currently, state law requires such information to be kept confidential until the board completes its own investigation.

Arnett said it is a good sign that the board is being sued by the CMA for allegedly disclosing too much information, while at the same time it is under attack from California news organizations for not disclosing enough. He said the board is “wending a careful path through the middle of extremes.”