Physician Lawyers (925) 283-1863
What is the Medical Consultant Program ?
- The Initial Complaint
The Medical Board of California has a unit called the Central Complaint Unit (CCU). This unit located at 2005 Evergreen Street, Suite 1200 Sacramento, California 95815 s the unit that processes the Consumer Complaint Form. Frequently a release of information is also provided by the patient. If you get an administrative subpoena from the board, you are likely in phase one of the investigation process.
2. Categories of Physician Complaints
The Board categorizes most complaints as quality of care (gross negligence, negligence or incompetence), prescribing, physician conduct, impairment, unlicensed practice or sexual misconduct. This article focuses on the quality of care analysis.
3. Levels of Medical Negligence
The Board defines Gross Negligence as an “extreme departure” from the standard of care. Negligence is any action below the standard of care but not “extreme”. A single negligent act will not lead to discipline. Incompetence is an inability to function at a level of care as compared to gross negligence where the ability to function may exist but there was a departure from the normal standard. There are no clear standards to differentiate gross vs. ordinary negligence. In fact, the result may drive the finding. If the recommendation is to move forward the negligence is “gross”. It is the choice of outcome that determines the label. The reviewer’s recommendation is basically “round file” – “investigate”.
Who Are These Physician Consultants ?
Physicians are utilized as “consultants” by the Board’s Central Complaint Unit (CCU) to review incoming complaints. Business and Professions Code § 2220.08 requires review by an expert before a quality of care complaint can be handled by a field office for further investigation.
Government Code § 6254(f) protects these reports so that neither the doctor nor the complaining entity knows its author or contents. So to whom do we delegate such awesome power ?
The “Star Chamber” quality of this process is addressed by rules requiring objectivity. In our experience there is a very wide level of competence and objectivity in the reviews. The board requires that the medical board reviewer have a valid and unrestricted medical license issued by the Board with no complaints within the last three years, no pending accusations, or prior enforcement or disciplinary action. The board prefers but does not require qualifications that are clearly minimal, at best.
1. Current, active practice or have been non-active or retired for fewer than five years; or a minimum of three years in practice; (in other words, almost anybody)
2. Board certified or with Peer review experience.
The pay is abysmal. The doctors are “independent contractors” so they get some tax write offs but no benefits. They keep $ 75.00 per hour for record review or report preparation. We have often looked for the fly on the wall to see just how many minutes constitute a $ 75.00 per hour / hour. Working Monday – Friday without a single day vacation, this works out to
$ 154,000 per year. Realistically, few top doctors are going to work at these rates. We know of a few. Some are semi-retired and do the work because it is interesting. Others are dedicated to public service. By analogy, many judges earn less than $ 200,000 a year. In private practice they could earn many multiples of that amount. Their choice to be a judge is in most cases truly a decision to serve the public. With those caveats, in reality, the review process is a sham and it is politically driven as much or more than it is medically driven.
The takeaway is this. The minute you get a record request you are a process that is unlikely to broadly view all of the issues in an objective manner. Absurd complaints will be round filed but your definition of “absurd” will be far different than the view of a medical reviewer. The minute you need complexities, explanations or clarifications – you can assume that the investigation will proceed. This is the time to line up your ducks in anticipation of an interview with another board doctor, an investigator and often a member of the Attorney General’s office. That is the time to shut down the investigation – if you can.
If you receive a board subpoena of any kind, call our California medical license lawyers at (925) 283-1863. You will reach a real person in the office if you call during business hours. Alternatively, fill out the initial form below (Click on Emergency) and we will contact you within a few hours.