Complaint: General Office Practices/Protocols
No. California law does not require physicians to have a male or female chaperone; however, if having a chaperone or assistant in the exam room makes the patient feel more comfortable and at ease, then the physician should accommodate the patient's request if possible or allow a friend or relative to accompany the patient.
Yes, the physician can choose to not accept a new patient who does not want to sign the Arbitration Agreement.
No. A physician has a right to determine whom to accept as a patient, just as a patient has the right to choose their physician. However, B&P Code Section 125.6 (and Civil Code 51) does not allow a physician to discriminate against a prospective patient on the basis of race, gender, disability, sexual orientation, citizenship or marital status. A physician also may terminate a patient without cause as long as the termination is handled appropriately (see Question "
Can a physician refuse to treat a current patient?").
There are no specific laws governing a physician's responsibility in regard to filling out forms or providing reports. Physicians can choose not to complete discretionary paperwork if, in their medical opinion, the services/equipment is not medically indicated. Patients requesting completion of applications for disability benefits, FMLA, and/or work restrictions may contact their treating physician for assistance. Patients should contact their attorney if one is involved, or the disability or Workers' Compensation program, requesting the information as they may have specific rules and/or laws regarding the timely filing of forms/reports. They also may have alternatives that the patient can use if the physician won't cooperate. The Medical Practice Act does not preclude the physician from charging for this service.
Yes, but the physician needs to follow appropriate guidelines. See California Medical Association (CMA) guidelines in regard to terminating the doctor/patient relationship. The CMA guidelines indicate a physician must notify the patient in writing informing the patient:
- the last day the physician will provide care, assuring the patient at least 15 days of emergency treatment and prescriptions before discontinuing service;
- alternative sources of medical care; i.e., referral to another physician, the patient's insurer/HMO, or the local county's medical society; and
- information necessary to obtain the patient's medical records compiled during this physician's care.
No. While there is no law mandating a physician provide "back up or cross covering" care when he/she is unavailable, most physicians do have emergency coverage available when they are unavailable, whether it be with another physician or directing the patient to Urgent Care or to a hospital's emergency department.
Starting January 1, 2024, the Medical Practice Act requires a physician to maintain medical records for at least seven years after their last date of service to a patient (see Business and Professions Code section 2266).
In addition, please note that other areas of the law establish longer record retention schedules under certain situations or conditions. For example, a ten-year retention period is required pursuant to Welfare and Institutions Code section 14124.1 (relating to certain Medi-Cal patients).
The Board receives and investigates a number of complaints about physician prescribing concerns which are sent by someone other than the patient. These complaints can be difficult to investigate when the patient does not consent to allow the Board to evaluate the care and treatment. It is very helpful in these situations if the Board is provided with as much information as possible, including but not limited to, the patient's name, patient's date of birth, what specific medication(s) is/are being prescribed and the quantity and frequency. Sometimes this information can be obtained from the pharmacy where the prescriptions are filled. The Board will try to validate the information and in the event that sufficient evidence is available to support a possible violation of the law, an investigational subpoena will be issued for the patient's medical records.
The Board has very limited jurisdiction over independent evaluation reports. The role of the evaluator is to provide an "independent opinion" of the individual's condition after 1) examining the patient and/or 2) reviewing the records of the treatment obtained by the other treating physicians involved in the patient's care. The Board will normally recommend that disability patients pursue an appeal through the disability insurance company.
Worker's compensation independent (IME) and qualified medical examiner (QME) evaluations are governed by the Medical Unit of the Division of Workers' Compensation. This state agency is responsible for regulating the conduct of IMEs and QMEs in workers' compensation cases, and may be able to advise you on other workers' compensation-related issues. You may contact them at DWC - Medical Unit P.O. Box 71010, Oakland, CA 94612 or by telephone at 510-286-3700 or 800-794-6900.
No, the Board does not provide referrals to physicians. You can contact your local medical association for referrals in various medical specialties or your individual insurance plan or HMO. To locate the medical association/society in your area you can log onto the California Medical Association's website at
cmadocs.org/partners.
There is no law which specifically prohibits a physician from evaluating, diagnosing, treating, or prescribing controlled substances to a family member, employee or friend. However, the practice is discouraged. There are laws to consider when assessing any prescribing issues which include, but are not limited to: 1) a physician cannot prescribe without an appropriate prior exam and a medical indication for the prescription, and 2) an adequate and accurate medical record relating to the provision of services to the patient and documenting the medical need for the prescription must be created and maintained by the physician. Basically, a physician must follow the same practice/protocol for any patient in which medications are prescribed.
Business and Professions Code section 726 states that sexual abuse, misconduct or relations with a patient are considered unprofessional conduct and grounds for disciplinary action. The Board considers any type of personal relationship between the doctor and the patient to be a very serious breach of public trust and investigates these complaints. Please refer to "Complaints: Investigations" which provides general information about complaint investigations.
The fact that the personal relationship between the physician and the patient at some point was consensual does not negate the fact that the physician breached professional ethics and boundaries, and possibly broke the law, by initiating a personal relationship with a patient. Filing a complaint with the Board would be strongly encouraged so the issue could be investigated in the event that other complaints with similar allegations had been reported.
No. Children from the age of 12-17 have the authority to "consent" to some types of treatment without the permission of their parent or guardian. The physician is obligated to maintain the doctor/patient confidentiality, particularly when the physician feels that the disclosure of the information will have a negative impact on the relationship with the patient. HIPAA also prevents the disclosure of doctor/patient information to the parent. i.e., treatment related to the prevention of sexually transmitted diseases.
The medical clinic must be wholly owned and controlled by a physician or physicians (a layperson cannot own a clinic). See Business and Professions Code sections 2400 - 2417 and Corporations Code sections 13400 - 13410 for the requirements on what business structures can be used (sole ownerships, professional partnerships, and professional corporations). If the physician/owner is practicing under a name other than their own name (i.e., a clinic name, like "Sun Valley Medical Clinic"), the physician must obtain a
Fictitious Name Permit (FNP) from the Medical Board. This is separate from any fictitious business name filings required by city or county governments. Applications for the Medical Board's FNP can be obtained either on the Board's website or from the Consumer Information Unit at 1-800-633-2322. If a physician who owns a clinic is a Medicare provider, he or she can obtain certification for the clinic through the Department of Public Health without having to apply for an FNP.
Health and Safety Code section 123148 requires the health care professional who requested the test be performed to provide a copy of the results to the patient, if requested either orally or in writing. When the patient requests their lab results, the health care provider should provide the results to the patient within a "reasonable" time period after the results are received by the provider. Results may be disclosed in electronic form if requested by the patient and if deemed most appropriate by the health care professional who requested the test. In the event that the provider arranges for the test results to be provided by Internet posting or other electronic manner, the results shall be disclosed to a patient in a reasonable time period, but only after the results have been reviewed by the provider. Depending on the results of the tests, some physicians may want the patient to schedule an appointment to review and discuss the results and any follow-up testing or treatment that might be required. The test results cannot be released by the lab performing the test and must be released by the provider requesting the test(s).
