Consumer Confidential: California faces a doctor shortage. But doctors just derailed a plan to fix it

David Lazarus, Los Angeles Times on

Published in Business News

Or is the doctors' opposition rooted in something as petty as having their status as primary caregivers threatened by well-trained colleagues who just want to address a crucial need for medical professionals?

Janus Norman, who oversees legislative matters for the California Medical Assn., dismissed such speculation as "red herrings."

He told me the only issue for doctors is ensuring that nurse practitioners are sufficiently experienced and monitored to guarantee high-quality care. "We're interested in protecting the patients of California," he said.

I asked if he could cite any documented evidence of malpractice from the 28 states, plus the District of Columbia, that have granted more independence to nurse practitioners.

Norman said he had no such data. But he said his group is aware of "massive" anecdotal evidence from doctors in other states about inappropriate referrals and unnecessary testing by nurse practitioners.

That's not very impressive.

In fact, a 2017 study found that instances of malpractice were far higher for physicians than for nurse practitioners. A 2018 study found that when nurse practitioners are given more authority to practice and prescribe, overall malpractice costs drop for all medical professionals.

Wood, the bill's author, said if there was proof that giving nurse practitioners greater independence is potentially harmful to the public, critics such as the doctors group would have it at their fingertips.

"They have nothing," he said.


What they do have is plenty of funding and political clout.

Unfortunately, that won't change when AB 890 returns in the future.

About The Writer

David Lazarus, a Los Angeles Times columnist, writes on consumer issues. He can be reached at

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