Bill to create physician health program advances after contentious hearing over scope and oversight

Assemblymember Berman presented AB 408, a bill authorizing the Medical Board of California to establish a physician health and wellness program that would promote early intervention, confidential treatment and monitoring for health conditions — including substance use disorders — that could impair a licensee’s ability to practice safely.

Supporters, including the Medical Board’s executive director and the California Medical Association, said California is one of the few states without a state-recognized physician-health program and argued that confidential programs reduce stigma and encourage clinicians to seek care before harm occurs. Rajiv Voorhees, executive director of the Medical Board of California, told the committee that the board’s current approach is reactive: “the board’s only tool ... is to go through the disciplinary process,” an often costly, lengthy route that can follow after patient harm. Dr. Shannon Utovic Constant, president of the California Medical Association, said physician-health programs are “confidential, supportive resources” that enhance patient safety by addressing impairments early.

Opponents — including the Consumer Protection Policy Center at the University of San Diego and survivors of patient harm — urged caution. The Consumer Protection Policy Center cited prior audits of the board’s previous treatment program and questioned whether the board currently had funding and staffing capacity to run a program without creating gaps in enforcement. A survivor who testified described being harmed by a physician who had an undisclosed substance-abuse history and argued that program rules in AB 408 could keep patient protections from public view. Several witnesses proposed alternatives: use of court-approved treatment centers or a reform of complaint processes to avoid perceived conflicts when the licensing board oversees treatment.

Committee members weighed the competing considerations. Several senators expressed support for the underlying goal of getting physicians treatment and preventing harm; others flagged potential problems in the bill’s current language, including whether the program could be used ‘‘in lieu of’’ discipline in some circumstances, the absence of clear time limits or completion triggers, and the risk of repeated or open-ended participation without a final enforcement step. Chair Ashby said she would not support the bill in its printed form because of concerns around the ‘‘in lieu’’ language and program triggers, but she pledged to work with the author if the bill advanced to the next committee.

The committee voted to pass AB 408 to the Senate Judiciary Committee after discussion. The transcript records a roll-call of support and a committee comment that further changes should be addressed in the next committee. Supporters said the bill is modeled on programs in other states that the Federation of State Medical Boards endorses for early detection, treatment and monitoring of physicians with impairing illnesses.

Why it matters: AB 408 creates a pathway for early intervention and rehabilitation for clinicians, which proponents say reduces the chance of patient harm; opponents worry the bill may reduce transparency and burden a licensing agency already facing resource constraints.