News Scrapbook 1989

San Diego, CA (San Diego Co.) Evening Tribune (Cir. D. 123,064)

San Diego, CA (San Diego_Co.) Evening Tribune (Cir. D . 123,064)

Fresno, CA (Fresno Co.) Bee (Cir. D. 134,964) (Cir. S . 157,228) APR 6

S an Diego, CA (San Diego Co.) Eveni ng Tribune (Cir. D . 123,064)

Jlll.,. '• ,. C. 8 - Wedd~gfbring on swarm of shuttle ·bugs '' EILEEN JACKSON SOCIETY Esr I 8&8 r ••

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Jllln. '• "· C. B fat. 1888 Consumer group assails system on doctor discipline c-:?fl5~ By Ron Rcrach Tribune Sacramento Bureau Chief SACRAMENTO - In 1984, a woman underwent what she thought was to be a routine hysterectomy at Mercy Hospital in San Die~o, but wound up with three operations m- stead of one because of an incom- petent doctor, a consumer group said here yesterday The group, the Center f?r Public Interest Law at the University of San Di~ fili!>lished her account, While wit bt g the names of patient and doctor to illustrate "the impact of the c~rrent disgraceful system" of doctor discipline. Releasing a scathing study of the state Board of Medical Quality As- surance and its record of disciplining doctors, the center urged the Legisla- ture to shake up the ystem. The study quoted the woman as saying that during the initial ope~a- tion her ureter was severed, requll'- ing a second operation. A year later, after developing severe and ann?Y· ing urinary problems, she h_ad a third operation, an ordeal she said left her "physically a wreck," the report said. She checked the doctor's reputa- tion and found that in August 1983 be had been sued on the grounds of mal- practice and that he had setUed for $50 000, the report said. In 1983-84, the' doctor was involved in litigation with Pomerado Hospital in Poway, and the hospital board voted to ter- minate his medical-staff member- ship for failing to meet "professional competence, professional ethics or worthiness of character," the report said. Earlier, she found, he had been ter- minated from the staff at Sharp Hos- pital where nine cases cited various failu~es, the report said. The woman said she fpent a week Please see DOCI'ORS: ~l.Z Col. 1 at the UCSD medical library prepar- ing an eight-page complaint, yet felt that her chances as a consumer were "as good as Michael J. Fox against Mike Tyson." The report quoted her as saying that the BMQA allowed the doctor to continue practicing. She was not invited to attend the complaint hearing and, she said, doc- tors at Pomerado and Sha!"J) hospi- tals were not called to testif , regard- ing past performance. Robert Fe:mrn~UI.' directc. of t e Center for Public Interest Law, said the woman "identifies the solicitude and .fragmentation whicQ plague the current system." Even though two hospitals revoked the doctor's privileges, "so long as one hospital anywhere is willing to take the monies generated, the physi- cian operates," the report said. "Only BMQA can say no as to all," it said, referring the state board's power to revoke licenses and other- wise discipline doctors. The results of a yearlong study by the center are contained in a report titled: "Physician Discipline in Cali- fornia: a Code Blue Emergency." In the medical field, "code blue" means that a patient is dying and immediate attention is needed. Fellmeth and his group are zero- ing in on their second major regula- tory agency in recent years, having hammered away at the State Bar for the past five years. As a result, the Legislature created the position of State Bar discipline monitor, and Fellmeth got the job as an appointee A-12 IBE

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Miss Jones graduated from fort I:ewis Col- , ..n .. n,,,.,nan f'nln and her fianc~ IS a gradu- .....b .... , .-- ... •-e-, --•-·• . ate of the Univ rsity of San Diego. d v· . . Mrs Thomas W. Sefton (Donna) an l.l'gm1a Lynch.Grady of La Jolla r~ently return~ ear from a circumnavigating trip around Baia I· fornia They crnised from Ensenada to many Please see JACKSON: D-2, Col. 1

NOTEPAD: Time magazine has a igned a reporter to the Sharon Rogers/La Jolla Country Day story. . . . .QSD...is honoring four judges at its Deans' Ball on April 15. But it won't name the judges. Explains PR man John Nunes: "The code of judicial con- duct doesn't allow them to use their names in any fund-raising events - even for civic or chari- table organizations." . . . On a typical day, San Diegans buy 416 new TV sets, and throw away 166. MAKING WAVES: After test- ing several styles with San Diego enlisted women, the Navy has ap- proved the first women's jumper version of its dress white uni- form: pullover top with V-neck, and a collar and neckerchief sim- ilar to Navy men's whites. Under- shirts will be required. But it'll be at least two years before the uniforms are issued. Alison DaRosa assists with the Neil Morgan column. --

Escondido, CA (San Diego Co.) Times Advocate (C1r. D. 45,900) (C1r. S. 47,000)

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San Diego, Thursday, April 6, 1989 DOCTOllS: Consumer group assails discipline system Ccntinued From A-3 :;;,._ q ':J'

of Attorney General John Van de Kamp. Sen. Robert Presley, D-Riverside, announced that he will carry a bill to implement the report's recommen- dations. The report proposed: • Authority for the attorney gen- eral to immediately suspend the li- cense of a doctor when a patient's health is endangered by the physi- cian's conduct. • A toll-free hot line for citizen complaints, controlled by a specially trained deputy attorney general. • More timely notification of the BMQA when a doctor has been charged with a crime, as well as when a hospital board revokes a doc- tor's privileges. • immunity for coroners and oth- ers from civil lawsuits when they re- port malpractice by a doctor. • Amedical-quality court with the standing of a Superior Court and an appeal channel to a select bench of the state Court of Appeal to replace the current system of administra- tive-law judge hearings with appeals to the court system. • Publication of all disciplinary actions. Fellmeth said the BMQA is "mori- bund" because it has not dealt with what he calls a "massive" problem of physician incompetence indicated by the numbers of malpractice judg- ments and disciplinary actions by hospital boards. • James Wheaton, a staff attorney for the center, which also has offices in San Francisco and Sacramento, said the system "is so slow ... that

death is weeding out incompetent physicians much faster than is the board." Fellmeth, Wheaton and the cen- ter's lobbyist, Steve Barrow, said they acknowledge that the vast ma- jority of doctors are dedicated pro- fessionals who deliver high-quality service. However, with 70,000 licensed phy- sicians in the state and 6,000 patient complaints annually, the report ques- tions why more licenses have not been revoked. Fellmeth reported 249 cases dur- ing 1987-88 in which hospitals denied or suspended physicians' privileges on grounds of medical incompetence. More than 700 physicians were hit with malpractice awards or judg- ments of more than $30,000 each dur- ing a ~riod when the BMQA revoked 27 licenses, 12 of them for incom- petence, the report said. It said that the BMQA sees its pri- mary task as rehabilitation of doc- tors who have made mistakes and that first-time offenders often are in- terviewed and warned. Instead, the report said, the board's primary role should be to protect the public, and it cited a backlog of 721 cases yet to be as- signed to the staff for investigation. Another 600 cases have been under investigation for six months, most of them top-priority cases in which'.' there could be public harm, the re- port said. The report received mixed re- views from Kenneth Wagstaff, exec- utive director of the BMQA. Wag- re say~ difficulty contacting the board, whose telephone number is not list- ed in some directories. And con- sumer calls are handled by people unschooled in law or medicine. • The board receives report~ on alleged criminal activity only if there is a conviction, and on ma!• practice allegatio:is only after a settlement or judgment too late, according to the center. The report's recommendations include · • Creanng a toll-fr e tele- phone number that patients can use o v01ce complaints, and set- tmg up a special unit m the Attor• ney General's Office to handle complaints. • Requiring that the board re- ceive notice of criminal accusa- tions at the time of arrest, and mal- practice claims at the time of fil. ing. • Raising doctors' license re- newal fees from the current $145 to $285 a year to raise more money for the program. . . • Creating a med1cal-quahty court with real judges to hear co~- plaints, a step the report said would shorten the process. The board would continue in existe1:ce as a rule- and standard-sf'.ttmg body for the medical professton. Fcllmeth srud the court could be staffed by Judges with both leg~I and medical backgrounds. He said doctor- v1tnesses could provide ey7 - pert testimony needed by the court

staff acknowledged that the lice revocation process is too slow - four to six years - and that during e administrative proceedings doctors continue to practice. He said that the BMQA has n trying to address the problems and that some of the recommendations in the report originated with the board. Wagstaff complained that the re- port used "exaggerated language and inflated data" and could "seriously mislead the public and alarm con- sumers about the quality of their health care." The 1'oard's confidentiality until formal charges are filed is a require- ment of law, Wagstaff said, and the process of conferences with doctors to discuss problems is a "profession- al review" established 10 law. "To claim that only 12 formal dis- ciplines for incompetence, or 42 cases where licenses are revoked or suspended, accurately reflects the impact of the board on physician practice is akin to saying that the only impact the highway patrol has on drivers is reflected in the number of convictions for drunk driving," Wagstaff said. Fellmeth said the American Medi- cal Association reported 10,000 physi- cians with alcohol or drug problems in California. Wagstaff said that the figure \'Jas unsubstantiated and that 210 doctors are in a confidential five• year diversion program.

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Santa Ana, CA (Orange Co .) Orange Co. Register (Morning Ed.) (Cir. D. 263,099) (Cir. S, 280 ,000)

Santa Cruz, CA (Santa Cruz Co.) Sentlnel (Cir. 5xW. 27,551) (Cir. S. 30,449) APR 6 -

989

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--~~--- " The system 1s so1icitous to phys,cians in the extreme, and I th nk the board doesn't make any secret about that ,, Robert Fellmeth director of Center for Pub 1c '1terest Law privileges suspended or revoked by hospitals because of drug im- pairment or incompetence, the r port said. • Currently, 721 cases consid- ered serious enough to be investi- gated have not been assigned to mvesllgators. Another 659 have been under investigat10n for more than six months without resolution, and another 1,000 are in backlog. • The discipline budget for physicians and other health protes- s10nals is less than one-third the level for attorneys, even though there are a comparable number of licensees and complamts 10 the two fields . • There can be a three-to-four- year period between the time the board receives a complaint and the time disciplinary action is taken The delay can be longer - six tD 10 years if the discipline 1s chal- lenged m the courts. • Patients who have com- plaints about doctors often have

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IX 1/ Medical discipline system

ribund' system

agreed that the system is slow af!d is hampered by a backlog, and sard the board would be seeking more staff to process cases. But he questioned some of the figures in the report, cautioned against altering the currei:t "peer review" system, and demed that the board had been overly lenient in disciplining physicians. In a six-page statement, Wag- staff argued that the board's influ- ence goes beyond the number of disciplinary actions it takes. "To claim that only 12 form~! disciplines for incompetence (m one year) ... accurately reflects the impact of the board 01: physi- cian practice is akin to saymg that the only impact the Highway P~- trol has on drivers is reflected m the number of convictions for drunk driving," he said Among other things, the report said that • Out of the approximately 3,000 complaints consider~ ser!- ous enough by the ~ard to mvesti· gate only 12 physicians were d1sc1- plin~d in the 1987-88fiscal year for incompetence-and five for drug or alcohol abuse. Discipline could consist of a license revocation or suspension, or just probation. • More physicians are con- victed of felomes each year, the report said. Far more 715 were on the losing end of malprac- tice suits in 1987-88 or agreed to settlements of $30,000 or more, and a ~d number, 249, had their

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coddles doctors, law center contends By Steve La.vrence / / The l¾SOciated Pre5i > 1-v/ SACRAMENTO - In a scathing report, a public-interest law center said Wednesday that the state's physician-discipline system cod- dles doctors, rarely takes disciplm- ary action and 1s clogged with un- resolved complamts . It called the system "essentially moribund" and urged creation of a medical-quality court to hear d1sci- plme cases mstead of the current physician-dommated board "The :;ystem 1s sohcitous to phy- sicians in the extreme, and I think the board doesn't make any secret about that," said Robert Fellmeth, director of the Center for Public Interest Law, which is part of the Univers1~ Diego. Fellmeth, who was involve~ in efforts to toughen attorney d1sc1- plinary procedures and serve~ as the State Bar discipline momtor, said at a Capitol news conference that the doctor-d1sciphne system is "very velj> s1ow ' Kenneth Wagstaff, executive di- rector of the Board of Medical Quality Assurance, which regu- lates physicians and other 15 other types of health professionals, L-------~---

agams~. altenng the current peer system, and demed ~at ~ad been_ ~verly leruent m disc1plinmg physicians. "What I am saying is when you look at the total pattern I do not lenient," Wagstaff told reporters after the press conference. "I think it could get stronger. I do not think In a six-page statement, Wagstaff argued that the board's impact on physician conduct (;oes beyond the number of disciplinary actions it "To claim that only 12 formal review the think the system 1s all that it's moribund." takes. one year) ... accurately reflects the impact of the board on physician practice is akin to saying that the only impact the highway patrol has number of convictions for drunk on drivers is reflected in the disciplines for incompetence (in

efforts to toughen attorney dis- ciplinary proced1:1re~ and serve_s as the State Bar disc1plmf'. ~orutor, also said the doctor discipline sys- tern is "very, very slow." "It operates by a Byzantin~ labyr- inth of separate step , which are duplicative and unnecessary," he said at a Capitol press conference. ''In the secret stage, it allows any of nine dilierent individuals to rec- closure of the ca e by Dutch-uncle speeches,, or Dutch-uncle con- Kenneth Wagstaff, executive di· rector of the Board of Medical Quality A urance, which regu- late phys1c1an~ and other 15 other agre d that the current system is slow and hampered by a backlog and said the board would be seek- ing more staff to process cases_ But h questioned some of the ommend and accomplish the ferences. type of health professionals,

tate·s phy c1an discipline system coddles doctors rarely takes dis· with unr olved complaints. It called the syst m "essentially moribund" nd urg d creation of a medical quality court to hear dis- cipllne e1, cs in t •ad of the current phy ic1an dominated board. "The y tern is sohcitou to phy • !clans m the extreme, and I think the board doc n't make any , ecret tor of the ~nter for Public t I.aw. which ts part of the about that," Id Robert Fellmeth, dlr Int_ purpo e of the y tern as rehabih t,,llon of phy 1cian ," fo'ellm th added "Although rehabilitation of b1 k, 1t should not be a preoccupa phy (clan i a proper tatutory cipllnary actlo~ and is clogged Un_!.versit "They an Di' o. openly d cribe th

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