The accreditors are paid by the surgical centers to issue their seals of approval, a flagrant conflict of interest that gives the accreditors a financial incentive to go easy. For a time, centers that lost accreditation from one of the four often could simply acquire approval from another, no questions asked. After I exposed the practice in a series of columns in 2010 and 2011, legislation by Price ended that sort of bed-hopping.
Price's measure required the board to collect information about every one of those centers, including the identity of their physician owners and their accreditation histories. The data were to be posted on a website so consumers can know exactly who they're dealing with when they go to these non-hospital settings for operations. Yet according to a study by Consumers Union, two-thirds of the listings still don't identify a doctor-owner; 30% of the listings don't provide the required accreditation records.
The board has yet to take its oversight of surgical centers seriously. "We don't regulate the [surgical] settings," Levine told Price and Gordon. "All we can do is regulate the agencies that accredit."
This is also 100% wrong. Here's what the law says: The Medical Board "may enter and inspect any outpatient setting ... at any reasonable time to ensure compliance with, or investigate any alleged violation of," the California health and safety law. If the inspectors don't like what they see, they can ask the attorney general or a local district attorney to act to shut down the place.
Most amazingly, Levine told the lawmakers that her board's members "have a keen interest in understanding the process of accreditation and in learning what the differences are among the four (organizations) in terms of their process, procedures and criteria for accreditation." Accordingly, they invited all four to make presentations on these topics last week.
Wrap your mind around this: The medical board has had legal authority over the accreditation process since 1996. It has been relying on these organizations for its regulation of outpatient centers performing major surgery since 2007 — six years ago. And they just got around to inquiring how accreditation works last Thursday?
It was after Levine's appalling performance in March that Price and Gordon raised the prospect of letting the sun set on the current board and its executive director, Linda Whitney. If that were to happen, they would be tossed out of their jobs Jan. 1 to make way for newly appointed individuals. State laws governing licensing and discipline would remain in effect and the board's staff would remain employed.
Not everyone thinks the change would be ideal. Fellmeth observes that the risk of sunsetting is that it will put inexperienced people in place — it might be better to leave the somewhat experienced people on the board "and push them to do better."
The most effective change, she says, would be to move all of the board's investigators over to the attorney general's office to provide consistent enforcement. That's an idea that has been under consideration since 2005, and just last week was added to a regulatory reform bill sponsored by Price. The board opposes the change.
But a drastic overhaul plainly is needed. All healthcare stakeholders are harmed by a do-nothing and know-nothing board. Good doctors should be incensed that the board allows bad doctors to continue practicing, sullying the reputation of the entire profession. Bad medicine drives up costs for insurers, who pass them on to their customers. And patients are more at risk of physician-caused injury and death.
This board has been comatose so long it's beyond resuscitation. Pull the sheet over its eyes and notify next of kin. The idea of sunsetting the board and starting over is the right one. The only question Californians should be asking is: Do we really have to wait until January?
Michael Hiltzik's column appears Sundays and Wednesdays. Reach him at email@example.com, read past columns at latimes.com/hiltzik, check out facebook.com/hiltzik and follow @latimeshiltzik on Twitter.