California bill would allow patients to have a say in doctor discipline

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Tracy Dominguez often thought of standing in the lobby of the Medical Board of California and screaming. Maybe then she would be heard, she said.

Since her 23-year-old pregnant daughter Demi died in 2019 while in the care of a Bakersfield doctor repeatedly chastised for neglect, according to Medical Board Records, Dominguez fought to have her family’s grief considered in disciplinary hearings by the medical board. Instead, she said state law restricted her daughter to being referred to as “Patient 1” in documentation given to board members who discipline doctors. Her grandson Malakhi, born as Demi lay dying, was described only as “a 4lb 7oz baby boy”. in the case against Dr. Arthur Park.

In December, the medical board allowed Park to avoid an administrative hearing and surrender his license with the possibility of requesting reinstatement at a later date. Park could not be reached for comment on Thursday.

“It’s a tragedy that no family should have to go through and then they make it so difficult in the complaint process,” Dominguez said. “Our voices are not heard.”

Senator Melissa Hurtado’s (D-Sanger) Senate Bill 920 would change that.

For nearly three decades, California law prohibited the state medical board from considering victim impact statements in its decision-making. Instead, a person filing a complaint with the medical board can provide a statement to an assistant attorney general assigned to their case, but those words cannot be shared with the members of the board who ultimately determine what Discipline, if any, is warranted.

“People feel like they don’t have a say in the disciplinary process and they want to be able to have their say and be heard,” Hurtado said. “I don’t think they expect everything to change overnight, but it’s something they desperately want.”

Medical board member Eserick “TJ” Watkins said the current process allows the board – made up of eight doctors and five members of the public – to ignore the harms patients say they have suffered. It’s a criticism shared by patient advocacy groups who have for decades accused the board of being too soft on the doctors it regulates.

The Times’ own findings in July revealed that the board had always allowed doctors accused of negligence to continue practicing and harming patients, sometimes leaving them dead, paralyzed, brain damaged or missing.

“Right now, doctors have a lot more rights. After a patient makes their initial statement, they may as well walk away,” said Watkins, an outspoken critic of the board on which he sits as a public member. “We choose when to use the law. We resolve almost all cases. There are very dangerous doctors walking the streets.

Watkins said the board receives summaries of allegations from the state attorney general’s office, from which many details about a patient’s allegations are redacted. At the same time, Watkins said, the summaries provided to board members voting on disciplinary action often rely heavily on expert assessments hired by a doctor who comes under scrutiny. Physicians may also provide written or oral statements at an administrative hearing.

“And then I get a page of doctor’s honors, where they went to school and such,” Watkins said. “The doctor is the only human in the conversation.”

With the Medical Council mounting criticism, the agency sent legislative leaders an 11-page letter last month calling for reforms to help it discipline bad doctors, including lowering the standard of proof needed to prove cases. and increasing the wait time for doctors to apply to reinstate their revoked or abandoned licenses.

“These proposals have been developed because we are listening, we want to improve, these proposals will help us improve, and we need the help of the legislature to improve ourselves,” medical board chair Kristina Lawson said. in a recent interview, adding that she anticipates the agency. will consider additional legislative proposals this month stemming from Times reporting.

A spokesperson for the Medical Council said the agency would discuss how to involve patients in the disciplinary process at its council meeting next week. Watkins and patient advocates had called for statements from patients or their loved ones to be considered in disciplinary hearings, just as Hurtado’s bill proposes, but an analysis by Medical Council staff found a loophole in that. this approach last month.

The council’s role is to determine whether a doctor violated medical practice law, “rather than the impact the failure may have had on their patients”, according to a medical council staff report. Instead, the agency plans to create a “complainant liaison unit”.

Hurtado’s bill is the second agency reform proposal to be introduced in the state legislature so far this year.

Assemblywoman Akilah Weber (D-San Diego), who is an obstetrician, is the author of Assembly Bill 1636 asking the Medical Board to permanently bar physicians convicted of sex abuse on patients.

The bill came after a Times investigation found the board had reinstated 10 doctors since 2013 who lost their licenses for sexual misconduct. In one case, Bakersfield internist Dr. Esmail Nadjmabadi sexually abused a woman and then reported her to immigration officials in a bid to make her ‘unavailable’ to investigators, records show. of the Medical Council.

Five other patients — including one in her mid-teens — have spoken to police and state regulators about similar sexual misconduct by Nadjmabadi. In 2009, he did not contest a criminal charge of sexual exploitation by a doctor involving two or more women and the following year gave up his medical license.

Five years later, he successfully petitioned the Medical Council to be reinstated, a surprise to the women he abused.

“I read this article and my stomach turned. It’s the kind of stuff you see in horror movies,” Weber said.

AB 1636 is backed by the California Medical Assn., the politically powerful physician lobby group that patient advocates have long accused of impeding reform and shielding bad doctors from disciplinary action.

A spokeswoman for the lobby group declined to comment Thursday until it could consider Hurtado’s bill to allow victims’ voices to be included in disciplinary proceedings.

“It will be interesting to see how it goes,” Hurtado said. “I don’t know why anyone would be against it.”

Patients who have been victimized by doctors have said the SB 920 is indispensable.

Fabiana Ramirez Flores, who was sexually abused by Nadjmabadi, thanked Hurtado “on behalf of each victim”, for her interest in bringing about change.

Another woman, who asked The Times to identify her only by her initials, TT, said the bill would help future victims, but it’s too late for her. TT was a patient of Dr. Zachary Cosgrove when the two started dating. In 2006, he showed up drunk and barefoot at her doorstep. After TT reported Cosgrove to the human resources department of the clinic where he worked, he showed up uninvited and demanded that she call the clinic and say her complaint against him was false, according to the records of the Medical advice.

When she refused, Cosgrove told TT – who he knew was being treated for depression and an anxiety disorder – to kill himself because it would hurt her less than it was going to hurt her, records show. advice. Cosgrove lost his license, but was later reinstated without TT being able to intervene.

Reached by phone Thursday, TT said she supported the bill.

“For future victims, this will help,” she said. “That’s a good thing. But for those of us who are already affected? What can we do?”

Marian Hollingsworth, co-founder of advocacy group Patient Safety League, said she would be “pleased” to see the law amended to require counsel to consider victim impact statements.

It would give patients a voice, Hollingsworth said.

“You would have the chance to tell the doctor how they hurt you and your family and have that taken into consideration by the board, that’s a great thing,” she said.

Counsel’s failure to consider such statements when deciding cases “teaches victims that they don’t matter, that they don’t have a say, that it’s all about the doctor”, said Hollingsworth.

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