Can Medical Board Oversight of Dangerous Doctors Be Reformed?

Four years ago, state lawmakers delivered a scathing indictment of the Medical Board of California for failing in its primary mission: patient protection. Physician oversight remains broken four years after that legislative “sunset review” committee threatened to shut down the Medical Board if it did not improve patient protection. Consumer Watchdog testifies at the sunset review hearing today and will call for the Board to be disbanded if it cannot improve. 
The Board’s worst failures are in its most important job: investigating and disciplining dangerous doctors to protect patients from harm. Many consumers who complain to the Medical Board when they are harmed by a doctor are not contacted or interviewed by the Board before it dismisses their complaint. In the few investigations that do move forward at the Medical Board, they take longer to finish today than they did four years ago. When investigations do result in doctor discipline, doctors on probation are not required to inform their patients. 
It would be unthinkable for police to close a rape case without collecting evidence and interviewing both the victim and the accused. It’s equally inconceivable that the Medical Board would get a complaint that a doctor’s mistake killed a patient but dismiss it after only getting the doctor’s side of the story. Even when investigations lead to discipline, patients are kept in the dark about the results. The stakes are too high for patient safety for these failures to continue without consequences.
While the current Board has acknowledged some of these failings, and staff changes have made a difference in tone, the Board has fallen far short of becoming a patient protection organization.  
A Southern California woman who has come forward about being sexually assaulted by Southern California doctor Michael Popkin will also testify to lawmakers today. Since she went public, law enforcement has uncovered multiple additional accusations of sexual assault against the same doctor that were reported to the Medical Board, but not to law enforcement or the public. He had also been placed on probation for gross negligence and improper prescribing in the treatment of several patients, but did not have to disclose this probation to his patients. Lisa L. Maki, who represents the woman who came forward, will also be at the hearing. Consumers are urged to contact detectives Edward Moreno at (818) 374-7714 or Ninette Toosbuy at (818) 374-7718 with information about the doctor.
The Senate and Assembly Business and Professions committees’ sunset review report identifies more than 500 doctors who are currently on probation statewide and continue to see patients. Consumer Watchdog will testify in support of the committee’s recommendation that doctors be required to disclose to their patients when they are on probation for offenses as serious as drug abuse, sexual battery, opioid overprescribing and negligence causing the death of a patient. Legislation to do this was killed at the hands of the California Medical Association last year, which acknowledged patients have a right to know but refused to support notifying patients of doctors' offenses.
Early last year, the California Medical Board considered the cases of three doctors who make the case for patient disclosure. 
Dr. Matthew Vuksinich has a history of drug and alcohol abuse including three DUIs, a meth arrest, and cycled in and out of alcohol treatment programs for over a decade. He will almost certainly be placed on probation, with random drug testing and other restrictions on his practice. Dr. Nathan Kuemmerle was the state's top prescriber of amphetamines, second-largest prescriber of opiates, and had a meth addiction when he was convicted of selling drugs in 2011. And the Board reinstated the license of Dr. Zachary Cosgrove, who lost it in 2008 after having a sexual relationship with and assaulting or threatening three of his patients. He also admits to having been a meth addict.
In a letter to the sunset review committee, we also urge the committee to mandate that the Board interview patients who submit a complaint about their doctor, obtain records directly from both the complainant and the doctor, and be prohibited from closing any investigation when the basic facts of the case are in dispute. In many cases, medical records are added to or altered after the fact in an attempt to close ranks around a doctor who has caused harm. 
The Medical Board’s failure to adequately investigate complaints is reflected in its surveys of consumers, in which 88% of respondents rate the Board’s handling of consumer complaints poor to very poor. 
Four decades ago, patients’ ability to hold dangerous doctors accountable in court was restricted with the promise that a strong Medical Board would substitute for this lost legal deterrence. How much longer will lawmakers allow the Board to fail in that duty?
On one bright note, the Board has begun to address the opioid overprescribing crisis by using the CURES database to proactively investigate doctors’ prescribing habits. Enforcement actions for improper and illegal prescribing have increased 97% since 2012. But the time it takes to finish those actions has gotten worse, not better. And the vast majority of complaints about doctors are dismissed before they are truly investigated. 

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