Letter # 1 in set of two

Chairmen Leroy F. Greene
Joint Legislative Sunset Review Committee
Room 2090 State Capital
Sacramento, Ca 95814

Oral Testimony for Presentation on November 17, 1997

RE A Change in the Composition of the Medical Board of California

I am a California-licensed community midwife and current licentiate of the Medical Board. I was also trained as a nurse and worked in acute care hospital setting (emergency medicine and labor & delivery room) for 20 years prior to entering the field of midwifery. Since May of 1993 I have been regularly attending the quarterly Board meetings.

My experience as a hospital nurse, parent of three now adult children, patient-advocate, direct-entry midwife and most recently, a grandmother, has exposed me to both the highs and the lows of medical care over the course of 34 years. I am not anti-medical in philosophy-- in fact, I believe that providing medical care is a very difficult job which is getting harder as a result of recent healthcare. I admire and appreciate the physicians who take on these hard and frequently thankless tasks. I know from personal experience that the members of the governing Board and those who work for the regulatory agency are good people doing a hard job and doing it very well.

I am proposing a change in the current configuration of the medical examiners oversight board as appointed by the governor and legislature of California. Currently the all-MD board regulates not only its own allopathic medical profession but also 19 other health professions including licensed midwives. This represents a very acute departure from the historical foundation of medical regulation as reflected in the original legislation passed by the California Legislature.

A historical study of the medical practice regulation, going back to the progenitor enactment of 1876 and all iterations and enactments since, reveals that the California medical board of examiners was originally an interdisciplinary board comprised of physicians who represented the various medical disciplines of allopathic, osteopathic, homeopathic, naturopathic and what was referred to as the "eclectic" school of medicine. This was abruptly changed as a result of the 1910 Flexnor Report, which contained recommendations for healthcare reform as promoted from behind the scenes by organized medicine. The Flexnor Report elevated a particular version of allopathic medicine and sought to eliminate or take control of all medical schools which taught other forms of the healing arts. Based on unproven theories as advanced in Flexnor Report and by the AMA’s medical education committee, the California Medical Practices Act of 1913 repealed the interdisciplinary board of medical examiners and replaced it with one comprised solely of 12 allopathic physicians and no public members. In 1922 naturopathic and chiropathic physicians sponsored a ballet initiative that created a separate board for governing of the chiropractic profession. Osteopathic physicians also have a self-governing board.

However, since 1913 all other non-allopathic healthcare practitioners have fallen under the regulatory umbrella of the Medical Board of California. In practical terms this meant that for many decades traditional healing arts such as homeopathy, acupuncture and midwifery were prohibited by the all-allopathic medical board which labeled them as quackery and/or illegal practices of medicine. In 1980 legislation added seven public members to the all allopathic board but this statutes prohibits the appointment of any non-physicians practitioner who is a licentiate of the medical board, thus excluding all 19 categories of currently licensed allied heath practitioners from membership on the board that regulates their profession.

The circumstances surrounding California’s current MD only rule for the medical board has never been re-examined in light of the changing demographics of healing arts and contemporary evidence-based research reaffirming the therapeutic efficacy of many traditional and alternative forms of healthcare. This situation is unsatisfactory from the standpoint of the citizens of California who often find themselves forced into an unregulated black market in order to receive alternative or complimentary therapies. It is also unfair to allied healthcare practitioners who bear the burden of regulation without representation.

Therefore I respectfully request your consideration of the following:

(1) That the role of Medical Board of California either be expanded to include an appropriate representation of non-allopathic practitioners on the 19 member governing board OR that the authority of the MBC be legislatively restricted to regulating only allopathic physicians. According to the latest statistics published by the MBC, there are 79,048 physician licenses in effect in California and 77,800 Allied Health practitioner licenses. In spite of a nearly 50-50 mix, no one other than MDs can sit on the Board according to the current legislative scheme. For instance, there are no midwives on the Board which regulates midwifery. This results in regulation without representation. and is an unwieldy, unsatisfactory way to govern the profession of healing arts in a state where more than half of all healthcare visits are to non-allopaths practitioners.

I want to thank you for permitting me to speak today and urge you to consider a legislative plan that permits the various non-allopathic healing arts to be appropriately represented in the regulatory process. I urge you to think in terms of keeping California on the leading edge of the changes in healthcare for the coming century, and to be a leader in how to incorporate the benefits of changing times while better protecting its citizens from the inevitable excesses.

Faith Gibson, Licensed Midwife #041

encl: Additional Written Testimony for the record

cc: Ron Joseph, Executive Director, MBC