The principle of the Hippocratic Oath is one of the oldest binding documents in history. The oath states: I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion. In purity and according to divine law will I carry out my life and my art. I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft. Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.
Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private. So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate. (U.S. National Library of Medicine, 2014) Medical Board of California
The Medical Board of California is the agency responsible for regulating physicians, surgeons and other allied health professions. The members of the board are appointed by the Governor of the state and have a four year term legislature. It is the responsibility of the members of the board to meet as one deliberating body. In addition, the board members are required to learn about policies and statutes of both licensing and enforcement functions. California Licensure Physician Statute
There is no single physician licensure statute in the state of California. Instead, physician licensure rules have been interspersed within the California code. Physicians wishing to practice medicine in California are required to obtain a full medical license issued by the state. Furthermore, there are no administrative regulations or state statue for granting a special or limited license to practice in the state remotely via telemedicine. The California licensure does not allow for license reciprocity between any states but allows physicians for consultative services without having to receive a full medical licensure. Moreover, licensed physicians in the military in any of the states, either a military physician officer or a civilian contract employee, are allowed to care for fellow military members without having to receive additional licensure. In the event of an emergency situation, a physician is allowed to administer care regardless if the physician is licensed in that particular state. A physical examination is required by the California Medical Board Licensure to allow administration or prescription of medication over the internet. Investigative Role
The investigative team consists of physicians that are a critical component to the board as they base its disciplinary actions on the opinions of physicians and not board staff. Physicians play a distinct role in the investigations. The board receives and reviews incoming complaints in the Central Complaint Unit (CCU). The physicians determine if there is a need for formal investigation by board investigative staff or if the complaint is largely resolved by a preliminary review of the medical records and the accompanying physician narrative statement. Medical experts are asked to review case materials and must clearly articulate whether the physician’s care under review fell below the standard. They must give their opinion if there is a potential violation of the Medical Practice Act. Business and Professions Code Section 2050-2079
According to the Federation of State Medical Boards, the 10th Amendment police power grants states the right to regulate the practice of medicine. Section 2052 of the Business and Professions Code states that any person who practices or attempts to practice, or who advertises or holds himself or herself out as practicing, any system or mode of treating the sick or afflicted in this state, or who diagnoses, treats, operates for, or prescribes for any ailment, blemish, deformity, disease, disfigurement, disorder, injury, or other physical or mental condition of any person, without having at the time of so doing a valid, unrevoked, or unsuspended certificate as provided in this chapter or without being authorized to perform the act pursuant to a certificate obtained in accordance with some other provision of law is guilty of a public offense, punishable by a fine not exceeding ten thousand dollars ($10,000), by imprisonment pursuant to subdivision of Section 1170 of the Penal Code, by imprisonment in a county jail not exceeding one year, or by both the fine and either imprisonment (California Business and Professions Code, 2014). Civil Complaint Process
The two major categories of incoming complaints to the Medical Care Board of California by the consumers are quality of care and personal conduct. All complaints require physician review and all complaints which are not closed by CCU staff are referred to one of the board’s district offices for formal investigation. According to the Medical Board, each district office is staffed with a supervising investigator, five investigators, a deputy attorney general, an investigator assistant, clerical support staff and one or more medical consultants (The Medical Board of California, 2014). Risk Management & Quality Assurance
It is important that physicians are credentialed and are given privileges in any health care organization prior to practicing medicine. Physicians must receive training and education in risk management and review of federal and state regulations mandates. A successful risk management strategy is to improve the quality of patient care and reduce the probability of an adverse outcome or a medical malpractice claim. Its objective is to reduce the risk to patients and liability to the physician. Furthermore, the foundation for risk management is the standard of care. Tracking the quality of care of physicians must include Ongoing Professional Practice Evaluations (OPPE) and a peer review committee within an organization. Criminal Prosecution for Malpractice
Physicians are in a unique position in regard to the law by the nature of their work. A physician may face a charge of criminal negligence, manslaughter, or second-degree murder if a patient in his care suffers severe or lethal injuries. “Negligence law offers plaintiffs the legal framework upon which to build their civil suit. A plaintiff in a medical malpractice action must satisfy four elements-duty, breach, causation and damage- in order to prevail. In a negligence case, the wrongdoer’s actions are compared to what would be expected of a reasonable and prudent person in the same or similar circumstance” (Monico, Kulkarni, & Calise, 2013). The practice of medicine is full of uncertainties. In some cases, bad outcome is the result of physician negligence. The patient and/or his family may institute a civil suit for malpractice if they believe that the bad outcome was a result of the physician’s actions. It is very rare that a prosecutor decides the facts of a case warrant a charge of criminal malpractice. The prosecutors must see a repetitive negligent behavior that constitutes to a pattern that can be documented before criminal charges can be filed. Conclusion
The medical profession has many dedicated people who give themselves and sacrifices for the sake of saving lives. Physicians practice their profession according to the Hippocratic Oath. Furthermore, the have learned the rules and regulations mandated by the Federal and State government in health care delivery. Quality of health care is an important objective of CMS. Physicians are required to adhere to the standards of quality care and the delivery of it.
When physicians get in trouble with the law, they have to face various criminal and civil charges based on the severity of their case. In the current trend, doctors commit white-collar crimes when they take kickbacks, order questionable procedures, overbill patients and insurance companies, and bill for services they did not provide.
The Medical Board of California ensures safety and protection of health care consumers through proper licensing and regulation of physicians by means of various objective enforcement of the Medical Practice Act.
California Business and Professions Code. (2014). Business and Professions Code Section 2050-2079. Retrieved from
http://www.liginfo.ca.gov/cgi-bin/displaycode?section=bpc&group Medical Board of California. (2013). Guide to the Laws Governing the Practice of Medicine by Physicians and Surgeons. Retrieved from http://www.mbc.ca.gov/about_laws/laws/_guide.pdf Monico, E., Kulkarni, R., & Calise, A. (2013). The Criminal Prosecution of Medical Negligence. Retrieved from http://www.ispub.com/IJLHE/5/1/5237 The Medical Board of California. (2014). Laws and Regulations. Retrieved from http://www.mbc.ca.gov/about_us/laws/ U.S. National Library of Medicine. (2014). The Hippocratic Oath. Retrieved from http://www.nlm.nih.gov/hmd/greek/greek_oath.html