BILL ANALYSIS AB 583 Page 1 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 Page 2 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 AB 583 Page 3 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 Page 4 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