California Medical Board “Death Certificate Project”
BLOG POSTED JULY 2021
The Medical Board of California (“MBC”), in collaboration with the California Department of Public Health (“CDPH”), previously operated the “Death Certificate Project” in which California death record data was utilized to identify potential opioid prescribing issues. Although the MBC has currently only evaluated 2012 and 2013 data under the project, it is preparing to launch its second round of the project to analyze death certificate data from 2019.
In October of 2020, the MBC held their quarterly board meeting in which they discussed the future of the project. The MBC has changed the name of the project to “Prescription Review Program” in order to “give a more positive descriptive emphasis of the goal behind the project” – the MBC’s purported goal is to review death data to determine whether physicians are inappropriately prescribing opioids to their patients, thus resulting in opioid overdoses and/or deaths.
Some doctors might argue that this program actually results in the death of their careers. Based on the 2012-13 data, 2,694 deaths were reviewed and resulted in the MBC initiating 520 cases against 471 physicians out of the state's 145,000 licensed doctors.
The data shows:
75 accusations filed against 66 physicians
2 pre-accusation public letters of reprimand issued
29 public reprimands issued
20 physicians placed on probation
11 physicians surrendered their licenses
133 cases of “simple departures”
151 cases closed with no violations
The Board emphasizes that not all patient deaths automatically imply a violation and that its goal is to “conduct a more robust review process from the beginning in order to reduce the number of physicians undergoing a formal investigation when they do not present a risk to the public.”
In addition to changing the name, the MBC has made other improvements to the project, including changing the methodology used to review CDPH data. 6 Medical Board consultants will review the prescribing history for each reported death and identify cases where inappropriate prescribing may have led to the death. The MBC will then run an overall prescribing report for that physician and contact the deceased’s next of kin to collect medical records, coroner and toxicology reports, and summaries of care and treatment provided.
The MBC then moves on to its normal enforcement review process in which the case will be reviewed by a medical consultant in the same specialty as the identified physician, the consultant opines on whether or not the violation warrants a formal investigation, and if so, the case will be forwarded to the Department of Consumer Affairs Health and Quality Investigation Unit to proceed with the investigation process. If the investigation process reveals departures from the standard of care, the case will then be forwarded to the Attorney General’s Office for filing of a formal Accusation.
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