Meth and Medicine: What Patients Deserve To Know About Their Doctors

UPDATE Saturday May 9 -- Those watching Friday's Medical Board meeting from home can be excused for coming away thinking they are champions of patient safety. Members said so often enough.  But true to form, the Board stuck with doctors' interests when they voted to support SB 1177 and take a neutral if amended stance on SB 1033.

The Board refused to discuss whether patients should have a right to know if the doctor they are seeing fails a drug test. In pursuing the creation of a Board-sanctioned substance abuse program for doctors in SB 1177, members are closing their eyes and ears to the last program's decades of failure. Doctors are free to choose to enter drug treatment confidentially today, and patients' lot isn't improved if the Board sanctions the program. The true benefit to patients would be a requirement that once doctors enter treatment, their patients be notified, but only if they don't follow the program. Doctors and the Board keep rejecting that kind of transparency.

If patients have a right to know if their doctor is on probation, the Board refused to take up the banner when it voted to remain neutral on SB 1033, the bill that would notify them. The Board could not even bring itself to take that neutral stance without calling for an exemption for most doctors at hospital and urgent care facilities. 

Thursday May 7: Today, the California Medical Board considered the case of Dr. Matthew Vuksinich, who has a history of drug and alcohol abuse including 3 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.

The Board also heard Dr. Nathan Kuemmerle's case today. He 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. 

The Board recently reinstated the license of Dr. Zachary Cosgrove, who lost it in 2008 after having a sexual relationship with and assaulting or threatening 3 of his patients. He also admits to having been a meth addict.

Could there be a single patient of Cosgrove, Kuemmerle or Vuksinich who wouldn’t want to know why their doctor is on probation, or to be notified if he fails a random drug or alcohol test?

At its meeting in Los Angeles this Friday, the Medical Board will decide whether to support legislation that would require doctors on probation to notify their patients, and legislation that could allow doctors in substance abuse treatment to hide a failed drug or alcohol test from patients.

The Board should embrace transparency and make patient safety paramount, not physician secrecy.

Sponsored by Consumers Union, SB 1033 by Senator Jerry Hill would require doctors to disclose to patients if they are on probation for violations including negligence in the death of a patient, sexual abuse of a patient, overprescribing of opioids or drug and alcohol abuse.

Although the Medical Board refused to enact a similar proposal itself just a few months ago, the Vuksinich case today should give them pause about hiding such information from patients.

SB 1177 by Senator Cathleen Galgiani, would allow doctors with drug and alcohol problems to keep them secret from their patients and the Medical Board. In 2008, the Board was forced to shut down a program for doctors with addiction problems after it failed five straight state audits. That program allowed drug and alcohol-addicted doctors to avoid discipline by entering the program secretly, hiding their abuse from patients while continuing to practice. SB 1177 would allow the Board to create another program with similar pitfalls, including a failure to require patients and the Board to be notified when a doctor fails a drug or alcohol test.

Patients deserve to know their doctors’ records, especially when drugs and alcohol are involved. The Medical Board should support efforts to require doctors on probation, and doctors who fail a drug or alcohol test, to inform their patients.

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