September 09, 2013
California legislators are currently considering a bill, SB 670 (Steinberg), that would increase the likelihood that limitations will be erroneously placed on a physician’s ability to practice. SB 670 allows the Medical Board of California to use a significantly lower standard of proof – ""probable cause"" instead of the more reliable ""clear and convincing evidence"" – to determine if a physician's prescribing of controlled substance is a danger to patients and the public. This reduces the level of evidence needed to justify placing a serious limitation on the physician’s license.
The use of this lower ""probable cause"" standard in the Medical Practice Act is unprecedented. No other health care professional, including others allowed to prescribe, order, furnish or dispense controlled substances, are subject to a similarly low standard.
SB 670 can destroy a physician’s ability to practice. Any limitation on a license, even a temporary one, can impact a physician’s ability to contract with payors or to maintain medical staff privileges, eviscerating a physician’s practice and livelihood. Limitations that are ordered based on weak evidence and incomplete investigations are more likely to be overturned, resulting in wasted time and resources with no improvement to public safety. Most importantly, the limitation undermines patients’ continuity of care.
The majority of people who abuse prescription drugs do not get them from a prescription. While the California Medical Association recognizes that there are a few physicians who do not prescribe appropriately and should be disciplined by the medical board, that discipline should be pursued when negligence is clear, not just probable. Facilitating unfair punishment that does not allow for sufficient due process hurts physicians and their patients.
Physicians are eager to be partners in the effort to address misuse of prescription drug abuse, but taking away physicians’ rights is not the solution.