BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 583|
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THIRD READING
Bill No: AB 583
Author: Hayashi (D)
Amended: 8/20/10 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 8-2,
6/29/09
AYES: Negrete McLeod, Wyland, Corbett, Correa, Florez,
Oropeza, Romero, Yee
NOES: Aanestad, Walters
ASSEMBLY FLOOR : 78-0, 4/13/09 (Consent) - See last page
for vote
SUBJECT : Health care practitioners: disclosure of
education and office
hours
SOURCE : California Medical Association
California Society of Plastic Surgeons
DIGEST : This bill requires a health care practitioner
disclose his/her name, license type, highest level of
academic degree, and for physicians and surgeons, and
osteopaths, their board certification, as specified.
Senate Floor Amendments of 8/20/10 exempt a pharmacist or a
pharmacy technician from disclosure of the highest level of
academic degree he or she holds.
CONTINUED
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Senate Floor Amendments of 8/17/10 specify the format of
name tag requirements and require a health care
practitioner who provides information on an Internet Web
site that is directly controlled or administered by that
health care practitioner or his/her office personnel to
prominently display on the Internet Web site specified
information.
ANALYSIS :
Existing law:
1. Requires a health care practitioner to disclose, while
working, his/her name and practitioner's license status
on a name tag in at least 18-point type or prominently
display his/her license in his/her office, except 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.
2. 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/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/her license or other disciplinary
action including an administrative fine not to exceed
$10,000.
3. 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.
4. Specifies requirements for the recognition and
advertising, or claims or statements made by dentists,
physicians and surgeons, podiatrists and optometrists
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regarding board certification, or recognition by an
accrediting organization, multidisciplinary board or
association.
5. Defines "health care practitioner" to include any person
who engages in acts that are the subject of licensure or
regulation under Division 2 of the Business and
Professions Code, including but not limited to
physicians, surgeons, nurses, chiropractors, and
dentists.
This bill:
1. Requires a health care practitioner communicate to a
patient his/her name, license type, and highest level of
academic degree by either of the following:
In writing at the patient's initial office visit.
In a prominent display in an area visible to
patients in his/her office, in at least 24-point type
as specified.
2. Exempts nurses, pharmacist, or a pharmacy technician
from the requirement to disclose their highest level of
academic degree.
3. Requires a physician and surgeon, and osteopaths,
disclose their board certification in addition to the
information required in item #1 above.
4. Provides that this bill does not apply to clinical
laboratory technologists, hearing aid dispenses,
respiratory therapists, acupuncturists, marriage and
family therapist, and social workers.
5. Requires a health care practitioner who provides
information regarding health care services on an
Internet Web site that is directly controlled or
administered by that health care practitioner or his/her
office personnel to prominently display the information
required by this bill.
Background
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Popularity of plastic surgery . The American Society of
Plastic Surgeons' (ASPS) website states that approximately
12.1 million cosmetic procedures were performed in 2008,
representing a $10.3 billion industry. ASPS indicates that
the top five surgical procedures were breast augmentation,
liposuction, nose reshaping, eyelid surgery, and tummy
tuck. Moreover, ASPS points out that there were 10.7
million minimally-invasive cosmetic procedures 2008. The
top five minimally-invasive procedures were Botox,
hyaluronic acid fillers, chemical peel, laser hair removal,
and microdermabrasion.
Recognizing the need to educate the public when considering
cosmetic surgery, the College of Physicians and Surgeons of
Ontario, Canada posted a fact sheet entitled "What You
Should Know About Cosmetic Surgery" to assist consumers to
make an informed decision. The fact sheet included an
explanation of the different kinds of doctors who provide
services, the various issues that consumers should be aware
of when considering cosmetic surgery, and a list of
questions to ask before making a decision about having
cosmetic surgery. This bill includes a provision requiring
the Medical Board of California (MBC) to also post on its
website a fact sheet for consumers.
Prior efforts dealing with cosmetic surgery practices . 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. It is
also common for doctors performing complex cosmetic
surgeries to receive their only training from weekend
courses or instructional videos. Currently, there are no
uniform standards for physician training related to
cosmetic surgery, and the regulation of outpatient settings
in which these surgeries occur need to be strengthened to
ensure public safety. The Legislature attempted to
regulate the practice of cosmetic surgery in previous years
with the introduction of several bills including:
1. SB 1423 (Figueroa), Chapter 873, Statutes of 2006,
required MBC in conjunction with the Board of Registered
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Nursing to promulgate regulations on or before January
1, 2009, to implement changes relating to the use of
laser or intense pulse light devices for cosmetic
procedures by physicians and surgeons, nurses, and
physician assistants.
2. SB 835 (Figueroa), 1999-2000 Session, would have enacted
the Cosmetic Surgery Patient Disclosure Act, which would
have required physicians who perform cosmetic surgery,
as defined, to provide MBC with specified information,
including training, board certifications, and number of
procedures performed, and requires MBC to make this
information available to the public upon request and
post the information on the Internet. The bill was
vetoed by then Governor Davis who indicated that the
methods prescribed by the bill were unduly burdensome.
3. SB 836 (Figueroa), Chapter 856, Statutes of 1999,
expanded and revised the prohibition against fraudulent
advertising by health practitioners.
4. SB 837 (Figueroa), 1999-2000 Session, would have
required cosmetic surgery procedures to be performed in
a licensed acute care hospital or in a licensed or
accredited outpatient surgery setting. The bill died in
the Assembly Appropriations Committee.
5. SB 1454 (Ridley-Thomas), 2007-08 Session, required for
purposes of advertising that a health care practitioner,
provide the type of license under which the licensee is
practicing and the type of degree received upon
graduation from professional training and that a health
care practitioner who is practicing in an outpatient
setting, as defined, wear a name tag which includes
his/her name and their license status. Required MBC to
adopt regulations on the appropriate level of physician
supervision necessary within clinics using laser or
intense pulse light devices for elective cosmetic
surgery, and that MBC establish as one of its priorities
the investigation of unlicensed activity within such
clinics. SB 1454 died on the Assembly Floor.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
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SUPPORT : (Verified 8/18/10)
California Medical Association (co-source)
California Society of Plastic Surgeons (co-source)
Association of Northern California Oncologists
California Psychiatric Association
California Senior Legislature
OPPOSITION : (Verified 8/18/10)
California Registered Veterinary Technicians Association
California Veterinary Board
Department of Consumer Affairs
Respiratory Care Board of California
ARGUMENTS IN SUPPORT : According to the author's office,
"Patients are often confused on who exactly the health care
practitioner is who is performing treatment or giving
health care advice. Patients may not understand the
educational background of a health care practitioner."
With respect to these concerns, the provisions in this bill
are meant to help educate the patient with regard to their
health care practitioners' license types and highest
academic degrees achieved.
ARGUMENTS IN OPPOSITION : The Respiratory Care Board of
California argues that the proposed requirement to disclose
the highest level of academic degree is onerous and
unnecessary and has potential to cause confusion among
patients. Further, they are concerned that implementing
this requirement for over 16,000 respiratory care
practitioners in the state will be difficult for some
employees. They are requesting an exemption from this
requirement, similar to those provided to nurses.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De Leon, DeVore,
Duvall, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,
Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,
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Gilmore, Hagman, Hall, Hayashi, Hernandez, Hill, Huber,
Huffman, Jeffries, Jones, Knight, Krekorian, Lieu, Logue,
Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,
Nestande, Niello, Nielsen, John A. Perez, V. Manuel
Perez, Portantino, Price, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: De La Torre, Harkey
JJA:mwk 8/20/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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