Direct Hiring, Physical Therapist Issue Head CMA List

During the California Medical Association’s 37th Annual Legislative Leadership Conference this week in Sacramento, the organization outlined some of the legislation it would fight for this year — and legislation it would fight against.

“Sometimes it feels like Groundhog Day around here,” CMA legislative analyst Jodi Hicks said. “Every year, it seems, we have this discussion about a plan to have some kind of direct hiring of physicians, and what that should look like.”

Last year, three different bills were proposed on the issue. Two new bills have been proposed this year to allow direct hiring of physicians by hospitals, in an effort to increase the number of primary care physicians working in rural and underserved areas in California.

AB 1360 by Assembly member Sandré Swanson (D-Alameda) allows all health care districts in the state to directly hire doctors, and AB 824 by Assembly member Wesley Chesbro (D-Santa Rosa) authorizes some rural hospitals to hire physicians. The CMA has generally opposed bills that would dilute the ban on corporate medicine, though it did support a limited, pilot program in the past. The CMA opposes both bills in their current form. The problem, Hicks said, is that allowing hospitals to have so much influence on doctors could compromise patient care.

“In the past, we’ve supported bills that required the medical staff to have a vote, and that makes a big difference in terms of patient protection,” Hicks said. “Also, we wanted to make sure we’re not displacing physicians who already exist in the community, and that hospitals can’t hire new doctors to get rid of physicians that they just don’t like.”

AB 1360 is scheduled to be heard in committee Apr. 12, and AB 824 is slated for an Apr. 26 hearing.

The other major point of opposition, Hicks said, is the physical therapists’ effort to become solely independent contractors.

“Physical therapy has become an issue yet again,” Hicks said. “There’s a medical corporations code, and the intent was how to structure a medical corporation and the code lists who can be part of a medical corporation. What was never put on the list was physical therapists.”

Hicks said adding physical therapists to the list would be basically cleaning up an administrative lapse. Some therapists disagree, and say that patients should get direct access to physical therapy without being referred by a physician.

Earlier this week, AB 783 by Assembly member Mary Hayashi (D-Castro Valley), a bill the CMA says would correct the codification of physical therapists, was passed 9-0 out of the Assembly Committee on Business, Professions and Consumer Protection.

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