Sunday, February 25, 2018

SB 1303 (Pan & Gagliani) would replace coroners with medical examiners (Part II)

Incredible as it may seem, it is still true in February of  2018 that non-medically trained persons are allowed by law to conduct autopsies including forensic autopsies where evidence that may be used at trial is being compiled. My previous post told about a particularly egregious abuse of the system, namely, the blatant political assertion of power politics to influence the collection of data to protect persons of authority who appear to have abused their authority to cover up a homicide. Now the tide is turning, or so some hope. Here's why:

State Senators Richard Pan, MD, and Cathleen Galgiani introduced SB 1303. This bill will require that counties of 500,000 or more use bona fide medical examiners for autopsies. The reliance on elected or appointed county coroners will go to the scrap heap of history. The medical examiner will have to be a liccnsed MD.

The wording of the bill needs to be more precise  -- it should say that the Medical Examiner shall be an M.D. licensed in California. There is a reason: when California's Utilization Review (UR) Guidelines were developed, licensed physicians were required to do UR. It was not felt necessary to say licensed in California since all the patients were treated in California  -- that led to a clever tactic by medical provider networks and insurance companies that then scoured the country for doctors who they felt would be willing to deny care to injured workers and others.

It helped insurance companies to use doctors not licensed in California because those doctors could not be held accountable to the California Medical Board for wrongful denials of care. In turn these denials of care enabled insurance companies to avoid paying for medical services. To avoid this quagmire in SB 1303 the bill should be amended to state that Medical Examiners shall be Medical Doctors (MDs) licensed in California. 

In Decmber of 2016 Chief Medical Examiner Bennet Omalu, MD, and Susan Parson, MD, resigned from their jobs in forensic pathology in San Joaquin County. Their complaint was "routine interference" from the Sheriff-Coroner in death investigations. The assertion was that political power was routinely asserted to impede  investigations where law enforcement personnel were involved, for instance, when a detained person died while in custody.

Loss of confidence in government has occurred as a result -- years of ignoring wrongful use of power under cover of authority has always required watchful eyes and is not a popular job. In the medical legal world, replacing elected or appointed coroners with Medical Examiners who are California licensed MDs is overdue.  

SB 1303 is sponsored by the Union of American Physicians and Dentists (UAPD) and by the California Medical Association (CMA). 

Note: Although this blog is independent, not supported by any corporate or union entity, this writer is a member of both UAPD and CMA.  

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