BILL ANALYSIS �
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THIRD READING
Bill No: AB 1621
Author: Halderman (R)
Amended: As introduced
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 9-0,
6/11/12
AYES: Price, Emmerson, Corbett, Correa, Hernandez, Negrete
McLeod, Strickland, Vargas, Wyland
ASSEMBLY FLOOR : 76-0, 4/9/12 - See last page for vote
SUBJECT : Physicians and surgeons: prostate cancer
SOURCE : Northern California Chapter of the American
College
of Surgeons
DIGEST : This bill exempts physicians and surgeons
working on a trauma case from having to provide patients
with specified information regarding examination of a
patients prostate gland when treating a patient who needs
trauma care.
ANALYSIS :
Existing law :
1. The Medical Practice Act provides for the licensure and
regulation of physicians and surgeons by the Medical
CONTINUED
AB 1621
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Board of California.
2. Requires, under the Grant H. Kenyon Prostate Cancer
Detection Act, that when a physician and surgeon is
examining a patient's prostate gland during a physical
examination to provide the patient with a written
summary of the availability of appropriate diagnostic
procedures, including, but not limited to, the prostate
antigen (PSA) test if any of the following conditions
are present:
The patient is over 50 years of age.
The patient manifests clinical symptomatology.
The patient is at an increased risk of prostate
cancer.
The provision of the information to the patient
is medically necessary in the opinion of the
physician and surgeon.
3. Provides that violation of the requirements regarding
the examination of a patient's prostate gland constitute
unprofessional conduct and is subject to a misdemeanor
penalty.
4. Authorizes the Department of Health Services to approve
the use of a publication from a recognized cancer
authority as the written summary and to review the
publications every three years in order to ensure that
the summary comprises timely, new and revised
information regarding prostate cancer treatment options.
5. Authorizes the Medical Board of California to
disseminate the written summary to physicians and
surgeons and post it on its Web site for public use.
6. Defines trauma case as any injured person who has been
evaluated by pre-hospital personnel according to
policies and procedures established by the Emergency
Medical Services (EMS) agency and who has been found to
require transportation to a trauma facility.
AB 1621
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This bill exempts a physician or surgeon working on a
trauma case from providing a written summary about the risk
and treatment options for prostate cancer to a trauma
patient.
Comments
Prostate Examination Procedures . According to the American
Cancer Society, prostate cancer is the second deadliest
cancer among men, and occurs most often in African American
men. However, survival rates are quite high. In fact, 91%
of all men with prostate cancer will live for 15 years
beyond their diagnosis. According to the U.S. Preventative
Services Task Force, 95% of men with cancer who are
followed for 12 years do not die from prostate cancer
including those who do not receive treatment.
Additionally, the National Cancer Institute found that 70%
of prostate cancer deaths occur after age 75.
The examination of a patient's prostate is a common
procedure that is recommended for men over 50 years of age.
There are several techniques that can be utilized to
conduct a prostate examination including an ultrasound, CT
scan, physical examination or blood test. In regards to
trauma cases, a physician or surgeon may utilize a physical
prostate examination if there is significant blood,
laceration or obvious trauma to the prostate. Otherwise, a
rectal examination, consisting of a physician or surgeon
inserting their finger into a patient's rectum, is commonly
utilized to determine if the prostate is dislocated or
deformed. This simple procedure is not considered to be a
formal prostate examination, but rather a preliminary
check. If a nodule or significant deformity to the
prostate is detected during this procedure, the physician
or surgeon would note this in the patient's chart.
However, if the trauma patient is transported to another
location, there is a risk that the patient will not be
provided with further information regarding the need for
further assessment.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 6/13/12)
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Northern California Chapter of the American College of
Surgeons (source)
California Chapter of the American College of Emergency
Physicians
California Hospital Association
Medical Board of California
ARGUMENTS IN SUPPORT : According to the Northern
California Chapter of the American College of Surgeons, the
sponsor of this bill, current law does not provide
exemptions for situations where providing written
information is impossible or impractical and this bill
provides a "common-sense emergency exemption."
The sponsor cites the example of an unconscious patient who
may be transported to an emergency room with severe
injuries requiring the placement of a urinary catheter.
The sponsor indicates that, in this situation, the
physician would need to conduct an examination to determine
the extent of the injuries including a rectal examination
to determine the status of the prostate gland. The
physician may also conduct an examination, similar to a
prostate examination, in order to check for pelvic fracture
or internal bleeding. However, by the time the patient is
stabilized or regains consciousness, he may have been
transported to a different unit or facility making it
difficult for the physician to locate the patient to
provide him with the written summary.
ASSEMBLY FLOOR : 76-0, 4/9/12
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Bonilla, Bradford, Brownley,
Buchanan, Butler, Campos, Carter, Chesbro, Conway, Cook,
Davis, Dickinson, Donnelly, Eng, Feuer, Fletcher, Fong,
Fuentes, Furutani, Beth Gaines, Galgiani, Garrick, Gatto,
Gordon, Gorell, Grove, Hagman, Halderman, Harkey,
Hayashi, Roger Hern�ndez, Hill, Huber, Hueso, Huffman,
Jeffries, Jones, Knight, Lara, Logue, Bonnie Lowenthal,
Ma, Mansoor, Mendoza, Miller, Mitchell, Monning, Morrell,
Nestande, Nielsen, Norby, Olsen, Pan, Perea, V. Manuel
P�rez, Portantino, Silva, Skinner, Smyth, Solorio,
Swanson, Torres, Valadao, Wagner, Wieckowski, Williams,
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Yamada, John A. P�rez
NO VOTE RECORDED: Blumenfield, Charles Calderon, Cedillo,
Hall
JJA:do 6/13/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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