Docs on Probation guest blog post by Suzan Shinazy of Bakersfield, CA
When you make an appointment with a physician, you should be immediately informed if that physician has been put on probation by the MBC (Medical Board of California). You deserve to know if the doctor you, or your loved one, is going to see has been disciplined for repeated negligent acts resulting in death, harm, or disabilities of patients. The MBC indirectly provides this information to the public by posting it online, but the MBC refuses to require all physicians on probation to directly tell their patients about their probation status. This indirect method of providing critical public health information only online has been proven to be very ineffective, and it also excludes millions of Californians that do not have internet access at home.
The White House’s recently published, “There Is A ‘Digital Divide’ In The United States” points out that high speed internet access remains out of reach for many Americans. Specifically, “older, less educated, less affluent and rural populations have fewer choices and slower internet connections.” Posting the disciplinary status of physicians only online is not enough. As shown on the White House digital divide graphic, 1 in 4 of all people do not have internet access at home, and this rate worsens as income levels drop; and 50% of the lowest medium income households do not have home internet. The U.S. Census Bureau reported California’s 2014 population at 38.8 million–that means 9.7 million of all Californians are without home internet.
Poverty and medical illness make it difficult, if not impossible, for Californians to get online. “One in three California households (31%) do not have sufficient income to meet their basic costs of living,” according to a United Ways of California 2015 report. According to the Public Policy Institute of California, about one in four California residents are living in or near poverty. Studies have linked poverty to higher levels of chronic health conditions. Medical illness often leads to financial hardship, loss of income, and even bankruptcy. According to a NerdWallet study released in 2014, three in five bankruptcies are due to medical bills. Ironically, patients with serious medical illnesses see the most physicians yet many of them cannot afford home internet, and therefore cannot access the physician’s probation status.
Who’s not online? A recent study by the Pew Research Center found that 39% of Americans 65 years and older are still not online. Also, many elderly face additional barriers such as lower incomes and problems reading text and typing. The New York Times quoted Nicol Turner-Lee, chief researcher at the Multicultural Media, Telecom and Internet Council: “Access to technology really mirrors the current wealth gap we see in our country.” The Pew study also reveals that a disproportionate percentage of Americans who do not use the internet are Black and Hispanic. Many Americans have a language barrier that prevents access to the medical board’s website. With these significant barriers to online access, it’s critical that the medical board require doctors to inform patients of their probation status in other ways.
The restaurant industry grade-card inspection system is a great example of how public health information can effectively reach consumers. The Orange County Grand Jury studied the success Los Angeles County had in reducing food-borne hospitalizations by 28.8% after posting ‘direct’ information known as ‘grade cards’ in restaurant windows, and stated, ‘Only a relatively small number of people know of, would take the time to find out, or have the ability to find restaurant inspection results posted online by the Health Care Agency.’ Orange County now also posts ‘grade cards’ in restaurant windows. Their study also showed, “Giving the information to the restaurant patrons right at the restaurant has caused restaurant owners to have cleaner restaurants. Those restaurants with an A grade have increased their revenue, while C-grade restaurants have either cleaned up their establishments or closed – a win either way for the consumer.” Restaurant grade-cards work to inform the public, whereas online postings alone weren’t proven to be effective.
In 2012, medical board staff asked board members to require consumers receive direct information regarding their doctor’s probation status, and the board said no. Consumers Union’s Safe Patient Project and several California advocates advocated for this information. In July, we presented the board with a petition that has over 5,100 signatures from California residents stating they do want to be informed of their physician’s probation status at the place of business. The board has promised to put this on the agenda for the October 2015 quarterly meeting in San Diego. California Safe Patient Project activists will be there and that the public is encouraged to attend. If you’re interested, contact the Safe Patient Project at firstname.lastname@example.org.
Doctors in California should have to notify patients of their probation status. We cannot ignore the real barriers that keep many Americans offline and prevent access to the medical board website. As restaurant grade-card systems in California show, increasing the direct information to consumers at the site of business has proven to have powerful economic incentives to improve public health safety. We have every reason to expect similar results from the medical industry.
–Suzan Shinazy, retired RN, founder of Medical Error Transparency Plan, Patient Safety Advocate with California’s Consumers Union Safe Patient Project, and Shirley’s daughter, who died of medical errors.
Read more about our Doctors on Probation campaign here. If you live in California, you can sign our petition online here. If you would like more information about the October medical board meeting in San Diego, please contact Daniela Nunez at email@example.com.