Pilots, college athletes, bus drivers and Disneyland cast members all are subjected to mandatory drug testing, but not the doctor performing open heart surgery, or a vasectomy. Not yet.

Substance abuse among doctor runs twice as high among doctors as the general population — 18% of physicians according to the California Medical Board. It’s no wonder, they can deal their own drugs.

It’s time for the change medical experts have been calling for a while. To make the case, this short, funny musical video “Pee In The Cup Part I” will be circulating around Disneyland on a mobile billboard this weekend, where the California Medical Association is convening.

The medical association’s confab in the magic kingdom is a perfect metaphor for the fantasyland the state’s medical establishment has been living in when it come to threats to patient today.

Drug overdose deaths, for example, are the leading cause of accidental death in America, according to the Centers for Disease Control. Nonetheless the golden state’s medical lobby worked hard in the legislature this year with the drug companies to keep the narcotics flowing without accountability.

Governor Jerry Brown recently vetoed a simple bill sending coroners’ reports about prescription drug overdose deaths to the state medical board because the doctors undermined it.  Legislation mandating that doctors check the electronic prescription drug database, known as CURES, about a patients’ history before prescribing narcotics didn’t make it out of the California Senate because the medical association stopped it.  A much-anticipated medical board overhaul, moving investigation of dangerous prescribers to the attorney general, never materialized because of the medical lobby’s opposition.

The only prognosis is that while today’s doctors are dealing with modern problems the medical association is still stuck in Walt Disney’s 1950s mentality that physicians should never be told what to do or have anyone looking over their shoulder, even if it’s a coroner.

Consider substance abuse among doctors. Nearly two in ten doctors abuse drugs and alcohol.

Yet the medical association has long sought to coddle physicians who abuse alcohol and drugs with a now discredited “diversion” program that withheld discipline and accountability for doctors if they went to rehab. After decades of abuse, and revolving doors, the California legislature finally pulled the plug.

Still, drunk and high doctors face little real discipline thanks to the slap-on-the-wrist physician discipline system the medical association has lobbied hard to maintain. Recently, a meth-using doctor convicted of drug dealing got his license back after one year.  A schoolteacher, police officer or lawyer would lose their credential, badge or license.

As a dramatic Los Angeles Times investigation recently showed, prescription drug overdoses are becoming all too common, particularly among teenagers and young adults, as a cadre of “pain management” doctors gets rich over the corpses.  What’s shocking is how the medical association fights in the face of such a scandal to protect the small minority of dangerous and dirty doctors that cause the vast majority of harm.  Stunned families who lost loved ones need only look to Disneyland for some answers.

Drug makers ply top physicians with lavish gifts, exotic seminars and fancy lunches, buying not only prescriptions of their products but political clout.  Is that why the white coats were the drug industry’s cover in the capitol to keep the drugs flowing without requiring physicians to check whether they are prescribing to addicts?  

Kaiser Permanente, which reportedly pays a huge check to the California Medical Association each year for the dues of its thousands of doctors, wields great power over the association too, including employing its current president. Is that why CMA’s doctors are the main opponents of reforms Kaiser and health insurers don’t like, such as a 2014 ballot measure to regulate health insurance rates through the same successful regulation that now applies to auto insurance and home insurance rates?  (A ballot measure I authored and my consumer group qualified for the ballot.)

One father, who lost two young children to an addict’s driving and reckless prescribing, has had enough. Bob Pack created the CURES electronic database only to have to fight the medical association for its funding and use.  He is now circulating a ballot measureto require mandatory drug and alcohol testing for doctors, force doctors to check the CURES database before prescribing narcotics, and to index for inflation a 38 year old cap on malpractice victims’ recovery.

Nothing is likely to shake the House at Disney so much as having to pee in a cup. After this year’s legislative debacle, it’s high time someone like Pack bring the medical association back to earth.

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Jamie Court is the president of the nonprofit, nonpartisan group Consumer Watchdog and a backer of the Troy and Alana Pack Patient Safety Act. Originally posted on the Huffington Post on October 10, 2013

Governor Jerry Brown waited until late Friday to veto legislation requiring coroners to report to the medical board whenever narcotics cause deaths. The medical establishment has opposed the bill, which is aimed at weeding out the small number of dangerous and drug dealing doctors who are responsible for the vast majority of prescription drug overdose deaths.

Brown cited state costs as his reason, but it just doesn’t add up.  The bill would have cost no more than hundreds of thousands of dollars. The power of the medical establishment is the real motive here, and their distaste for any accountability or transparency.  The arrogance of medical-pharmaceutical complex is astounding, but what’s really disturbing is that they have Jerry Brown’s ear and pen.

The Los Angeles Times did a groundbreaking investigation of prescription overdose deaths and dirty doctors based on obtaining coroner reports like the ones that SB 62 would have required to be reported to the medical board. The fact that such a simple measure cannot get past the governor’s desk shows why we need to go to the ballot with the Troy and Alana Pack Patient Safety Act, which requires mandatory drug testing of physicians and other patient safety measures.

Drug testing physicians is not only critical to protecting the public from substance abusing doctors, but it is also remedies another epidemic — the belief by the doctors lobby that they are above it all.  Make them pee in a cup and some of the arrogance we have been witnessing in response to common sense measures like SB 62 will be reduced too.

After today, it might be wise to make Governor Brown pee in a cup too. The loss of judgement and clarity in the deliberation of SB 62 makes one wonder.

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Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

A drunk Orange County plastic surgeon reportedly disfigured at least a half dozen patients before losing his license. A Rocklin anesthesiologist was arrested for taking anesthesia through an extra IV line while administering it to a patient.  A meth-using doctor who was convicted of drug dealing will get his doctor’s license back after a year.

Does your doctor oppose mandatory drug testing for physicians? Check the list.

Substance abuse among California physicians is higher than the general population, yet unlike bus drivers and pilots, physicians don’t have to take drug tests.  A proposed patient safety ballot measure requires mandatory drug testing of physicians, but a group of doctors is raising big bucks to stop these and other common sense patient safety measures.

Consumer Watchdog has published the list of doctors across the state who have given money to the opponents of the Troy and Alana Pack Patient Safety Act. We think patients should know if their doctors are standing in the way of their safety and will be sharing the list with millions of Californians.

Troy, 10 years old, and Alana, 7, were hit and killed by a drug abusing driver prescribed thousands of pills by negligent physicians. Their dad, Bob Pack, is the author of the ballot measure to create mandatory drug testing among physicians, require doctors to use an electronic prescription drug database and modernize patient safety laws.

Check the list and ask your doctor if he or she opposes modest patient safety reforms.

It’s time for the medical establishment to explain why it is resisting common sense solutions to weed out the small number of dangerous and dirty doctors that commit the vast majority of medical malpractice.

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Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

Ten doctors that the California Medical Board failed to take off the streets before repeated acts of negligence and patient endangerment harmed or killed their patients make the case for reforming California’s patient safety laws, said Consumer Watchdog today.

Consumer Watchdog released a “Top Ten Dangerous Doctors” list of physicians whose negligence injured or even killed their patients.

These ten dangerous doctors are some of the most egregious overprescribers, repeat offenders, and drug and alcohol users in California. Their stories show the urgent need for action by California lawmakers to replace a Medical Board that has allowed bad doctors to continue to practice, and to raise the outdated cap on patients’ ability to hold negligent doctors accountable in court.

Last month, Consumer Watchdog joined the 38IsTooLate.org coalition to announce a patient safety ballot measure that will raise the cap on damages in medical negligence lawsuits and require physicians to check a prescription drug database before prescribing narcotics. The coalition, including Bob Pack who lost his two children to a drug addict who was overprescribed narcotics, will place the measure on the ballot if the legislature fails to enact patient safety reform legislation this year.

The “Top Ten Dangerous Doctors” who make the case for patient safety reform include:

• Dr. Van Vu and Dr. Carlos Estiandan, identified as over-prescribers in a Los Angeles Times investigation and who together had at least 25 patients die from prescription drug overdoses. Neither has lost their medical license.
• Dr. Aria Omar Sabit and Dr. Israel Chambi, neurosurgeons who together have had at least 55 medical malpractice lawsuits filed against them. Chambi continues to practice despite 10 malpractice settlements and having lost his post at two medical centers. No action was taken against Sabit after he moved his practice out of state.
• Dr. Craig Alan Bittner, Dr. Efrain Gonzalez (and his wife Dr. Yessennia Candelaria), all physicians who practiced cosmetic surgery with no formal training. The three had their licenses suspended or revoked by the Medical Board only after arrests had taken place and at least 21 of their patients were severely disfigured.
• Dr. Brian West and Dr. Daryl Westerback were each arrested twice for driving under the influence of alcohol or prescription drugs. West did not lose his license until nine years after the first complaint against him and being arrested for drunk driving on the way to treat a patient. Westerback, who is accused of treating patients while under the influence, lost his license to prescribe but continues to practice.
• Dr. Andrew Rutland had his license revoked a decade ago after the deaths of two infants and 15 malpractice claims, but was reinstated five years later. Rutland lost his license again in 2011 after being found responsible for another patient death.
• Dr. Shane Sheibani, a plastic surgeon who left dozens of patients disfigured, had his license suspended in 2009 but continued to practice and harm patients for three more years before his license was finally revoked.

Reforms being considered in “The Troy and Alana Pack Patient Safety Act” include:

— Raising or repealing the cap on damages in medical malpractice cases.

— Mandatory drug and alcohol testing for doctors.

— Full funding of the CURES database and mandatory use by physicians before prescribing narcotics.

— Medical Board reform including a public member majority, increased transparency of complaints and transferring investigative powers to the Department of Justice.

Top Ten Dangerous Doctors

Dr. Aria Omar Sabit

Neurosurgeon. Twenty lawsuits were filed against Sabit stemming from the 17 months he practiced in Ventura County, alleging misplaced screws in spinal fusions, post-op infections and botched brain surgery. Victims say Sabit made so many mistakes in such a short period of time that Community Memorial Hospital in Ventura and Ventura County Neurosurgical Associates Medical Group should have intervened long before the medical group fired him in December 2010. Attorneys for those patients have dubbed Sabit “The Butcher.” Community Memorial officials said they asked the Medical Board of California to investigate. In February 2012 Medical Board representatives would not comment on the possibility of an investigation involving Sabit, but told a reporter no action had been taken against him since he was licensed to practice in California in 2009. Sabit is now practicing in Michigan.

Dr. Van Vu

Pain management specialist, California Pain Center of Fountain Valley and Huntington Beach. Seventeen of Vu’s patients died of overdoses connected to medicine he prescribed — the most deaths connected to any of the 71 Southern California doctors identified by the Los Angeles Times whose patients had suffered 3 or more prescription drug overdose deaths. The Medical Board began an investigation only after the article exposed Vu. There are currently no restrictions on his practice.

Dr. Shane Sheibani

Plastic surgeon. Sheibani drew dozens of complaints and lawsuits from patients who were left disfigured, with open wounds and in pain. He was placed on probation by the Medical Board in 2009, but continued to practice and more patients were harmed. His license was finally suspended in August 2012. He now calls himself a “psycho-spiritual coach,” yet told an undercover news reporter he could still perform surgery.

Dr. Craig Alan Bittner

Was a Beverly Hills radiologist who performed liposuction. He allowed his assistant, who was also his girlfriend, to perform liposuction although she was not a doctor and had no formal training in the procedure. Patients began complaining as early as 2008, and at least nine women were left disfigured and in pain. Bittner did not surrender his license until 2011. In criminal prosecution, Bittner was allowed to plead guilty to just one misdemeanor count. His five-year sentence was reduced to two. He has reportedly changed his name and is now attending law school.

Dr. Efrain Gonzalez

A gynecologist performing cosmetic surgery, and his wife, Dr. Yessennia Candelaria, a pediatrician. Multiple complaints to the California Medical Board ultimately uncovered at least 15 patients who alleged their failed cosmetic surgeries by Gonzalez left them deformed and, in at least one case, with paralysis. Only after more than 18 months of investigation and an arrest – in which Gonzalez was charged with 31 felony counts – was his license suspended in March 2013. Candelaria’s license was suspended in May 2013, after she was charged with 15 felony counts and a DEA warrant affidavit alleging she had a drug habit. In one case, she allegedly administered anesthesia to a patient “…while simultaneously administering the drug to herself via an additional intravenous line. According to a medical assistant assisting in the procedure, Dr. Candelaria lost consciousness in the operating room.”

Dr. Israel Chambi

An Orange County neurosurgeon. Western Medical Center in Santa Ana, removed Chambi as head of neurosurgery in 2003 after it was reported there were more than 35 malpractice lawsuits against him. The department he chaired generated over $38 million a year for Western Medical Center. Patients and families alleged that they or their loved ones were severely disfigured, suffered devastating brain or nerve damage, or in one case, narrowly evaded invasive brain surgery by Chambi when other doctors said none was necessary. Chambi had previously lost his post as a medical professor at UCI Medical Center after accusations of unnecessary surgery and incompetence were raised by other UCI doctors. Of the 35 malpractice suits, 10 won settlements totaling $3 million. The Medical Board opened three investigations but no action was taken. Dr Chambi today runs his own brain, spine and nerve practice.

Dr. Brian West

Orange County plastic surgeon. Complaints against West began in 2000, ultimately filed by at least six patients who said he left them severely deformed. None of them knew that West had a substance abuse problem, or that he had entered the Medical Board’s secret addiction monitoring program. In 2005, he was placed on five years probation after two convictions of driving under the influence of alcohol, as well as “multiple acts of dishonesty” while a participant in the addiction monitoring program. Documents say he directed an employee to falsify Alcoholics Anonymous sign-in logs to make it appear he had attended meetings. In 2009 he was found guilty of disfiguring a former breast cancer patient after performing a surgery she had not consented to and lying to an investigator about being on his way to the hospital when he got into a drunken driving accident.  West’s case helped spur the closure of the Medical Board’s failed drug and alcohol diversion program, which allowed doctors with substance abuse problems to hide that information from their patients. The Medical Board finally revoked his license in May 2009.

Dr. Carlos Estiandan

Operated three pain clinics in Los Angeles.  According to court records, Estiandan prescribed powerful painkillers to addicts who had no medical need for them, conducted sham examinations and appeared to be a key supplier for drug dealers. He wrote more prescriptions than the entire staffs of some hospitals and took in more than $1 million a year. Despite investigations by the US Drug Enforcement Administration and LA County Sheriff’s department, the Medical Board did not stop him from prescribing until four years after opening its own investigation. Eight of his patients died of overdoses in the period while the investigations dragged on.

Dr. Daryl Westerback

A Thousand Oaks psychiatrist. Dr. Westerback was arrested twice this year for driving under the influence of prescription drugs, and sheriffs now accuse him of overprescribing to patients. He is connected with at least one overdose-related death, and is suspected of treating patients while under the influence of opiates. No action had been taken against Dr. Westerback before the criminal investigation began; his license to prescribe has now been suspended, however his medical license remains current.

Dr. Andrew Rutland

An obstetrician-gynecologist in Anaheim. Dr. Rutland had his license revoked for negligence in 2002 after the death of an infant in childbirth, the death of a second infant, and numerous other allegations that led to 15 civil lawsuits. The Medical Board reinstated Rutland’s license in 2007. Rutland was forced to surrender his license again in 2011 after an investigation finding him responsible for the death of another patient, this time a 30-year-old who he gave the wrong dose of anesthesia.

Sources: Los Angeles Times, Ventura County Star, OC Weekly, Sacramento Business Journal, Orange County Register, Fox 11 – KTTV, KABC – 7, CBS 2/ KCAL 9, News 10 ABC, CBS Sacramento and Medical Board of California

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Posted by Carmen Balber, Executive Director of Consumer Watchdog. Follow Consumer Watchdog online on Facebook and Twitter.

Last month, at an emotional in hearing in Sacramento and in a San Francisco Chronicle op-ed, we called for the state agency that oversees doctors to become a stronger regulator or to go out of business.  The Legislature has to renew the doctor-run medical board every ten years, and that’s this year. Sacramento apparently agrees with us.

After an emotional outpouring from families who lost their love ones to dangerous doctors, and thousands of emails from Californians, the chairmen of the Senate and Assembly Business and Professions Committees sent a message.  The Los Angeles Times is reporting that chairs Curren Price and Richard Gordon have written the medical board to state that they will not reauthorize the board unless it commits to major changes.

This is a big and important step toward strong patient protections in this state. The California Medical Association has for too long stymied real change for patients in the Capitol, and now Gordon and Price have upped the ante by acknowledging the depth of the problem for patients.

Three important areas need to be reformed, as Carmen Balber and I outlined in the San Francisco Chronicle op-ed:

A true overhaul of physician discipline would move complaint investigators into the attorney general’s office to work hand in hand with prosecutors and would create a public-member majority on the medical board.

Real reform should also include mandatory random drug testing of high-risk surgeons and physicians – as is mandated now for bus drivers, college athletes and pilots.

Finally, the state’s 38-year-old limits on the rights of injured patients need to be revisited, too. It’s time for the public to take the power back for itself.

The movement is afoot, and we have taken another step toward greater patient safety. Stay tuned. Momentum is building but we still have a long march ahead.

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Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

There aren’t too many great days for patient safety in state capitols, where the medical establishment tends to rule the roost through the power of its political giving and tentacles. But Monday was a great day for patient safety in Sacramento, when powerful testimony reminded legislators of the human cost of inaction.

The families of victims of overprescribing spent an hour and half in the Senate and Assembly Business and Professions Committees and presented some of the most compelling testimony ever heard there. Their stories and faces were felt around the Capitol Tuesday from huge photographs on the front pages of the Sacramento Bee and Los Angeles Times to TV news stories echoing legislative sympathy for reform.

The medical establishment  is now on the defensive.  A Medical Board overhaul is in the air. Debate is turning to the government not protecting patients enough.

Will the clarity these courageous families brought to the failure of California’s laws to protect patient safety grow or wither in the coming days?  It’s up to us, but I think it will grow.

Carmen Balber and I asked in an oped in Monday morning’s San Francisco Chronicle whether it wasn’t time to pull the plug on the current physician-run medical board. We wrote:

For decades, the medical board has failed to identify dangerous practice patterns, such as over-prescribing, which should trigger investigation. In fact, the board only acts on complaints by consumers, and then rarely. Once an investigation is begun, it takes years to resolve, too long for patients who may be at imminent risk of harm.

When prosecuted, an enforcement case can stagnate in five layers of review. Sadly, little other deterrence exists to medical negligence.

Those listening to the tragic stories in Sacramento this week could not help but understand the human consequences of such inaction.  Sons, daughters, brothers, uncles lost. Preventable deaths.

All because the California Medical Association and the state medical board it controls won’t agree to a $9 increase in physician license fees — the cost of two cappuccinos — for workers to find overprescribing doctors in a state database. And due to the grip of this medical establishment over our regulators and the legal system — where families who lose nonwage earners to dirty doctors cannot get legal representation due to a 38 year-old cap on their recovery.

We called for these changes in Monday’s Chronicle.

A true overhaul of physician discipline would move complaint investigators into the attorney general’s office to work hand in hand with prosecutors and would create a public-member majority on the medical board.

Real reform should also include mandatory random drug testing of high-risk surgeons and physicians – as is mandated now for bus drivers, college athletes and pilots. Finally, the state’s 38-year-old limits on the rights of injured patients need to be revisited, too. It’s time for the public to take the power back for itself.

It’s Wednesday morning. Eyes are wide open. And we are a lot closer to patients taking power back than we were before.

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Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.