California College of Midwives

Legislative Fact Sheet with Citations
California Citizens for Health Freedom 888 / 557-8092

  Statements from Medical Board meetings reveals
the unworkability of Physician Supervision

Participants:  Dr Joas, MD, appointed member of California Medical Board
Judge Cologne, lawyer, former judge & lobbyist for CMA and current representative of the three doctor-owned malpractice carriers in CA   -- NorCal, Doctors Company and Skippy
Joan Hall: Lobbyist for California Medical Associaiton (CMA)
Dr. Leon Schumel, midwife-friendly obstetrician in Davis
Nancy Chavez, Administrative aide to Senator Luncy Killea, author of SB 350
Anita Scuri, senior counsel for the MBC

Dr. Joas: Legislation is the art of compromise. ... you’ve got to accept it at that point and you’ve got to say "OK, now we have to go back and get additional cleanup legislation". That’s how I see it and that’s the name of the game.

Judge Cologne: Doctor, if I could make a comment on that very point. We think the CMA has come a long way. When I used to work for the CMA, which was 4 years ago, I was handed the same bill and I was told to kill the bill and I did. The bill died. Now you find the CMA accepting the bill, they supported this bill when it came through.

Joan Hall: This was the first time the medical association was willing to sit down and discuss it and understand the need to legitimize this process because you {the midwives}definitely have something to provide. ... we believe that the standards that are in the bill are standards that make for safe, capable practitioners. Yes, we believe in the standards in the bill. ... there will be competent capable practitioners under the standards that are set up in this bill. So we very much believe in the standards in this bill.

Judge Colone: If you're talking about a consulting capacity and that’s the way the bill was worded originally, we weren't opposed to it because it was consulting and the doctor was given immunity except for bad advice. Now that’s totally different from when it was amended and made him a supervisor. He is liable whether he gives bad advice or not. He might be liable because he did not investigate well enough the qualifications of this lay midwife. There are a lot of things that can make that doctor liable.

With the lay midwife, we knew from the very beginning that what she wanted to do was home deliveries and in home deliveries, if you have a consulting capacity, we don't have a problem with that but if your doing home

Judge Colonge: If you went back and said that the supervisorial relationship will constitute no liability except for advise for given to the lay midwife which is improper it would solve an awful lot of problems but the trial lawyers wouldn’t let you get it through.

Judge Cologne: I’m ... talking about the one who is taking on the role of supervisor. That’s a very significant legal issue here, because if your a supervisor, you have vicarious liability ... If your a backup doctor and just taking the case that’s presented to you as an emergency, that’s not a supervisorial role. You may have some liability but every obstetrician has that. What were concerned about is the vicarious liability that a doctor assumes when the doctor takes on this special relationship as supervisor.

Dr. Schimel: Obviously, the simplest (solution) is something we can’t do because we have a legal restraint of requiring the word "supervisorial" so we can’t turn the clock back at this time in relation to implementation of this bill which would be simpler if we didn’t have that and it would eliminate the vicarious liability.

Nancy Chavez, Senator killea’s legislative Aide: ...since we keep talking about the problem in the bill with supervision, since that seems to be the problem, that nobody can control here, ummm, if it were a consultative relationship in the law, would none of this discussion have to take place?

Anita Scrui, Senior Counsel, MBC: That’s correct

SB 1479 ~California Citizens for Health Freedom 888 / 557-8092