BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 916
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          Date of Hearing:   April 30, 2013

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                              Richard S. Gordon, Chair
                 AB 916 (Eggman) - As Introduced:  February 22, 2013
           
          SUBJECT  :   Healing arts: false or misleading advertising.

           SUMMARY  :   Prohibits a physician from using the terms "board,"  
          "certified," or "certification" in advertising  unless those  
          terms are used in reference to a certifying board meeting  
          specified criteria.   Specifically,  this bill  : 

          1)Prohibits a licensed physician and surgeon who is certified,  
            as specified, from using the terms board," "certified," or  
            "certification" in advertising unless the full name of the  
            certifying board is also used and given comparable prominence  
            with the terms "board," "certified," "certification," or  
            "board certified" in the statement and unless the term or  
            terms are used in reference to a certifying board, as  
            specified.

          2)Deletes an obsolete definition of the term "board certified".

          3)Makes finding and declarations relative to the importance of  
            preventing false advertising of certified medical services.  

           EXISTING LAW  

          1)Establishes the Medical Board of California (Board) and  
            specifies the responsibilities of the Board to regulate  
            physicians and surgeons as specified. (Business and  
            Professions Code (BPC) Section 2004)

          2)Provides that a physician and surgeon licensed by the Board  
            may include a statement that he or she limits his or her  
            practice to specific fields, but shall not include a statement  
            that he or she is certified or eligible for certification by a  
            private or public board or parent association, including but  
            not limited to a multidisciplinary board or association unless  
            the board or association is:

             a)   An American Board of Medical Specialties member board;









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             b)   A board or association with equivalent requirements  
               approved by that physician and surgeon's licensing board;  
               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. (BPC 651)

          3)Prohibits a physician and surgeon licensed by the Board who is  
            certified by a qualified board association from using the term  
            '"board certified" unless the full name of the certifying  
            board is also used and given comparable prominence with the  
            endorsement. (BPC 651)
          4)Defines multidisciplinary board or association to mean "an  
            educational certifying body that has a psychometrically valid  
            test process as determined by the Board for certifying medical  
            doctors and other healthcare professionals that is based on  
            the applicant's education, training and experience." (BPC 651)

           FISCAL EFFECT  :   None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.

           COMMENTS  :   

           1)Purpose of the bill  .  This bill aims to protect consumers from  
            false or misleading advertisements about the training and  
            qualifications of physicians by prohibiting the use of the  
            terms "board," "certified," or "certification" in advertising  
            unless the physician is certified by an acceptable certifying  
            body, as specified.  This bill is sponsored by the California  
            Society of Plastic Surgeons. 

           2)Author's statement  .  According to the author, "This bill aims  
            to protect the public by requiring better information about  
            the qualification of health care providers.  Some physicians  
            misrepresent themselves by advertising they are part of a  
            board, are certified or have certification.  While most  
            physicians and surgeons are following the letter of the law,  
            some physicians mislead the public by implying they are board  
            certified.  'Board certification' represents the gold standard  
            for training a physician has received in their specialty.   
            This bill seeks to protect the public from misrepresentation  
            and/or misleading advertisements."









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           3)Practicing without a specialty certification  .  Board specialty  
            certification as held by physicians is not a requirement for  
            licensure; it is a voluntary process granted by a member board  
            of the American Board of Medical Specialties (ABMS), a private  
            organization, or other equivalent board.  However, current law  
            is quite clear that a physician may not advertise that they  
            are "board certified" unless they have been certified by the  
            appropriate certifying entity.  Unfortunately, restrictions on  
            variations of that term are not as clear.   

          This restriction is important in advertising because patients  
            may choose a licensed physician based on their board  
            certification.  Recent news articles have highlighted cases of  
            individuals who may be selecting doctors based on false  
            representation of their certification credentials.  In a  
            recent news story by CBS 13, patients of a Rocklin-based  
            doctor were left deformed and paralyzed after receiving  
            plastic surgery procedures from a doctor whose background and  
            training were in another medical specialty.  This bill helps  
            to prevent the misrepresentation of a physician's credentials  
            by prohibiting them from using words to imply board  
            certification.   

           4)Board certification and licensure  .  Licensure for physicians  
            and surgeons requires a Doctor of Medicine degree from an  
            approved school and one continuous year in a single  
            postgraduate training program accredited by the Accreditation  
            Council for Graduate Medical Education or Royal College of  
            Physician and Surgeons of Canada.  However, being licensed  
            does not indicate whether a doctor is qualified to practice in  
            a specific medical specialty, such as pediatrics, plastic  
            surgery or dermatology.  Currently, there are three  
            accrediting entities that provide board certification for  
            licensees regulated under the Board.  Between Board-approved  
            specialty boards and the ABMS, there are 28 certificated  
            specialties.

            The Board has approved the following four specialty boards,  
            American Board of Facial Plastic and Reconstructive Surgery,  
            American Board of Pain Medicine, American Board of Sleep  
            Medicine and the American Board of Spine Surgery. 

           5)American Board of Medical Specialty  .  The AMBS is non-profit  
            organization made up of twenty-four medical specialty boards  
            and is responsible for overseeing the certification of  








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            physician specialists throughout the United States.  The  
            individual specialty boards represented under the AMBS include  
            Allergy and Immunology, Anesthesiology, Colon and Rectal  
            Surgery, Dermatology, Emergency Medicine,  Family Medicine,  
            Internal Medicine, Medical Genetics, Neurological Surgery,  
            Nuclear Medicine, Obstetrics and Gynecology, Ophthalmology,  
            Orthopaedic Surgery, Otolaryngology, Pathology, Pediatrics,  
            Physical Medicine and Rehabilitation, Plastic Surgery,  
            Preventive Medicine, Psychiatry and Neurology, Radiology,  
            Surgery, Thoracic Surgery and Urology.  

            Each of the twenty-four AMBS specialty boards is responsible  
            for establishing the standards of competency for specialty  
            certification.  The specialty boards are governed by a board  
            of trustees or a board of directors who are certified in the  
            board's specialty area.  

            When an individual physician seeks board certification, they  
            would contact that board directly for its certification  
            standards and process.  For example, the board certification  
            process for pediatrics includes an application to take a  
            certifying examination, and meeting general admission  
            requirements including a medical school degree,   
            satisfactorily completion of three years of  
            pediatric-accredited training, and a valid and unrestricted  
            license to practice medicine.

           6)Arguments in support  .  The California Society of Plastic  
            Surgeons writes in support, "[This bill] is a simple measure  
            that looks to protect the use of the term board certified and  
            allow patients to truly understand the training and education  
            of the healthcare practitioner they are considering for their  
            medical care.  Board certification represents the 'gold  
            standard' for training a physician has received in their  
            specialty.  When an individual sees an advertisement stating a  
            physician is board certified in a certain specialty such as  
            plastic surgery they have confidence the plastic surgeon in  
            the advertisement has received extensive training."  

            California Chapter of the American College of Emergency  
            Physicians writes in support, "As Californians are being asked  
            to be more involved with their healthcare decisions,  
            understanding the training and education of healthcare  
            practitioners is becoming even more important.  Board  
            certification represents the gold standard for the training  








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            and education a physician obtains.  [This bill] protects the  
            use of the term board-certified and allows patients to better  
            understand the training and education of the healthcare  
            practitioner whom they are considering for their medical  
            care."

           7)Previous legislation  .  AB 583 (Hayashi), Chapter 436, Statutes  
            of 2010, required health care practitioners to provide their  
            name, license type, and highest level of academic degree, and  
            board certification in a written disclosure or in their  
            offices, as specified.   

            SB 1454 (Ridley-Thomas) of 2008, required any advertising by a  
            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.  SB 1454 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.  AB 2734 was held on the  
            Assembly Floor.
             
            SB 836  (Figueroa) Chapter 856, Statutes of 1999, expanded and  
            revised the prohibition against fraudulent advertising by  
            health practitioners.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Society of Plastic Surgeons (sponsor)
          California Chapter of the American College of Emergency  
          Physicians
          California Orthopaedic Association

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Elissa Silva / B.,P. & C.P. / (916)  
          319-3301 










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