BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 583
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          Date of Hearing:   March 31, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
                 AB 583 (Hayashi) - As Introduced:  February 25, 2009
          
          SUBJECT  :   Health care practitioners: disclosure of education  
          and office hours.

           SUMMARY  :   Requires health care practitioners to display their  
          educational degree, license type and status, and board  
          certification on either their nametag or in their offices, as  
          specified.  Requires supervising physicians and surgeons to post  
          their hours in each office.  Specifically,  this bill  :  

          1)Adds additional disclosure requirements for health care  
            practitioners to disclose their license type and highest level  
            of academic degree on their nametag, in their office, or in  
            writing to their patients, as specified.   

          2)Exempts nurses from the requirement to display their highest  
            level of academic degree.

          3)Requires physicians and surgeons, including osteopathic  
            physicians, who are certified by:

             a)   an American Board of Medical Specialties member board; 

             b)   a board or association with equivalent requirements  
               approved by that person's medical licensing authority; or,

             c)    a board or association with an Accreditation Council  
               for Graduate Medical Education approved postgraduate  
               training program that provides complete training in that  
               specialty or subspecialty, 
           
            to disclose the name of the certifying board or association:

             a)   On a name tag in at least 18-point type;

             b)   In writing to a patient at the patient's initial office  
               visit; or,

             c)   In a prominent display in his or her office.









                                                                  AB 583
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          4)Requires a physician and surgeon who supervises an office in  
            addition to his or her primary practice location to  
            conspicuously post in each of those offices a schedule of the  
            regular hours when he or she is present in the respective  
            office, and the hours during which each office is open and he  
            or she is not present. 

           EXISTING LAW  

          1)Makes it unlawful for health care licensees to disseminate or  
            cause to be disseminated any form of public communication, as  
            defined, containing false, fraudulent, misleading, deceptive  
            statements, or images, as specified, to induce the provision  
            of services or the rendering of a product relating to a  
            professional practice or business for which he or she is  
            licensed, and provides that any person so licensed who  
            violates this provision is guilty of a misdemeanor and that  
            such a violation shall constitute good cause for revocation or  
            suspension of his or her license or other disciplinary action  
            including an administrative fine not to exceed $10,000.

          2)Authorizes advertising by health care licensees if it includes  
            certain general information regarding the practitioner and  
            requires certain disclosures to be made regarding dentists,  
            physicians and surgeons, podiatrists and optometrists  
            regarding the advertising of their education, accreditation,  
            certification or specialty.

          3)Specifies requirements for the recognition and advertising, or  
            claims or statements made by dentists, physicians and  
            surgeons, podiatrists and optometrists regarding board  
            certification, or recognition by an accrediting organization,  
            multidisciplinary board or association.

          4)Requires a health care practitioner to disclose, while  
            working, his or her name and license status on a name tag in  
            at least 18-point type, but provides that if a health care  
            practitioner is in a practice or office where their license is  
            prominently displayed, they may opt to not wear a name tag.

           FISCAL EFFECT  :   Unknown.  This bill is keyed non-fiscal. 

           COMMENTS  :

           Purpose of this bill  .  According to the author's office, "The  








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          number of cosmetic procedures performed in the United States is  
          increasing at a rapid rate and consumers are presented with  
          advertisements for medical procedures intended make them look  
          and feel better fast.  These medical procedures are becoming  
          increasingly available in medi-spas and other out patient  
          facilities located in shopping malls, office buildings and  
          retail stores across the country.  In California, cosmetic  
          surgery can be performed by any licensed physician, from a  
          plastic surgeon to a pediatrician.  Many physicians, who may or  
          may not be trained in cosmetic procedures, are conducting  
          increasingly complex procedures in settings outside of hospitals  
          such as outpatient surgery centers and doctors' offices, or are  
          delegating procedures to other personnel.  

          "AB 583 will provide consumers of cosmetic procedures an  
          opportunity to make informed choices about the qualifications of  
          their healthcare practitioner prior to electing to receive  
          cosmetic medical procedures."

           Background  .  The American Society of Plastic Surgeon's (ASPS)  
          website states that the 12 million cosmetic surgeries performed  
          in 2007 represents a 7% increase from 2006, and a 59% increase  
          from 2000.  According to ASPS, the top five surgical procedures  
          were breast augmentation (348,000, up 6%), liposuction (302,000,  
          unchanged), nose reshaping (285,000, down 7%), eyelid surgery  
          (241,000, up 3%), and tummy tuck (148,000, up 1%).    Moreover,  
          ASPS points out that minimally-invasive cosmetic procedures rose  
          by 9%, to nearly 10 million procedures in 2007.  Hyaluronic acid  
          fillers, popularly known as Restylane, Hylaform, Hylaform Plus,  
          and Juvederm, jumped from fifth most popular in 2006 to second  
          most popular in 2007.  The top five minimally-invasive  
          procedures were Botox (4.6 million, up 13% from 2006),  
          hyaluronic acid fillers (1.1 million, up 35%), chemical peel (1  
          million, down 4%), laser hair removal (906,000, up 2%) and  
          microdermabrasion (897,000, up 10%).

          In California, cosmetic surgery can be performed by any licensed  
          physician, from a plastic surgeon to a pediatrician.  Many  
          physicians, who may or may not be specially trained in cosmetic  
          procedures, are conducting increasingly complex procedures in  
          settings outside of hospitals. 

           Previous legislation  .  

          SB 1454 (Ridley-Thomas) of 2008, required any advertising by a  








                                                                  AB 583
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          chiropractor, dentist, physician and surgeon, nurse, vocational  
          nurse, psychologist, optometrist or physician assistant include  
          the type of degree received upon graduation from professional  
          training, among other things.  This bill was held on the  
          Assembly Floor.

          AB 2734 (Krekorian) of 2008 required medical advertisements to  
          include a name and a valid license number from the appropriate  
          licensing agency.  This bill was held on the Assembly Floor.

           Support  .  The California Society of Plastic Surgeons writes,  
          "Oftentimes patients consult with the CSPS [California Society  
          of Plastic Surgeons] after receiving what the patient believes  
          is a poor outcome.  When patients learn that they were treated  
          by a non-physician or a physician not board certified in plastic  
          surgery they are surprised.  Patients are confused with the  
          numerous varieties of health care practitioners currently  
          performing medical procedures.

          "AB 583 is intended to help patients better understand the  
          credentials of their health care practitioner prior to receiving  
          treatment.  Giving patients this important information will  
          allow them to make safer, more educated decisions."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Medical Association (co-sponsor)
          California Society of Plastic Surgeons (co-sponsor)
          California Psychiatric Association

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Ross Warren / B. & P. / (916) 319-3301