Updated Disciplinary Guidelines for Medical Board

The Medical Board of California (MBC, Board) is updating its Manuel of Model Disciplinary Orders and Disciplinary Guidelines to reflect changes in the law that have been enacted since the last guidelines were drafted and adopted in 2011. While the majority of the changes are merely to clarify language and update citations, there are some significant changes coming – particularly to the terms of probation – of which licensees should be aware.

PACE is No Longer the Only Option

One major change was removing all specific references to the Physician Assessment and Clinical Education (PACE) at the University of California, San Diego. PACE used to be the ONLY acceptable method of evaluation or courses to be taken by physician disciplined by the MBC. Now, disciplined physicians will no longer be compelled to undergo an evaluation or take a course at PACE, specifically. Rather, physicians will be ordered to complete any program which is comprised of the following:

  • Two-day comprehensive assessment of respondent’s physical and mental health; basic clinical and communication skills common to all clinicians; and medical knowledge, skill and judgment related to the respondent’s area of practice in which he or she was alleged to be deficient; and
  • A minimum 40-hour program of clinical education in that area.

This change is being made to eliminate the appearance of bias in favor of one program over any other. Furthermore, it is to accommodate many professionals located throughout the state who could not make such a time and travel commitment.

Other Miscellaneous Changes

In addition, the guidelines made the following changes:

  • Extends the time the Medical Board has to issue an accusation and/or petition to revoke probation after a temporary suspension order is put in place. The Medical Board previously only had fifteen (15) days to take further action, but they will now have thirty (30).
  • Shortening the time in which a physician who is required to be chaperoned has to replace a chaperone. In the event a doctor’s chaperone became unavailable, the physician used to have sixty (60) days to have a new chaperone approved without having to cease practicing medicine. Now, they will only have thirty (30) days to do so. Chaperones are typically a requirement for physicians who had previous disciplinary findings of of misconduct or inappropriate relationships with patients. The chaperone accompanies the physician when they are physically examining a patient.
  • Prohibiting physicians on probation from supervising advanced practice nurses – such as nurse practitioners or certified nurse midwives. This is in addition to the existing prohibition on the supervision of physician’s assistants.
  • Differentiates between physicians residing in California and out of California during periods of non-practice. Physicians in California must abide by ALL terms and conditions of probation, while physicians residing outside of California only need to comply with the following conditions:
    • Obey All Laws;
    • General Probation Requirements;
    • Quarterly Declarations;
    • Abstain from the Use of Alcohol and/or Controlled Substances;
    • and Biological Fluid Testing
  • Allows physicians who have an out-of-practice period of longer than eighteen (18) months to complete a SPEX exam rather than a comprehensive assessment before returning to practice.

The revised language and other rulemaking materials are available at the MBC’s website. Public comment is open until December 30, 2015 and may be directed to Paulette Romero, Enforcement Program Manager. She can be reached by the following methods:

  • Mailing Address:  2005 Evergreen Street, Suite 1200, Sacramento, CA 95815
  • Telephone No.:  (916) 263-2467
  • Fax No.:  (916) 263-2435
  • Email Address:  paulette.romero@mbc.ca.gov