On November 4, 2014, residents of California will be voting on Proposition 46, an initiative that has the potential to greatly impact physicians and pharmacies in this state. According to the California Official Voter Information Guide, the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative proposes five amendments to current healthcare practices:

  1. Require drug and alcohol testing of doctors and reporting of positive tests to the California Medical Board.
  2. Require the Board to suspend doctors pending investigation of positive tests and take disciplinary action if the doctor was impaired while on duty.
  3. Require doctors to report any other doctor suspected of drug/alcohol impairment or medical negligence.
  4. Require health care practitioners to consult state prescription drug history database before prescribing certain controlled substances.
  5. Increase $250,000 cap on pain and suffering damages in medical negligence lawsuits to over $1 million to account for inflation.

Our position, in which we always attempt to maintain neutrality, is that the passage of this legislation will impact healthcare.   The increase of the capitation amount for pain and suffering damages will result in increased healthcare cost for providers. The increase of malpractice cap will increase professional insurance rates. I fear the day when fellow or competing healthcare practitioners can arbitrarily report another of suspected drug and/or alcohol impairment.  This initiative may also compel doctors to leave California to practice in states where medical liability insurance is not as costly, resulting in reduced access to care.

The supporters of Proposition 46 argue that it will save lives by deterring negligence and holding doctors accountable.  Physicians are already under high scrutiny from regulators in regards to appropriate prescribing of opioids, and this proposal would augment the threat of punishment and possibly licensure revocation.

While it is unfortunate that there are individuals seeking to abuse pain medication, the majority of individuals in acute and chronic pain require treatment. If laws are making it more difficult for people in severe pain to obtain medication, forcing doctors and pharmacists to become paranoid about prescribing and dispensing drugs, how are those suffering from pain supposed to access proper treatment?

To learn more about this initiative, I encourage you to visit the website: http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm*

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