A 220 page report by the California Senate Committee on Business, Professions and Economic Development says than 635 physicians are currently on administrative probation.

Doctors were disciplined for allegations such as sexual misconduct with patients, performing surgery under the influence of controlled substances and health care fraud.

Although physicians must report their probation to their employer and insurance company, they are not obligated to inform patients.  And lawmakers are considering a change to that by requiring physicians to inform each patient that they are on probation.

Issue 28 of the report says that while it is true that important information is available on Medical Board of California (MBC) website, a key issue for the Committees remains how easily available it is for California patients to access easily understandable information about physicians who have been the subject of disciplinary action, placed on probation and are practicing. When the MBC places physicians on probation, generally they continue to practice medicine and see patients under restricted conditions. Terms of probation may include certain practice limitations and requirements, but most commonly physicians on probation are not required to provide any information to their patients regarding discipline taken by MBC.

A determination of probation is a step in a lengthy disciplinary process, conducted in accordance with the Administrative Procedures Act, and offering due process for accused licensees. In reviewing MBC data for current physicians on probation, proven violations that result in probation include gross negligence or incompetence, substance abuse, inappropriate prescribing, sexual misconduct or conviction of a felony.

Probationary status is not secret. MBC only orders probation for a licensee once multiple steps in the life of a case have been taken. Probation is not loosely issued for suspicions or complaints or facts gained during an investigation that lead to the filing of an accusation for which clear and convincing evidence is present.

And the report says that patients may be especially deserving of greater access to information about a physician on probation given the potential for future disciplinary action. The 2008 CRB study reported that physicians who have received serious sanctions in the past are far more likely to receive additional sanctions in the future. According to the CRB report, “These findings strongly imply that disciplinary histories provide patients with important information about the likely qualities of different physicians.”

According to MBC data, there are currently 635 physicians on probation (this includes those issued a probationary license at application and those with an out of state address of record, for a total of 497 on probation with an address in California, 83 on probation with an address in another state, 38 with a probationary license with an address in California and 17 with a probationary license with an address in another state.) The Appendix to this report starting on page 70 is a listing by name, location and type of offense of those physicians and surgeons currently on probation.

It would be interesting to review the 635 names to see how many of them currently treat i worker’ compensation cases or are members of an approved MPN.

In October, 2012 MBC staff made a proposal to the MBC to require physicians to inform their patients when the physician is on probation and required to have a monitor. In its recommendation staff said, “This would insure the public has the ability to make informed decisions regarding their healthcare provider.” MBC did not approve the staff proposal.

Jerry Hill is Chair of the Committee. He says patients need to be able to make appropriate health care decisions.

“There is no one watching or overseeing the physician to make sure that those terms of probation are being followed,” Hill says. “It meets and requires, and I think, it mandates that the patient takes responsibility for their own health care in this case.”

The committee recommends amending current law to require physicians to tell their patients they’re on probation.

A legislative committee will review the report.