 |
... is for good men to do nothing. Edmund Burke
|
|
URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) Re: Transfer of Peer Review Records from one Hospital to Another ------------------------------------------------------------------------------------------------------------------ 32 PAGES SENT VIA FAX: June 12, 2011 ATTENTION: California Assemblymember Mary Hayashi FAX 916-319-3306 and Dear Senator Negrete McLeod, First and foremost, I would like to express my deepest appreciation for your personal involvement, over many years, on behalf of Physicians and Patients in CA, in order to assure the best possible quality of delivery of care in our great State. As you know, CMA's Government Affairs Dept. submitted last week an amendment to AB 655, presently under review by the CA Hospital Association, CHA. In fact, despite everyone's best efforts and good intentions, this bill in its current form is very dangerous and contrary to the spirit and the letter of current CA law. Following, please find, for your consideration the comments, thoughts and suggested amendments provided by prominent members of our community regarding this bill. The following correspondence, twenty seven (27) e-mails, is between myself and: 1) Dr. Hinsdale, President, California Medical Association, CMA, 2) Dr. Weinmann, Past President, Union of American Physicians and Dentists, UAPD, affiliated with the AFL/CIO, 3) Dr. Zwelling, Past President, Los Angeles County Medical Association, LACMA, 4) Dr. Garfinkle, prominent General Surgeon, in Hayward, CA, 18th District, 5) Dr. Rao, victim of retaliation by Washington Hospital, in Alameda County, because of his participation in a documentary entitled, " Life for Sale ", http://evelynlimd.blogspot.com/, see: Is Peer Review on a Collision Course with Finance? by Robert Weinmann, M.D. Summary of Retaliation against Dr. Rao from The Weinmann Report. http://politicsofhealthcare.blogspot.com/2011/01/is-peer-review-on-collision-course-with.html 6) Sharon Kramer, prominent CA Healthcare Activist, particularly regarding the adverse effects of toxic elements in building, such as Mold,... 7) Dr. Moza, victim of retaliation by hospitals in CA, http://allianceforpatientsafety.org/moza.php Clearly, there still is a lot of work to perfect AB 655 and I have no doubt that your dedicated staff will work diligently to incorporate the enclosed suggested amendments as fast as possible, but this is not a speeding competition, as haste is not only waste, but could be counter productive,if AB 655 does not accomplish what it was intended to achieve. Hence, I respectfully request that you provide a copy of this fax to all members of the Senate B&P Committee, on Monday, June 13, 2011,so that they can benefit from the enclosed analysis by experts in these issues, sharing their knowledge and legitimate concerns. Please incorporate this correspondence into the legislative history of AB 655, thanks. I am available to you and your hard working staff, 24/7, to answer any questions you may have. Once again, I wish to thank you very much for your dedication,Respectfully submitted,
Gil Mileikowsky MD - President and Founder, - Alliance For Patient Safety, AFPS, http://allianceforpatientsafety.org/ - http://allianceforpatientsafety.org/socalphysgm.pdf - http://allianceforpatientsafety.org/blackbox.pdf ENCLOSURES: Correspondence, twenty seven (27) e-mails, between myself and: _______________________________________ 1. From: uapdhq@aol.com Subject: Re: AB 655 (Hayashi): Healing arts: peer review. Date: March 14, 2011 10:24:40 AM PDT To: gil@allianceforpatientsafety.org, Any legislation that purports to upgrade peer review should contain provisions to expunge wrong or incorrect information in doctors' files. Fiona Ma proposed such legislation (AB 245). It was opposed by the med board. Why would the med board want to maintain posting of material they know is incorrect? Robert L. Weinmann, MD, Editor, The Weinmann Report www.politicsofhealthcare.blogspot.com 2. From: rlweinmann@yahoo.com Subject: Re: Comments re: Amended AB 655 (Hayashi) Date: June 4, 2011 8:42:49 AM PDT To: gil@allianceforpatientsafety.org But the "but" could, and probably will, loom large one day when a hospital, in compliance with the law, sends a contaminated report to another hospital that accepts it in good faith. If and when the defamed doctor finds out about the elements of bogus peer review in the reports from the first hospital, and complains to the second hospital, he'll be told that he has to get the first hospital to rectify the mistake. Then the first hospital will tell the aggrieved doctor that he doesn't have standing there anymore and to see his lawyer. Twenty grand retainer later, that's what he'll do, that or just hunker down and live with it, if he can. BTW in my 1995 editorial in Clinical EEG I used the term "bogus," not "sham." No particular reason except that peer review doesn't just include official judicial hearings -- it may also be done in M & M hearings, panel selection, etc. Anyway, there isn't much interest in AB 655 except from the sponsor (you can guess who). There's no great worry. Why should there be? After all, even within individual hospitals, most peer review hearings are fairly conducted, right, pal? bob Robert L. Weinmann, MD, Editor The Weinmann Report 3. Subject: URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another From: gil@allianceforpatientsafety.org Date: June 5, 2011 12:44:06 PM PDT Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.net, Solo_SmallGroupDelegates@cmanet.org, ExCom@ssgpf.comand 51 more… URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) Re: Transfer of Medical Peer Review Records from one Hospital to Another ---------------------------------------------------------------------------------------------------------------- Attention: Dr. Hinsdale - President - California Medical Association, CMA Dear Dr. Hinsdale, Following careful review of the latest version of AB 655, I do not see where it mandates that copy of every single information transfered from one hospital to the other has to be provided to the involved physician, otherwise the physician is a sitting duck exposed to possible malicious defamatory reporting without his or her knowledge. A typical example of such vicious and malicious defamatory conduct exhibited by hospitals and their attorneys can be observed in the following case, among many others, see: Retaliation Against Paul A. Ironside, M.D., Ph.D., http://allianceforpatientsafety.org/ironside.php 90. Declaration of Paul A. Ironside, M.D., dated 3/24/2004 Regarding the past conflict of interest of Suzanne Van Hall Esq, while acting simultaneously as hospital attorney and Medical Staff attorney, at Simi Valley Hospital in California. Dr. Ironside was the target of a sham peer-review at Simi Valley Hospital. After leaving California, he was futher pursued in Tennessee, despite exoneration by the Medical Board of California's investigation and hearing. See all supporting documents attached to Dr. Ironside's declaration, Download PDF File Kindly review this matter, forthwith, and request that CMA's legislative and legal Departments submit the appropriate amendment to protect physicians from bogus unfounded allegations solely instigated to ruin their reputation. We must prevent this recurrent and pervasive conduct by implementing the appropriate measures to remedy this problem once and for all. Thank you very much in advance for your diligent attention to this serious matter that has reached epidemic proportions. I wish to express my deepest gratitude to you and CMA for your long standing advocacy, in the best interest of CA Physicians and Patients. Respectfully submitted, Gil Mileikowsky MD - http://allianceforpatientsafety.org/socalphysgm.pdf P.S: Following, please find, the latest amended text of CA Bill AB 655 (Hayashi), as of June 1, 2011, regarding the Transfer of Peer Review Records from one Hospital to Another, http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=ab_655&sess=CUR&house=B&author=hayashi The CA Senate Business & Professions Committee should review it on or about June 13, 2011. 4. From: rlweinmann@yahoo.com Subject: Re: URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 1:44:11 PM PDT To: drhinsdale@aol.com, gil@allianceforpatientsafety.org
5. From: DRHINSDALE@aol.com Subject: Re: URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 3:07:53 PM PDT To: rlweinmann@yahoo.com, gil@allianceforpatientsafety.org Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.net, Solo_SmallGroupDelegates@cmanet.org, ExCom@ssgpf.com, mikecouris@aim.comand 49 more… OK, Gil, Bob: This has my attention. It's hard to argue that a doctor could have peer review data, activity, or whatever, sent around the world without his knowledge. In every hospital or place I've been to, a doctor has had the right to look at what they were dropping into his file. That's bedrock to me. I further believe that a doctor should know that his personal info is being sent elsewhere, and to where. Hell, we do as much for patient confidentiality in HIPPA, almost to the extreme. 6. From: gil@allianceforpatientsafety.org Subject: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 4:05:36 PM PDT Cc: rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.net, Solo_SmallGroupDelegates@cmanet.org, ExCom@ssgpf.com,... Dear Dr. Hinsdale, I am most impressed by your swift response, let alone on a sunday ! I had no doubt that we would agree on all of these principles, as they are so basic. Unfortunately, some hospitals maintain so called administrative files on physicians, which are not part of the physicians' credential files and medical staff offices' attorneys do not voluntarily make these file readily available to the physicians. It is very common during administrative proceedings, i.e. Hearings, for hospitals to deny access of the credential files to the physicians and ask their hospital appointed and remunerated hearing officers to determine which documents the physician will or not be allowed to review and enter into evidence to defend itself against concocted allegations. This process is often characterized as the " Spanish Inquisition in the Wild West ", others use the terms " Kangaroo courts " or " Star Chambers ", http://en.wikipedia.org/wiki/Star_Chamber. Hence, any information transmitted by any hospital to another hospital pertaining any physician MUST be copied to the physician, so that the physician can assure the accuracy of such records, whether electronic or in any other form, whether in the credential file or any type of " Administrative " file, which is usually kept by any administrator, such as a CEO, COO, CNO, in the Q&A Dept, Performance Improvement, PI, Dept,... I am most familiar with all the above loopholes of the law or outright violations of both the spirit and the letter of the law, as I discovered such practices during my numerous aborted hearings and my multiple cross examinations of administrators, such as the COO of Encino-Tarzana Regional Medical Center, ETRMC. ETRMC is not alone, as this is the usual and customary standard of practice of hospital administrators in CA, at West-Hills Hospital and Medical Center, WHHMC, an HCA facility and all over the country, as evidenced on our website, at: http://allianceforpatientsafety.org/ Unfortunately, as it is written presently, AB 655 does NOT protect any physician from any type of malicious conduct performed without the physician's knowledge and approval, whether perpetrated by the medical staff office and any other administrative or medical branch of a hospital. Hence, since we agree on all of the above necessary safeguards, kindly instruct CMA's legal counsel to draft together with the legislative dept. the appropriate amendments that will assure that all of our concerns are implemented and unequivocally mandated prior to June 13, 2011, when CA's Senate Business & Professions Committee will consider approving or denying AB 655. Once again, I wish to salute your personal involvement on behalf of all physicians to assure the best quality of care to our patients. Respectfully yours, Gil Mileikowsky MD P.S: I am available 24/7 to assist you and anyone else prior to submitting such amendments of AB 655 7. From: garsurg@comcast.net Subject: RE: URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 4:48:59 PM PDT To: DRHINSDALE@aol.com, rlweinmann@yahoo.com, gil@allianceforpatientsafety.org Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 51 more… Jim, May I suggest that CMA ask Dr’s Mileikowsky and/or Weinmann to provide CMA with the desired language for an amendment, if they haven’ already done so. I personally believe that the physician should have the opportunity to see the information, of course with appropriate confidentiality for the peers, which is intended to be sent before it is sent. This would afford him/her the opportunity to point out and suggest corrections of any factual errors, which the sending administration/medical staff may or may not be willing to accept and correct. But if they do make the corrections it could save everybody a lot of headaches that would be involved if the physician were to have to try to correct them after the fact. Jay Garfinkle 8. From: rlweinmann@yahoo.com Subject: Re: URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 4:49:23 PM PDT To: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 52 more…
9. From: rlweinmann@yahoo.com Subject: RE: URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 4:58:58 PM PDT To: DRHINSDALE@aol.com, gil@allianceforpatientsafety.org, garsurg@comcast.net Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.net, Solo_SmallGroupDelegates@cmanet.org, ExCom@ssgpf.com, mikecouris@aim.comand 48 more…
10. From: DRHINSDALE@aol.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 5:01:36 PM PDT To: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com Cc: rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 52 more… All right, Gil. Thanks. I typically don't "instruct" Mr. Silva on how or what to do as an attorney, but simply treat him as what he is: a superb attorney that advises us physicians and tries to put the concepts and values we want to convey into action, consistent with what the law is---or how we want to shape our law to be. 11. From: rlweinmann@yahoo.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 5:45:25 PM PDT To: surgeonsconsultant@yahoo.com, gil@allianceforpatientsafety.org Cc: sabussey@aol.com, dchiappetta@uapd.com, al@uapd.com
12. From: vishvendra@gmail.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 7:57:40 PM PDT To: gil@allianceforpatientsafety.org Cc: DRHINSDALE@aol.com, rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.comand 53 more… Dr Mileikowsky is correct. It is common knowledge that administrators keep a separate file on physicians which is not under medical staff control, ( Hoover's dossier system). This file comes out in disciplinary hearings. Washington Hospital Fremont has medical staff bylaws and policy contains a provision that a physician can request access to credential files and also request material to be expunged or contested . I used to religiously request access to the file every year and was provided a sanitized version. When I went for hearing they produced documents as exhibits from 1999 including letters about dispute IPA which I was heading at that time. The issue is how do you define peer review material ? What are the protections to prevent unsubstantiated unverified material from being transmitted and damaging a physician ? The hitch is that at the time of re appointment we routinely sign authorization papers allowing the other healthcare facilities to provide information RVR 13. From: marcy@z-doc.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 8:09:41 PM PDT Cc: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.comand 55 more… It would seem to me that the obvious thing to do is to legislate full disclosure ... Anything that is NOT disclosed should never been admissible to any proceedings. How best to do that ? Marcy Zwelling-Aamot, M.D. 14. From: rlweinmann@yahoo.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 5, 2011 8:37:50 PM PDT To: vishvendra@gmail.com, marcy@z-doc.com Cc: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.organd 53 more…
------------------------------------------------------------ 15. From: SNK1955@aol.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 5, 2011 8:38:53 PM PDT To: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com Cc: rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 52 more… Gil, Good catch. I did a quick read of the bill. Looks to me that a hospital could easily retaliate against a physician who chose to leave a hospital with problems under this bill. I could see a hospital sending damning info to a new hospital for the purpose that the doctor does not speak or is discredited of what occurred (and is maybe still occurring) in the first hospital- -Under this bill in its current form, the physician would have no way to defend himself against the dissemination of misinformation about him. The hospital has immunity for the info they relay. No names are to be disclosed of who relayed the info. The language of the bill in its current form. http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_0651-0700/ab_655_bill_20110601_amended_sen_v97.pdf Thanks for helping to keep integrity in the CA medical profession. Sharon 16. From: rlweinmann@yahoo.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 5, 2011 9:14:18 PM PDT To: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, SNK1955@aol.com Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 52 more…
17. From: garsurg@comcast.net Subject: RE: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 5, 2011 9:30:21 PM PDT To: SNK1955@aol.com, gil@allianceforpatientsafety.org, DRHINSDALE@aol.com Cc: rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 51 more… Sharon, You may not have intended this but you raised an interesting issue, and that is the situation in which a physician has already left a medical staff. The reason for leaving is irrelevant. He/she may simply have relocated to another town or state for reasons totally unrelated to his/her practice history at My First Community Hospital. When he/she applies for privileges at My New Community Hospital a request for info will be sent from New to First. As the law now exists the doc has no way of knowing what First will tell New. The doc is no longer on First’s medical staff and is probably not entitled to any significant credential’s file access or protection and would have little recourse for correcting errors short of the courts. Perhaps the amended AB655 should also address the issue of docs who have already left the staff of one hospital and are applying to another one. This probably should also factor in reports to the medical boards and data banks. Marcy, Your statement that “…anything that is NOT disclosed should never been admissible to any proceedings…” suggests to me that you may be thinking of JRC’s or other legal and quasi-legal proceedings. The problem we are addressing here, at least I think the problem we are addressing here, is that related to the processing of an application for appointment or reappointment to a medical staff. This is long before there is any consideration ofproceedings. This is the Credentials Committee phase where there is the potential for decisions to be, at least in part, based on hearsay, reputation, and unsubstantiated accusations. This is the early phase of credentialing where it is critical that false statements, accusations, innuendoes, etc. must be prevented from entry into the process. Jay Garfinkle 18. From: garsurg@comcast.net Subject: RE: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 5, 2011 9:38:31 PM PDT To: rlweinmann@yahoo.com, gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, SNK1955@aol.com Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 51 more… Bob, May I humbly suggest that simultaneously is already too late to be of optimal protective benefit? The pig is out of the barn by then and you can’t put it back into the tube. It would be preferable, from my standpoint, to require the sharing of the contents of the document with the doc before it is actually put in the mail to the requesting entity. And the doc must be afforded a reasonable time in which to study it and submit an ok or objection. Jay Garfinkle 19. From: DRHINSDALE@aol.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 5, 2011 9:56:38 PM PDT To: garsurg@comcast.net, SNK1955@aol.com, gil@allianceforpatientsafety.org, DRHINSDALE@aol.com Cc: rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.netand 51 more… Everyone: I have been impressed with the discussion. It has been civil, educative, and focused on the issues of protecting doctors. It is late Sunday night and I will confer with Mr Silva tomorrow. There may be stuff that has happened, despite what we see in the bill's language, that I, and many of us, need to be brought up to speed on. I often quote a line from Francois-Marie Arouet (Voltaire): "May God spare me from my friends: My enemies I can defend against" 20. From: vishvendra@gmail.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 5, 2011 10:14:03 PM PDT To: SNK1955@aol.com Cc: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.comand 56 more… I did look at the website. As the proposed bill stands now the information cannot be transmitted without consent and release from the physician Page 3 line 22 and 23 . I fail to see the issue about the information being transmitted in uncontrolled manner . Only issue is How do you define a "peer review body constituted for medical disciplinary cause or reason" (section 1 B line 10 )? ( Does it include investigative committtees , MEC , departmental committees ?) The physician should be allowed to inspect the material which is being transmitted to make sure that the material is accurate, complete without any omissions RVR 21. From: SNK1955@aol.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 Date: June 6, 2011 3:22:18 AM PDT To: vishvendra@gmail.com Cc: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, rlweinmann@yahoo.com, "The physician should be allowed to inspect the material which is being transmitted to make sure that the material is accurate, complete without any omissions."...before consenting to its release. Yes. If I am reading it correctly, that is exactly what is missing. The physician has no mechanism of review or correction if the info being relayed about them from one hospital to the next is incomplete and/or inaccurate. Right? (It does have a clause about acting in good faith, but that is after the fact and the damage would already be done). http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_0651-0700/ab_655_bill_20110601_amended_sen_v97.pdf Pg 3 (d) Prior to the release of any peer review information pursuant to this section, the licentiate under review by the peer review body requesting information pursuant to this section shall, upon request, release the responding peer review body, its members, and the health care entity for which the responding peer review body conducts peer reviews, from liability for the disclosure of information in compliance with this section. (e) The responding peer review body is not obligated to produce the relevant peer review information pursuant to this section unless both of the following conditions are met: (1) The licentiate provides a release, as described in subdivision (d), that is acceptable to the responding peer review body. c) says, "(c) The responding peer review body acting in good faith is not subject to civil or criminal liability for providing information to the requesting peer review body pursuant to this section. The peer review body responding to the request shall be entitled to all confidentiality protections and privileges provided by law as to the information disclosed pursuant to this section. Prior to the release of any peer review information pursuant to this section, the requesting peer review body shall, upon request, sign a mutually agreeable peer review sharing agreement with the responding peer review body, and shall also indemnify the responding peer review body for any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorney’s fees, resulting in any manner, directly or indirectly, from the receiving peer review body’s improper release or disclosure of information shared pursuant to this section ---Sharon Kramer 22. From: vishvendra@gmail.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Pee... Date: June 6, 2011 7:33:03 AM PDT To: SNK1955@aol.com Cc: gil@allianceforpatientsafety.org, DRHINSDALE@aol.com, rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, The defect in the proposed bill can be remedied by adding 1) For the purposes of this section Peer review Body is defined as a panel convened for physician disciplinary action under California Business and Professional code 809 2) Requesting peer review body will inform the licentiate the receipt of the transmitted information within 4 weeks 3) Licentiate at his own expense can inspect and copy the information received by the requesting peer review body 4) Licentiate shall be allowed to provide any additional relevant information regarding accuracy and completeness of the information received (He will be allowed to contest the findings? ) The issue is that each hospital has to make independent disciplinary decision and hearing on physician irrespective of disciplinary action in another facility . I think this is supported by case law. So can the receiving peer review body use this as an exhibit in its disciplinary action? This creates a substantial prejudice to the contesting physician in a different disciplinary hearing . This can create a snowball and ripple effect . I can also see apposite point of view regarding the issue of public safety where the physician is engaged in repeated acts of negligence and skips one facility to another.But I think that is already addressed by the National Data Bank, access to 805 report by healthcare facilities and access to any disciplinary actions taken by MBC(resulting from adverse recommendations of original peer review body) . So why is the need for another bill? Practical effect of the law is that disciplinary action from one facility can be carried over to another facility hearings irrespective whether the original disciplinary action is a fair or sham review . This creates a burden on the physician in the second hearing in trying to convince the panel that the information received is a bad faith action by the responding peer review body. RVR 23. From: garsurg@comcast.net Subject: RE: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) - specific considerations Date: June 6, 2011 9:14:08 AM PDT To: DRHINSDALE@aol.com, SNK1955@aol.com, gil@allianceforpatientsafety.org Cc: rlweinmann@yahoo.com, kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, Good morning Jim, If there is to be further consideration by CMA attorneys and/or lobbyists of amending AB 655 I would like to be sure that they consider incorporating the following thoughts: 1. The requested information can be shared with only a requesting hospital’s peer review committee and not its credentials committee. 2. The subject physician has the opportunity to review and either object to, or agree with, the accuracy of the information to be released before it is released and that the information may not be released until the objection has been satisfied or that a reasonable effort on the part of the releasing hospital has been made to remedy the objection. 3. The information that may be released/shared can be only that which has been derived from a completed peer review process or processes and that no reference can be made to any review still in process. That is, if there is a JRC planned/scheduled/in process no reference can be made to this fact without the specific, not just implied, consent of the subject physician. 4. The information can be only that which has been obtained and recorded in a completed peer review processand may not be information obtained by an administrative process on the part of the hospital (as distinguished from the information obtained by the medical staff’s peer review committee; as I believe that the administration’s information may not be 1157 protected.). If my concerns are irrelevant to the issue being discussed in this thread I apologize for the diversion. Have a great week, Jim. Jay 24. From: SNK1955@aol.com Subject: Fwd: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) - specific conside... Date: June 6, 2011 9:21:24 AM PDT To: gil@allianceforpatientsafety.org I would say that you hit a nerve! Good job on this. It looks to me that the way that bill is written, it is presumed the accused physician is guilty and assumed the hospital (and its attorneys and insurers) will relay accurate info. Sharon ---------------------------------------------------------------------------------------- 25. From: josephmoza@aol.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) re: Transfer of Peer Review Records from one Hospital to Another Date: June 6, 2011 10:50:42 AM PDT To: gil@allianceforpatientsafety.org There is a problem with sharing the information? Are they going to share the medical records and other evidence that may exonerate the physician? 26. From: rlweinmann@yahoo.com Subject: RE: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) - specific considerations Date: June 6, 2011 10:34:07 PM PDT To: DRHINSDALE@aol.com, SNK1955@aol.com, gil@allianceforpatientsafety.org, garsurg@comcast.net Cc: kboroski@cmanet.org, lcobb@humboldt1.com, fsilva@cmanet.org, dcorcoran@cmanet.org, astridmeg@yahoo.com, jgivens@cmanet.org, neurosurgery@verizon.net, ExCom@ssgpf.comand 48 more…
27. From: vishvendra@gmail.com Subject: Re: F/U - URGENT AMENDMENT REQUIRED in AB 655 (Hayashi) - specific considerations Date: June 6, 2011 11:25:52 PM PDT Cc: DRHINSDALE@aol.com, SNK1955@aol.com, gil@allianceforpatientsafety.org, garsurg@comcast.net, kboroski@cmanet.organd 54 more… The issue is again what is the need for the bill ? The peer review body has access to 805 report, National practitioner data bank and any disciplinary action by MBC. The concern is that any bad faith review action is carried on to different facility peer review body and influence it from making independent judgment. The issue is that each hospital has to make independent disciplinary decision and hearing on physician irrespective of disciplinary action in another facility . I think this is supported by case law. So can the receiving peer review body use this as an exhibit in its disciplinary action? This creates a substantial prejudice to the contesting physician in a different disciplinary hearing . This can create a snowball and ripple effect. I can also see apposite point of view regarding the issue of public safety where the physician is engaged in repeated acts of negligence and skips one facility to another.But I think that is already addressed by the National Data Bank , access to 805 report by healthcare facilities and access to any disciplinary actions taken by MBC(resulting from adverse recommendations of original peer review body) . So why is the need for another bill? Practical effect of the law is that disciplinary action from one facility can be carried over to another facility hearings irrespective whether the original disciplinary action is a fair or sham review . This creates a burden on the physician in the second hearing in trying to convince the panel that the information received is a bad faith action by the responding peer review body. The defect in the proposed bill can be remedied by adding 1) For the purposes of this section Peer review Body is defined as a panel convened for physician disciplinary action under California Business and Professional code 809 2) Requesting peer review body will inform the licentiate the receipt of the transmitted information within 4 weeks 3) Licentiate at his own expense can inspect and copy the information received by the requesting peer review body 4) Licentiate shall be allowed to provide any additional relevant information regarding accuracy and completeness of the information received (He will be allowed to contest the findings? ) We gave our input it is time for legal brains to figure it out RVR ---------------------------------------------------------------------------------------- |
