BILL NUMBER:  SB 820
  VETOED	DATE: 10/12/2009




To the Members of the California State Senate:

I am returning Senate Bill 820 without my signature.

Peer review is an extremely important part of assuring the integrity
and quality of care provided in our California hospitals.
Unfortunately, the peer review process has also been criticized over
the years because it increases litigious behavior, and lacks
transparency and responsiveness.  While perhaps well-intentioned,
this bill does not provide a solution to the problem, but rather,
jeopardizes the entire process by narrowing the reporting element to
"serious" cases of incompetence involving only patients.  How is this
good policy?  For example, what about a physician that engages in
egregious behavior against hospital staff or even other physicians ?
how does this serve the public by keeping these reports from the
Medical Board?

This bill also fails to align with recent Joint Commission
requirements that hospitals adopt a "zero tolerance" policy towards
physicians engaging in disruptive behavior in their interactions with
nurses and other hospital staff.   A peer review body should not be
limited from acting on this type of behavior and in fact, should be
encouraged to act more swiftly.

I believe the peer review process is worth preserving.  It does
however, deserve to be thoroughly reviewed and reworked to ensure
that inappropriate behavior of any kind is immediately acted upon.  I
would ask that the author and interested stakeholders work with my
Department of Consumer Affairs to streamline and improve the peer
review process in order to increase its effectiveness in taking
action against providers that jeopardize quality or safety measures.

For this reason, I am unable to sign this bill.

Sincerely,



Arnold Schwarzenegger