Patients May Get More Doctor Information

A state senator has reached a compromise with key interest groups that would allow consumers, for the first time, to learn about medical malpractice settlements involving their physicians from state regulators.

The bill, which still must clear the Assembly, would allow patients to get a fuller picture of a doctor’s legal history from the Medical Board of California before undergoing treatment, said state Sen. Liz Figueroa (D-Fremont), the bill’s author.

Also for the first time, the board would be required to prioritize investigations of cases in which a patient was harmed or died as a result of perceived physician misconduct.

The California Medical Assn., the doctors’ trade group, has complained for years that the board places more emphasis on cases involving alternative therapies than complaints involving patient harm.

Lawmakers said the task of writing a bill was difficult because interest groups representing consumers and doctors had divergent goals. The Legislature is expected to pass some kind of bill this year, because one is needed to extend the mandate of the medical board.

“I feel very, very good about the product we have now,” said Figueroa, chairwoman of the Joint Legislative Sunset Review Committee. “You hear about people being locked up in a room and saying, ‘This is going to be done.’ That was pretty much the mind-set with this process.”

The bill passed the Senate in May and could be heard by the Assembly Health Committee as early as Tuesday.

During its review of the medical board, Figueroa’s committee found that most complaints filed by the public were closed without a formal investigation, and that 65% of those who complained were dissatisfied with its action. Also, the number of disciplinary actions taken by the board has fallen even as complaints increased.

The compromise bill falls short of the demands made by consumer groups and the medical board itself, particularly in the area of disclosure about physicians’ histories.

In May, the medical board voted to support public disclosure of all medical malpractice settlements and misdemeanor convictions related to physicians’ qualifications.

The compromise bill would only allow the board to publish settlements on its Web site if a physician in a “low-risk” specialty, such as family practice, has three or more settlements of more than $30,000 in a 10-year period. Doctors in a “high-risk” specialty, such as neurology, would need four or more settlements to trigger disclosure.

The board would not be allowed to disclose the actual dollar amount of settlements, but would instead indicate whether the settlement is below average, average or above average compared with other doctors in the same specialty. The bill would only apply to settlements in the future, not in the past.

As it stands, the medical board does not disclose settlement information; such deals are often sealed from public view.

Misdemeanors would not be disclosed under the bill.

Consumer advocates say they will continue to support the bill, because it calls for the appointment of an independent monitor to report on the board’s disciplinary system over the next two years.

As for disclosure, “Once you get the door open, it’s a little bit easier to kick it open wider a few years from now,” said Julianne D’Angelo Fellmeth, administrative director of the Center for Public Interest Law at the University of San Diego law school.

Linda Whitney, the medical board’s chief of legislation, said the bill doesn’t fully achieve the board’s objectives.

“This is certainly a start because it’s the beginning of the release of settlements,” Whitney said. “We have never been able to release settlements prior to this.”

The California Medical Assn. has removed its opposition to the bill even though it would prefer that settlements not be disclosed. Vice President Steve Thompson said the compromise will ensure that consumers receive enough information to put them in context and not tarnish all doctors who settle cases.

“We think that is of more value to the consumer than simply listing them all,” Thompson said.

But medical malpractice carriers oppose the bill, predicting it will prompt doctors to fight in court rather than settle a case.

“He’s going to be disincentivized from settling a suit if he knows it’s going to go on the Web,” said Dr. Wendell Moseley, a board member of the SCPIE Companies, a malpractice carrier based in Los Angeles.

Among the other changes included in the compromise bill:

* It closes loopholes that had allowed doctors to avoid reporting settlements or legal judgments to the board.

* It requires a physician to review a complaint from a patient before it can be disclosed by the medical board.

* It allows automatic revocation of a physician’s license if he or she is found guilty of certain repeat sexual crimes.

* It adds two more public members to the board, bringing the total membership to 21 (12 physicians and nine public members).

* It increases the criminal penalty for unlicensed practice.