Bill misses point on patient access
Few dispute that getting access to a doctor is one key ingredient to staying healthy and tackling illnesses and injuries before they turn into bigger problems.
As a trauma surgeon at a public hospital, I am passionate about treating the underserved. The majority of my patients are uninsured or on Medi-Cal.
Improving patients' access to care is a top priority for the California Medical Association and is one reason it supported a pilot program allowing rural hospitals to directly hire physicians to treat underserved patients.
This program provides hospitals in areas with a recognized shortage of physicians a temporary exemption from the state's long-standing ban on the corporate practice of medicine, as long as at least 50 percent of their patients are underserved and other provisions are in place that ensure doctors' medical decisions can't be influenced by hospital corporate interests.
But now, hospitals are pushing to expand the program without the same requirement for treating the underserved. The measure -- Senate Bill 726, by state Sen. Roy Ashburn, R-Bakersfield -- has passed the Assembly and is now awaiting a Senate hearing.
That's one of the fundamental problems with SB 726 that must be changed to win CMA's support. Unfortunately, that's not what the vocal proponents of the bill -- hospital districts and labor unions -- want to hear.
Instead of addressing the shortcomings of the legislation, proponents are attacking CMA with outlandish accusations. This reached a new low in a recent blog by the bill's primary sponsor, the Association of California Healthcare Districts, that alleged CMA is a "formidable foe" to patients on Medi-Cal and is fighting SB 726 for "protection of profits."
The charges are absurd. The No. 1 priority of physicians is the welfare of their patients. That is what the ban on the corporate practice of medicine is all about -- preventing hospitals or any other financial interests from influencing a physician's judgment about medical treatment.
Private-practice doctors are the backbone of the Medi-Cal delivery system, along with doctors at community clinics and public hospitals. They do all they can to treat Medi-Cal patients, but there are only so many most doctors can see without taking a financial loss and jeopardizing their practices because government reimbursements are so low.
That is why this legislation is so critical. If passed as is, SB 726 would allow hospitals to expand their medical staffs and cherry-pick what patients they serve -- there would be no mandate to treat the underserved -- and so it would further erode the safety net.
This would be bad news for counties like Kern County, which has 125,000 residents who are uninsured and 216,402 who are on Medi-Cal.
CMA supported the original pilot program and favors its expansion. CMA backed SB 726 in the form it was passed by the Senate last summer.
Proponents of the bill should quit slinging mud and face reality: Doctors will support the legislation if it provides the proper guarantees it will improve access for underserved patients and allow physicians to do their jobs, without hospital interference.
Dev GnanaDev, M.D., is a trauma surgeon and medical director at Arrowhead Regional Medical Center, which is San Bernardino County's public hospital. He is immediate past president of the California Medical Association.
