PHYSICIAN OVERSIGHT: Battle Brews Over State Podiatry Board

      A former state senator credited with helping to kill a proposed measure several years ago that would have "restructured the physician-dominated California Medical Board with a layperson majority," has switched his views, the Wall Street Journal/California Regional Edition reports. Robert Presley (D) recently wrote to his former colleagues urging them to "approve a bill to convert the doctor-dominated Board of Podiatric Medicine to a public-member majority." Presley, who has been sitting on the podiatry board since 1995, said he doesn't believe the switch would "result in a disciplinary crackdown on those in the field." He said, "[A]s far as the public is concerned, it's perception. And the public's view of a public majority board is much better." The Journal reports that "Presley's unexplained change of heart makes it a drama worth watching, especially at a time when the future of managed care is such a sensitive political issue." In particular, "[o]pponents of changing the board makeup -- mostly doctors' groups -- are fearful that a successful restructuring will lead to similar efforts with other health-related panels," including "the mother of all such bodies, the California Medical Board." Jamie Court, director of Consumers for Quality Care, said that "[i]f the podiatric-medicine board is reshaped, 'it is clearly something we would seek to continue to spread.'"

Under The Sunset
      Under the current law, the podiatry board will be sunsetted and its functions "absorbed by the Department of Consumer Affairs" if the state Legislature does not renew its authority this year. Currently the board has two public members and four podiatrists. The board has proposed that it be restructured as a "nine-member entity, with five laypersons, or a seven-member board with four public members." Both the California Podiatric Medicine Association and the California Medical Association oppose the restructuring. Officials with the podiatric association "contend that the medical issues the board addresses are too complex for a layperson majority to effectively master." They also note that "no medical board in the nation today has a public-member majority." John Bailey, executive director of the California Podiatric Medicine Association, said, "We do not believe that California's podiatrists should be used as guinea pigs." The association also contends that "as managed care continues to put the squeeze on specialists ... they'll need an even stronger voice in the regulatory arena." However, "officials at the podiatric-medicine board counter that it's health care consumers -- not providers -- who have been getting short-changed under managed care." Jim Rathlesberger, executive director of the board, said, "We need to represent the broad public to the greatest extend possible." While Gov. Pete Wilson is supportive of the restructuring, Rathlesberger notes that "the key to the fight will be Mr. Presley's performance" (Benson, 1/4)