State Medical Board Considers Fee Increase, Shift in Investigator Reporting Amid Consolidation Threat
Medical Board of California Executive Director David Thornton on Friday in a board meeting plans to propose system changes including increasing physicians' licensing fees, but such reforms "could be scuttled" by Gov. Arnold Schwarzenegger's (R) proposal to eliminate the board and give its responsibilities to the state's consumer services agency, the Los Angeles Times reports (Rau, Los Angeles Times, 1/21).
Schwarzenegger during his State of the State address earlier this month proposed consolidating or eliminating about 100 state regulatory boards, including some health-related commissions (California Healthline, 1/7).
In response to criticism of the board's complaint investigations and purportedly lax monitoring of the board's physician substance abuse recovery program, Thornton is expected to recommend that the board increase physicians' fees to $800 from $600 for a two-year license. He also is expected to suggest that all investigators be moved under the authority of the state attorney general's office.
Julie D'Angelo Fellmeth, executive director of the Center for Public Interest Law at the University of San Diego School of Law and monitor of the medical board, in November issued a report recommending that the board make changes to improve patient protection. Fellmeth's report found that the board:
- Lacks oversight of the substance abuse diversion program;
- Has poor cooperation among board investigators and lawyers in the attorney general's office;
- Has a limited number of board enforcement staff;
- Is often slow and incomplete in reporting medical malpractice instances and lawsuit settlements; and
- Is slow to collect medical records for investigations.
Thornton called problems between prosecutors and board investigators "a territorial thing." He added, "If the investigators are no longer employed by the medical board, then they're working for the same boss" as the prosecutors.
Nathan Barankin, a spokesperson for Attorney General Bill Lockyer (D), said the board's "fundamental problem" is a lack of investigators and attorneys to handle all cases.
California Medical Association CEO Jack Lewin, speaking about the suggested licensing fee increase, said, "We haven't the evidence of an effective and clear understanding yet of why the fees need to be increased and what they will go for."
Sen. Liz Figueroa (D-Fremont) said she opposes Schwarzenegger's proposal to consolidate the board. She said, "I think it's really wrong to say, 'Oh, yeah, it has a lot of problems, let's get rid of it.' The problems will still remain. They'll be larger and they'll be hidden."
The board will discuss the changes until Jan. 25, at which time Figueroa will chair a board oversight hearing (Los Angeles Times, 1/21).