Larger Type Proposed for CA Med Board Posting Notice

Cheryl Clark, for HealthLeaders Media , April 24, 2009

If a Medical Board of California proposal is approved next month, California doctors will soon have to post a sign in 48-point Arial type in their office:


Medical doctors are licensed and regulated by the Medical Board of California
(800) 633-2322

The 48-point type requirement is twice as large as originally suggested. The larger type is "more legible and easier to read," says board spokeswoman Candis Cohen.  

The controversial posting requirement’s exact language was released on Thursday and the board will consider the change at its May 8 meeting.

The proposed notification also requires physicians to include this information in a written statement that is signed and dated by the patient or the patient’s representative, and retained in that patient’s medical record, stating the patient understands the physician is licensed and regulated by the board.

Also, physicians will have to include the notice in a statement on letterhead, discharge instructions or other document given to a patient or the patient’s representatives, "where the notice is placed immediately above the signature line for the patient in at least 14-point type."

The added stipulations are intended to inform patients of physicians, such as emergency room doctors, pathologists, and radiologists, who do not usually see patients in office settings.

The board's staff has proposed this requirement in the belief that too few patients know where to file complaints if they’re not happy with care. Many think the only recourse they have is through the courts, and that may cost money upfront, board officials point out.

The Medical Board of California licenses and disciplines 125,000 physicians in the state, although a national patient advocacy group, Public Citizen, recently criticized the board for having one of the lowest track records for censuring physician practices in 2008.

California Medical Association officials and many physicians throughout the state say they fiercely fight the requirement because they believe it unnecessarily sours the relationship between the physician and the patient from the start.

California Medical Association trustee, Ted Mazer, MD, objects to the notification proposal saying it is more strict than what had been previously discussed. The prior proposal did not suggest that the physician would have to have patients sign such notices indicating they had received the information and place those signed documents in the patient's chart.

Also, the proposal previously required the sign's type to be half as large.

"The latest changes are quite worrisome and go well beyond simple patient education," Mazer says. "Please show me any other regulated business or profession that is required to so notice its customers of who to complain about them to, beyond a sign on the wall or window about the regulating agency."

The San Diego physician adds, "If the problem is that patients who fail to educate themselves [about their option to complain to the medical board] before seeking an attorney—which then might result in costs for litigation—perhaps the onus should also fall on the attorneys. Why shouldn't the attorneys be required to advise the potential client about the use of the MBC before they take a dime from the patient and begin court action?"

CMA representatives also say they don't think the posting requirement will do any good. It shifts to physicians the responsibility of educating patients about the existence of the medical board, which they say is the medical board's job, not the doctors' responsibility.

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