California Docs Must Now Tell Patients Where to Complain About Their Care

Practicing California doctors now have until June 27 to post signs in their offices or—if they don't have an office—to otherwise notify their patients in writing the name of the licensing agency to call with quality of care complaints.

The new regulation is designed to "inform consumers where to go for information or with a complaint about California medical doctors," according to a statement from the Medical Board of California, the disciplinary and licensing agency for the state's 125,000 doctors.

The wall notification must say, in bold, conspicuous type:

"The Medical Board's mandate is public protection, and this new requirement will assist patients by directing them to our Web site and our call center, where they can access very basic yet important information about our public services," says Medical Board President Barbara Yaroslavsky. "And it will take very little effort for physicians to comply."

The regulation has been over a year in the making, and is not popular with the California Medical Association, whose officials characterized the proposed rule as one that could erode the doctor-patient relationship.

Any of the state's 125,000 physicians who treat, test, or diagnose patients must comply with the rule.

CMA trustee Ted Mazer, MD, has been an outspoken opponent of the notification rule.

"The effort appears aimed at putting a wedge between patient and physician under the guise of improved consumer education," Mazer says. "Why then only physicians, rather than attorneys and other professionals having to tell new and existing clients in bold print who they should complain to?"

He adds that "if this were an even-handed effort for consumer protection, it would apply across the board, not just to doctors who need their patient's trust rather than suspicion. There are already numerous ways for consumers to find out where to report their concerns about doctors, without starting the relationship with a sign telling them how to report their doctor."

Mazer says "physicians will obviously comply with this poorly conceived regulation, wasting more resources on things that do not improve patient care."

Under the new rule, physicians must provide the notice in one of three ways:

• Prominently post a sign in an area of their offices conspicuous to patients.
• Include the notice in a written statement, signed and dated by the patient or patient's representative, and kept in that patient's file.
• Include the notice in a statement on letterhead, discharge instructions, or other document given to a patient or the patient's representative, where the notice is placed immediately above the signature line for the patient in specified type.

"The three options are designed to serve a multitude of practice settings, including emergency departments, skilled nursing facilities, and surgical settings," according to Candis Cohen, spokeswoman for the Medical Board.

California is not the only state with a posting requirement for doctors. Texas, Kansas, Georgia, and Idaho are among other states that have similar sign rules.

After more than a year in the regulatory process, the new rule stemmed from concerns by some board members and patient advocates that many patients injured by providers seek remedies through lawsuits without notifying the agency that could discipline physicians for that wrongful conduct.

Once the medical board files accusations against misbehaving doctors, they are posted on the medical board's Web site and may serve as a warning for patients who might choose those practitioners for their care.

Last year, one member of the medical board, Woodside plastic surgeon Mary Lynn Moran, MD, said that such signs are required for cabdrivers.

"It should certainly be expected of physicians to let the public know that they are held to a set of standards and regulated by the state," she said.