California quacks, look out. As of July 1, the Medical Board of California now has unlicensed practitioners in its sights with its revitalization of "Operation Safe Medicine."
The team of four investigators plus staff will focus full-time on unlicensed practitioners, especially those from Mexico or "Hollywood-culture doctors from other countries" who try to sell unapproved procedures and treatments, says medical board spokeswoman Candis Cohen.
Many of the unlicensed practitioners "prey on sick and desperate patients," many of whom have low income, she says.
"Because of its underground nature, it's impossible to know the extent of the problem in California," Cohen says. Investigators believe that with those so far discovered, "we are just scratching the surface. We need more patients to come forward."
The board licenses 125,000 physicians. After lengthy investigations verifying allegations of misconduct, the board refers those doctors for discipline through the state Attorney General's office.
With this office, the board now has a team dedicated just to systematically finding and stopping unlicensed practitioners, especially those who have the potential to harm patients.
Many of the illicit treatments include unlicensed drugs or herbal remedies from other countries or surgical "cosmetic" procedures geared to changing one's physical appearance. And, many of the illicit practices have been found in Los Angeles and surrounding areas, Cohen says.
"Many in the physician community in California have been horrified at the disfigurement they have seen at the hands of unlicensed individuals," Cohen says.
Examples of recent cases that have come to the board's attention include these unlicensed and often, untrained, practitioners:
- A woman who dispensed non-prescription drugs she injected in women in the bathroom of a swap meet. One of her victims died the following day at home.
- A man who performed breast augmentation procedures resulting in severe infections and disfigurement in his patients.
- A female who injected corn oil into victims' buttocks. One almost died from a fat embolism.
- A man who administered vaccinations, allegedly as part of an immigration process, but the vaccines turned out to be saline injections, thus failing to protect a larger population.
- A practitioner in a laser clinic who was allowed to work with insufficient supervision who burned his patient.
- An individual who used the wrong device to remove a tattoo, and instead branded the patient.
The practitioners lack qualifications and training, and their care all too often results in "dangerous reactions and infections from faulty diagnosis, untreated disease, health complications and even deaths," the board said in its recent newsletter.
Cohen says that in the past, unlicensed activity has taken place in beauty shops, private homes, even doctors' offices "as when doctors aid and abet the unlicensed practice of medicine because they don't want to pay an assistant who is licensed."
In an effort to prompt more patients to be aware that physicians can only practice in the state if they are licensed by the board, the agency now seeks approval to require all practicing physicians to notify patients they are licensed.
Physicians have three ways to comply. They can post a sign in their offices, include it in a written notice signed by the patient, or include the notice in routine statement, such as discharge instructions, that require the patient's signature. The rule is sought so more patients will know there's a state agency ready to receive their complaint. That option is not as clear with an unlicensed provider from outside the state or the U.S.
The new Operation Safe Medicine office, which will cost about $600,000 a year and be paid from licensed practitioner fees, is actually being reestablished from a similar operation that began in 2000.
During portions of 2001, 2002 and 2003, board investigators caught 146 unlicensed practitioners, whom they referred for discipline to city and district attorneys for criminal felony and misdemeanor prosecution.
"The OSM had become an effective mechanism for dealing with unlicensed activity and the so-called backroom clinics in the Los Angeles and Orange County areas," the board said in a recent newsletter.
But as sometimes happens, the unit had to close in 2003 because of budget shortages. Investigators were transferred to traditional units in which investigators looked into problems involving the state's licensed physicians.
Because of OSM's previous success, however, the board voted in 2007 to reestablish the unit, but it took 18 months to gather data and submit a budget change, Cohen says.
"The Medical Board is pleased that with the reestablishment of OSM we may once again proactively protect the public against the unlicensed practice of medicine," says executive director Barb Johnston. "This unit is staffed by highly trained, Medical Board investigators who are solely dedicated to stopping and preventing the unlicensed practice of medicine and the corporate practice of medicine."
The board is establishing the revitalized team in Rancho Cucamonga, in Southern California, first but hopes to soon have a Northern California office as well. However, the renewed OSM office will be in place only for another two years and will require the board to justify its continuation to the Department of Finance.