What is the Medical Board of California?
The Medical Board of California (MBC) is a state government agency within the Department of Consumer Affairs responsible for licensing, regulating, and disciplining physicians and surgeons (MDs), as well as certain allied healthcare professionals, in California.
Its primary mission is to protect healthcare consumers by ensuring proper licensing, enforcing the Medical Practice Act objectively, investigating complaints, and promoting access to quality medical care.
The MBC also provides public information on licensee records, handles disciplinary actions when needed, and supports high standards in medical practice.
The Medical Board of California also allows the public to verify a physician's license and review the doctors disciplinary history.
For more details, visit the official website at mbc.ca.gov. The main office for the board is 2005 Evergreen Street, Suite 1200, Sacramento, CA 95815 and the general phone number is (916) 263-2382.
The board itself is filled by political appointees. There are 15 members total. 13 members are appointed by the Governor. The other two come from the State Assembly and Senate. The Speaker of the Assembly appoints one member and the Senate Rules Committee appoints the other. The current President of the Board is Kristina Daniel Lawson who is a lawyer from Walnut Creek, California She is a partner in the law firm Hanson Bridgett LLP which has a large medical law practice. Their webpage describes the firm's medical practice this way.
For more than 30 years, our attorneys have advised Medical Staff leaders in a variety of settings, including in general acute care hospitals that are part of health systems, stand-alone community hospitals and specialty hospitals, hospital districts, academic medical centers, ambulatory surgery centers, and medical group peer review committees. Our attorneys have significant expertise and experience:
- Guiding Medical Staffs on governance, credentialing, and legal issues
- Advising Medical Staff leaders regarding provider health, conduct, and care
- Representing Medical Staffs in fair hearings and litigation
- Supporting Medical Staffs in drafting, developing, and revising Bylaws and policies
See: Hanson Bridgett Medical Staff Page
Eight of the fifteen board members have to be physicians and many but not all of the public members are attorneys. There is an administrative staff which is effectively in charge of the day to day operations of the board. Reji Varghese is the "CEO" (Executive Director). Previously he worked for the Oklahoma State Board of Medical Licensure and Supervision as their financial manager/comptroller from 1989-2008, and as deputy director from 2009 to 2020.
An interesting position is that held by Aaron Bone, Chief of Legislative and Public Affairs. This role interfaces the board with the Legislature. It can get very heated and controversial. For example, in 2019, the California Legislature enacted Assembly Bill 241. As of January 1, 2022, all continuing medical education courses in California must include discussion of “implicit bias.” This would have been vetted with the Chief of Legislative and Public Affairs as most medically related bills are discussed with the board and this directly affects required yearly education courses that physicians must take. There is now a lawsuit challenging this bill alleging that the forced curriculum violates the First Amendment rights of the people teaching the courses. (See: Lawsuit Here) This lawsuit named many in the executive leadership of the board as defendants.
Another lawsuit of interest was reported in the Lassen News. It says that Granville Marshall, Jr., a former Susanville physician, has filed a United States District Court Eastern District of California lawsuit against the Medical Board of California. Dr. Marshall alleges that there were due process violations in his disciplinary proceedings as the Lassen News notes that "This follows a broader 2021 California Research Bureau report that found significant racial disparities in how the MBC handles complaints and discipline against Black and Latino physicians.". This lawsuit is important because the actual mechanisms of the medical board have been largely hidden from public view. The concept has been that the board has public members and physician members so that fairness can be implied by a non-partisan and broad based composition. Legally great deference has been given to administrative agency decisions. However, the Chevron case (Chevron U.S.A. Inc. v. Natural Resources Defense Council, Inc. in Loper Bright Enterprises v. Raimondo) end the rule of deference to administrative decisions so that courts now have the ability to directly review administrative decisions (e.g. like the medical board) by objective standards.
The difficulty Dr. Marshall will face is that his original discipline was based upon patient safety issues and he did not appear at a second hearing that alleged that he failed to adhere to probationary terms that had allowed him to practice. He may have forfeited his rights to a judicial challenge by not pursuing his full administrative remedies before filing in court. In addition, he filed in a court district that is very low on judges (Congress has been slow in approving new judges). His case will take years to be heard. In addition, he filed pro per and a complex case of this type generally needs an attorney to raise the issues fully and properly.
WHAT ARE THE LIMITS OF THE POWERS OF THE MEDICAL BOARD?
The medical board in general has very broad powers. Its stated purpose is to protect patients/consumers by licensing, regulating, and disciplining physicians, surgeons, and allied health professionals under the Medical Practice Act. Its primary powers include investigating complaints, suspending or revoking licenses, placing licensees on probation, issuing public reprimands, and enforcing regulations to ensure safe medical practice. The board can issue supoenas for records bypassing a judicial sign off (in other words not warrant affidavit is needed). They can get an administrative law judge to summarily suspend a license and they can file a public Accusation without judicial permission. But there are limits.
The area of limits gets murky as courts can review the board's actions but they are very deferential to the board. Courts apply the 'independent judgment' standard to review factual findings in Medical Board cases (because licensure represents a fundamental vested right), but only 'manifest abuse of discretion' for penalty review. Under Bixby v. Pierno (1971) 4 Cal.3d 130, courts exercise independent judgment on the evidence for factual findings. But for penalty determinations, neither trial nor appellate courts are free to substitute their judgment - only arbitrary, capricious, or patently abusive exercises of discretion warrant intervention. So in determining a violation of the standards of care there is some oversight - in terms of penalty there is greater deference to the board.
A case that outlines a lot of these issues is is Magit v. Board of Medical Examiners, 57 Cal.2d 74 (1961). In this case Dr. Magit employed three unlicensed but highly trained physician-anesthesiologists to administer anesthesia to his patients under his supervision.
The legality of this practice was genuinely unsettled — the controlling case law had held that licensed nurses could administer anesthetics, and no statute or court decision squarely prohibited what Dr. Magit did. That was a failing (in our opiniion of the medical board in that an issue well known and disputed had not been specifically addressed)
He acted in good faith after consulting legal counsel who advised the practice was lawful. The Board nonetheless revoked his license — the maximum penalty available. The California Supreme Court held this was "a clear abuse of discretion." The court ordered the case returned to the Board for reconsideration, finding that "suspending judgment" or "Placing * * * upon probation" would be a more appropriate discipline given the physician's evident good faith, the high competence of his anesthesiology staff, and the legal ambiguity surrounding the question. A medical board attorney needs (at times) to review board meeting notes/minutes to see if an issue has been raised but not resolved.
We had a chiropractic case many years ago in Stockton, California where a chiropractor was criminally charged for hiring board certified anesthesiologists to put patients under so that an otherwise very painful adjustment could be done. He was charged with practicing medicine without a license. We won that case and part of our proof was that this was a known issue that neither the medical board, osteopathic board or the chiropractic board had addressed. In other words, was the chiropractor the "Captain of the Ship" directing the doctors or were they using their own independent judgment. The fact that this issue was never addressed negatively by any of these boards was a factor in our favor.
In terms of sanctions and penalties (again) the board has wide discretion. There is a case where the courts overruled the board and its facts are instructive. In Yakov v. Board of Medical Examiners, 68 Cal.2d 67 (1968), the California Supreme Court affirmed a superior court judgment annulling the Board's revocation of Dr. Yakov's license. Dr. Yakov had been convicted of furnishing amphetamines to undercover state agents posing as weight-loss patients. The Board charged moral turpitude in addition to the underlying violations. The superior court exercising independent judgment found that the moral turpitude finding was not supported by the weight of the evidence. The Supreme Court agreed, holding "we hold as a matter of law that the doctor's conduct did not exhibit such 'baseness, vileness and depravity' as to constitute moral turpitude." The court found that the doctor's motivation was benign — to assist patients with weight control at prices below drug store rates — and that there was "no evidence of subjective intent other than to serve the best interests of his patients." Because it was impossible to determine how much the unsupported moral turpitude finding contributed to the revocation, the court affirmed the order annulling the Board's decision and remanding for reconsideration of the appropriate penalty. Again, this was an extreme case and generally once factual findings favor the board there is broad discretion to fashion a remedy.
Other resources
Medical Board video on Disciplinary Guidelines
Our Blog on Disciplinary Guidelines
