Doctors Don't Have to Tell Patients They're on Probation, Except in One State

California is the first state to require physicians to inform patients about their history of sexual misconduct, overprescribing medications, criminal convictions or substance abuse. Will others follow?
by | January 2019
(AP)

After failing for two years to get legislation passed requiring doctors to alert their patients if they’ve been placed on probation for misconduct, it would have been easy for California state Sen. Jerry Hill to give up. The California Medical Association had lobbied hard against Hill’s bill. But that was before the #MeToo movement and the national attention to the case of Larry Nassar, the USA Gymnastics team physician who was sentenced to prison after being accused of sexually abusing hundreds of young female athletes.

After some of those athletes testified in favor of Hill’s bill, California’s first-in-the-nation Patient’s Right to Know Act passed in August and was quickly signed into law by Gov. Jerry Brown. It will require doctors to tell patients if they’ve been disciplined for sexual misconduct with patients, overprescribing medications, a criminal conviction involving harm to patients, or drug or alcohol abuse.

The California law has given patients’ advocates hope for similar legislation in other states. Currently there is no national standard in place to alert patients if their doctors have been placed on probation; usually only insurance companies and the health-care systems that doctors are affiliated with are informed of such disciplinary actions. There are online databases for a patient to check on a doctor’s probationary status, but that puts the onus on the patient to seek out the information.

Hill says he first became interested in the idea of a more proactive system of alerting patients after reading about an Orange County, Calif., doctor linked to 16 overdose deaths who was simply placed on probation and allowed to continue practicing. It seemed absurd to Hill that there wasn’t a better system to alert patients about such incidents, particularly since a study by the California Research Bureau had found that doctors who had been placed on probation were 30 percent more likely to re-offend.

How the law will be implemented when it goes into effect this July is being worked out, but Hill imagines that when a patient goes to a doctor’s office, the paperwork will include a form listing the terms of a disciplined doctor’s probation. There also is expected to be a website and phone number where a patient can learn more about the accusations against a doctor.

Before the bill passed, Eli Adashi, a former dean of medicine at Brown University, wrote in the Journal of the American Medical Association about the gravity of the measure and the unlikelihood that it could be enacted. The medical community’s argument was that the legislation would put an unnecessary shadow over a doctor’s practice and could put rehabilitated doctors out of business. But as political momentum for the legislation built, the Medical Board of California got behind it and the California Medical Association adopted a neutral position.

Hill says he hasn’t heard from lawmakers in other states about adopting a similar law, but he warns that such efforts are likely to encounter the same kind of opposition from state medical associations as his bill drew at first. For his part, Adashi says that it might take a few years before other states move in California’s direction, but “we make a special effort to look at California, because it tends to be a hotbed of interesting ideas.”

Adashi admits that he was surprised at the passage of Hill’s bill, but that “it was a right-minded effort. The right to know is an important concept, and we are all patients at one point.”