A pending bill in the Legislature — AB 408 by Assemblyman Marc Berman, D-Palo Alto, sponsored by the Medical Board of California — would prioritize the treatment of doctors with physical or mental impairments, including substance use disorders, ahead of the needs of patients. While a substance abuse treatment program sounds good on paper, doctors would still be able to work while confidentially in the program, without any requirement to share this information with their patients. And, as a patient, there is nowhere to investigate whether your doctor is in a rehabilitation treatment facility or not.
In this bill, the board is working to create a substance abuse rehab program for doctors that it would like to oversee itself — controlling who will avoid discipline and keeping those details close to the board. In turn, if doctors voluntarily attend the rehab program, there is no disciplinary action against them.
Most people likely think of the Medical Board of California as an enforcement body that protects the public from unsafe or unethical medical practice. But in reality the board is composed primarily of doctors — and in this instance, appears more interested in protecting its own members than the public it serves.
As the administrative director for the Consumer Protection Policy Center at the University of San Diego School of Law, I lead a nonprofit, nonpartisan academic and research center focused on various regulatory agencies in California.
While the Medical Board claims similar programs are successful in other states, our research has shown the opposite. Consumer Protection Policy Center made public records act requests in states highlighted by the board or that were similarly sized to California, with only Washington and New York providing helpful information. In reviewing the data, Consumer Protection Policy Center found that participation rates are extremely low (less than 1%) and show little measurable impact on patient protection.
For example, Washington has a similar rehabilitation program in place. We found that there were just 81 enrolled participants out of 37,425 licensees (0.22% participation) who participated in the fiscal year 2024, which may also include participants in other states and for reasons other than substance abuse disorders. When contrasted with California’s 153,462 licensees, these figures suggest that implementing a rehabilitation program would likely yield a similar statistically insignificant impact.
The board also wants to take on this additional responsibility while it already struggles financially. The program would cost $32 million each year to serve just 200 participants (about 0.1% of doctors). The board does not address any of the cost challenges, and has no plan to increase licensing fees or rely on a stable revenue source. Without a sufficient budget, there is no guarantee the participants would be properly overseen. This highlights another unresolved issue behind the board’s past failures and patient harm.
To be clear, Consumer Protection Policy Center supports doctors seeking treatment for substance use disorders. What we oppose is a program managed and controlled by the very entity tasked with disciplining those doctors. We believe a rehabilitation program should be regulated independently, with meaningful oversight. For example, when someone gets arraigned for a drug use-related crime, an independent judge, not a law enforcement agency, determines whether treatment is recommended and then that individual could attend a court-approved program. Our judicial system doesn’t contract with its own rehab center. We believe a similar approach should be adopted here as well.
So why is the Medical Board working so hard to create a rehab program for doctors — even working to create legislation on it? The board argues that discipline is currently its only tool, and that enforcement actions are costly and time-consuming. That may be true. But the answer to bureaucratic inefficiency is not secrecy and self-regulation. It’s reform and accountability. The board’s funding is largely supported by physician licensing fees, which raises legitimate concerns about conflicts of interest — particularly when policies favor doctors over patients.
Instead of pursuing meaningful reforms to protect patients, the board is backing a bill that shields doctors. Suppose a doctor harms a patient after being diverted into the program. In that case, the victim can potentially sue the board for antitrust violations without the board being able to claim state-action immunity. And thus, you should ask yourself if the Medical Board of California is true to its statutory responsibility of prioritizing patient protection over any other interest sought to be promoted.
Allowing impaired physicians to enter a confidential, board-supervised rehab program while still treating patients puts public safety at risk. Patients deserve transparency — and a regulator that puts them first.
Friedman is the administrative director of the Consumer Protection Policy Center at the University of San Diego School of Law and lives in Mission Valley.