California Health Care Community Debates Mexican Doctors Bill

A bill that would allow 120 Mexican doctors and dentists to enter the state and provide care in underserved areas while "bypass[ing] California's complex licensing rules" has "divided" the state's health care community, the San Diego Union-Tribune reports. Some believe that the bill would help the uninsured, while other say the measure would lead to "nothing more than ghettoized health care." AB 1045, sponsored by Assembly member Marco Firebaugh (D-Los Angeles) and passed by the Assembly 48-15 last month, would grant three-year licenses to 70 doctors and 50 dentists from Mexico, where residency programs and requirements are "shorter and less intense than those California normally requires for foreign medical or dental school graduates." All candidates would be required to speak and read English and would have to serve in a California clinic for six months under a University of California teaching program. Firebaugh said that the measure "addresses the critical shortage of physicians and dentists, and brings culturally and linguistically competent physicians to practice in underserved areas." In addition, Firebaugh said that his bill would reduce uninsured patients' reliance on expensive emergency room care. Arnoldo Torres, spokesperson for the Hispanic Health Care Association, a not-for-profit organization of 66 clinics statewide that is supporting the legislation, said, "We must realize there's a huge, huge mismatch in California, not enough doctors or dentists who speak the language and know the culture of their patients."

The measure, however, now faces a "huge battle" in the state Senate amid criticism that allowing doctors with less extensive training to practice in California could threaten patient care. "This creates a second tier of licensure," Dr. Robert Hertzka, past president of the San Diego County Medical Society and a representative of the California Medical Association, said, adding that in Mexico, "you have doctors who are trained in obsolete medical equipment and have never heard of certain pharmaceuticals, diagnostic and radiological tests that are used in the United States." Hertzka and Dr. Hector Flores of the California Latino Medical Association, which opposes the bill, said "they are not ignoring the problem" of the uninsured, but they "want the solution to include people with California medical degrees and training." Hertzka said that "numerous graduates of California medical schools could be recruited" to work in underserved communities, while Flores said that "graduates of foreign medical schools already residing legally in California" seeking their medical licenses "should be the first to fill those clinic spots." And Greg Knoll, head of the San Diego-based Consumer Center for Health Education, said, "I'm very concerned that poor people receive the same quality of care, but this doesn't look at first blush like it would do that. Besides, this seems like a drop in the bucket in trying to deal with the massive underinsured problem" (Clark, San Diego Union-Tribune, 6/24).