State Board Grants Wide Access to Data on Doctors : Disclosure: Information includes malpractice judgments, felony convictions, loss of hospital privileges.

By VIRGINIA ELLIS

May 8, 1993 12 AM PT

TIMES STAFF WRITER

SACRAMENTO — For the first time, the California Medical Board agreed Friday to give patients access to a broad array of information about their doctors, including legal and disciplinary actions for poor medical treatment.

The physician-dominated board voted to give consumers information about their doctors, ranging from malpractice judgments exceeding $30,000 to felony convictions to loss of hospital privileges. The board’s staff is expected to begin making the disclosures by midsummer, although whether the information will be available over the phone or in writing is undecided.

The 9-4 decision, which gives California one of the most liberal physician disclosure policies in the nation, was a dramatic departure from the board’s current practice of revealing only the status of a doctor’s license and any recent disciplinary action taken by the medical board.

It was a major victory for Gov. Pete Wilson and consumer advocates, who have pressured the board for months to allow wider disclosure of information about doctors. The California Medical Assn. opposed some of the new disclosure provisions.

Calling it the first “shred of true consumer protection” approved by the board in recent years, consumer advocate Julianne D’Angelo said the decision showed that the panel had finally recognized the vast changes that have occurred in the doctor-patient relationship in America in the last few decades.

“In our health care setting today we don’t have Dr. Marcus Welby, who has been a physician we have known for years,” said D’Angelo, supervising attorney for the University of San Diego’s Center for Public Interest Law. “We go to an HMO and we might not know who we are going to see. We need quick information on doctors and we are entitled to quick information on doctors from the public agency that is suppose to protect us.”

The panel’s action was the most controversial part of a package of doctor disciplinary reforms that had been advocated by the Wilson Administration, several board members and Dixon Arnett, its newly appointed executive director.

The board also voted to establish a rigid system of priorities for handling doctor disciplinary cases and to give itself the power to levy fines and issue citations and public warnings against physicians who are found guilty of minor infractions. This would give the board a wider range of tools for reprimand short of revoking a medical license.

By establishing priorities, Arnett said, the board would be able to concentrate its financial and staff resources on the most egregious complaints rather than waste them, as critics have often said, on the least serious ones.

“We don’t have enough money, energy or ability to deal with everything. . . . We have decided to go after the most terrible (physicians) and put them out of business and not spend our time piddling around with complaints that some doctor was late for an appointment,” he said.

Arnett acknowledged that many of the changes were designed to improve the agency’s public image and to make it more efficient.

For years, the medical board has been criticized by the Legislature, the courts and patients groups for failing to adequately protect consumers from bad doctors. In January, the California Highway Patrol found after an investigation that top managers on the board’s staff had ordered the arbitrary dismissal of hundreds of cases in an attempt to erase a backlog.

Arnett said most of the board’s action Friday involved broad policies; the details will have to be fleshed out in the next several months.

One of the issues to be ironed out, he said, will be whether all the disclosure information is to be made over the telephone or if some of it will be made only in writing.

The disclosures will be made to anyone who asks. They will contain final decisions or judgments, including past disciplinary history in California as well as other states. Pending complaints, investigations and lawsuits will not be covered by the new rules.

D’Angelo said the board will need legislative approval before it can disclose information provided by hospitals that have revoked a doctor’s privileges. But she said the board could make the other disclosures without legislative action.

Several of the board’s decisions were made over objections from the CMA, the state’s largest physician organization.

Tim Shannon, a lobbyist for the CMA, told the board that the organization was concerned about disclosures that might unfairly tarnish a doctor’s reputation. He said it was especially worried about the proposal to disclose malpractice judgments, which he said sometimes gave an inaccurate picture of a doctor’s ability.

He said the courts can often issue judgments against doctors while the medical board looking into the same set of circumstances might find nothing wrong.

His concerns were echoed by some members of the board, who said they also feared that if actions against a doctor’s hospital privileges were made public, it might discourage hospital review committees from taking action.

Madison Richardson, a Los Angeles physician, said the committees would still take action against the very bad doctors but that they might become reluctant to discipline borderline doctors for fear that disclosure would ruin their reputations.

But Gayle Nathanson, a public member of the board and co-author of the proposal, said the need for consumers to have more information about doctors overrode the concerns about physician reputations.

“If I’m making a determination as to what to do about my life and my children’s life,” she said, “I want to know everything (about my doctor).”