Medical Board To Tighten Oversight of Foreign Doctor Program
The Medical Board of California plans to "beef up oversight" of a program that allows foreign doctors to practice medicine in the state because of "numerous violations" by participants and a "frustrating lack of enforcement authority," the Sacramento Bee reports.
Section 2113 of the Business and Professions Code, created in 1974, allows doctors who are licensed in a foreign country to practice in the state under the supervision of an academic medical center. Participants must have completed at least three years of postgraduate training and must be either board-eligible or have board certification in their native country for their specialty. According to incomplete board records dating to 1989, about 600 guest doctors have participated in the program, including about 150 who currently are practicing in the state, the Bee reports.
Participants, who can remain in the program for five years, are given by the state medical board a "certificate of registration," which is different than a state medical license and includes certain restrictions. The certificate provides participants with full faculty privileges and allows them to conduct research, teach students and see patients.
Cindi Oseto, an analyst with the medical board's licensing division, said some doctors have ignored restrictions in the program and violated the law by:
- Referring to themselves as state-licensed physicians, even though participants are not permitted to refer to themselves as state "medical doctors" outside of their sponsoring institutions;
- Failing to annually renew their program application;
- Billing insurance companies and state-sponsored health care programs for medical care, even though the state prohibits participants from seeking reimbursement for care; and
- Admitting patients to nursing homes and signing death certificates.
The board, which will hear recommendations for changing the program in May, plans to "more closely monitor participants," including possibly requiring them to report their malpractice history, as is required of state-licensed doctors.
Sacramento lawyer Brooks Cutter, who won a malpractice settlement involving a 2113 participant, said, "There is no disclosure to anybody that these doctors aren't licensed. People expect when they go to an institution they are getting a fully credentialed physician."
Oseto, who will present the recommended changes to the program, said, "We have a very, very weak statute. One of my goals is to significantly strengthen the statute to ensure that anyone reading it would know what an individual should and should not be doing."
While many participants technically have practiced medicine without a license, none has ever been disciplined by the board, Oseto said. "The reason for that is these are very old statutes and there is no enforcement mechanism," she said (Griffith, Sacramento Bee, 3/20).