The Role of Physicians in Board Investigations

Physicians are a critical component to the board's investigative team, as the board bases its disciplinary actions on the opinions of physicians and not board staff. There are employment opportunities for physicians who are interested in assisting the board where they can observe directly how board staff review complaints, gather evidence and reach case resolution. There are three distinct roles physicians play in board investigations.

Physicians are utilized as "consultants" in the board's Central Complaint Unit (CCU) to review incoming complaints, with their related medical records. In this role, physicians are asked to determine if there is a need for formal investigation by board investigative staff or if the complaint is largely resolved by a preliminary review of the medical records and the accompanying physician narrative statement. Many quality of care cases are closed at this juncture. The consultant is asked to write an opinion with a description to support his or her recommendation.

Some physician consultants, who live locally in Sacramento, can conduct this review at the CCU office, but most physicians opt to conduct reviews at their own offices, with materials mailed to them. Those who are interested in more information about this role can contact CCU Manager Ramona Carrasco at Ramona.Carrasco@mbc.ca.gov or click here for more information.

There are two major categories of incoming complaints: "quality of care" and "personal conduct." The former complaints require physician review as described above, and all complaints which are not closed by CCU staff are referred to one of the board's district offices for formal investigation. Each district office is staffed with a supervising investigator, five investigators, a deputy attorney general, an investigator assistant, clerical support staff and one or more medical consultants.

The district office medical consultants are board-certified physicians who work side-by-side with investigators to assist in evaluating the case evidence as it is received. They may be asked to do the following: research new medical procedures and/or drugs; review and comment on medical records; be present during interviews with physicians to assist in the discussion of the medical options available to the physician; write memoranda; give opinions if there is a potential violation of the Medical Practice Act; and assist in obtaining medical expert reviewers. Medical consultants are occasionally required to testify in court; however, most of their duties are performed in the district office. Physicians employed in this capacity are civil service employees. They must apply through the California Department of Human Resources process, be interviewed and placed on a statewide list. They work varied hours as permanent-intermittent employees, receiving an hourly wage and certain state benefits. Those who are interested in this employment opportunity can contact the Health Quality Investigation Unit's personnel office or obtain information through the California Department of Human Resources: calhr.ca.gov/Pages/Job-Seekers.aspx.

The final category for physician involvement at the board is to become a medical expert reviewer. Physicians are needed in all specialty areas and must: be board certified; have been practicing their specialty for a minimum of three years; and have no current complaints or disciplinary action pending against their license. Medical experts are asked to review case materials gathered in the course of an investigation and provide a written opinion describing the standard of care applicable to a given case at a given point in time. Then they must clearly articulate whether the physician's care under review fell below the standard, and if so, to what degree. Medical experts are expected to be willing to testify in court to their opinions. Those interested in more information about this role can contact the board's medical expert program analyst, Susan Goetzinger at Susan.Goetzinger@mbc.ca.gov or click here for more information and the application.