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.

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

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.