Commentary: Local medical professional’s thoughts on Proposition 46

I try to avoid politics in my column, but this year Proposition 46 has pushed me into the arena. Here are my thoughts.
As I see it, Prop. 46 was initiated by a man named Bob Pack from Danville, who tragically lost his two children when they were killed by a driver who was impaired by prescription drugs.
He and his backers want this bill to force doctors to consult an online, statewide controlled-drug database called CURES, before they prescribe these drugs to their patients.
I actually look forward to using this system to help me weed out chronic drug seekers, of which there are many out there. My problem is that I don’t think I should be forced by law to use this system and I wonder what the punishment would be to a doctor who, for whatever reason, bypassed the use of CURES.
Not only has this system been somewhat burdensome to use up until now, but I can’t imagine how CURES will handle thousands of doctors’ multiple daily requests for drug-use information.
One only needs to remember how the computer system to sign up for Obamacare worked.
Consulting the CURES program for every controlled drug prescription will also take up precious time of approximately 5 to 10 minutes per request, giving even less time for the doctor to spend with his or her patient.
Another aspect of Prop. 46 is mandatory random drug testing of physicians with physicians paying for their own testing.
I’m not saying that all doctors are perfect and some have used drugs or alcohol while treating a patient, but I can honestly say that, in my 40 years of medical practice, I have worked with well over a thousand doctors and I cannot personally recall any of those doctors being found to be practicing under those conditions. And, it was a patient on alcohol and drugs, not an impaired doctor who killed Mr. Pack’s children.
Thrown into this proposition — and sponsored by the Consumer Attorneys of California and many law firms from across the state — is raising the cap of economic damages in malpractice cases from the current $250,000 to $1,000,000.
The cap, which the legislature passed years ago, has decidedly decreased the number of malpractice cases and has kept malpractice insurance rates from soaring as they were doing at the time this legislation was enacted. There has, however, never been a cap on economic damages or for reimbursement of medical bills.
I would like to quote information written by the Legislative Analyst found in the California General Election Official Voter Information Guide which all registered voters recently received in the mail.
I quote: “Raising the cap would increase the amount of damages — thereby increasing the amount that could potentially go to an attorney representing an injured party on a contingency-fee basis. This in turn, makes it more likely that an attorney would be willing to represent an injured party, thereby increasing the number of claims. On the net, these changes would likely result in higher medical malpractice costs, and thus higher health care spending in California.”
This higher health care spending in California could be in the billions of dollars.
In this same guide, the State Attorney General says “Increased state and local government health care costs from raising the cap on medical malpractice damages, likely ranging from tens of millions of dollars to several hundred million dollars.”
Higher malpractice insurance premiums are likely to cause a number of doctors to leave the state as well as having older, seasoned doctors retire sooner than they had planned. These factors would make it even more difficult for patients to find doctors and clinics to care for their needs.
My main concern is for you the patient, who will likely face higher health care costs and less opportunity to find a doctor to care for you.
Again, these are my own personal thoughts on Prop. 46 and how we all could be affected by it.
– Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or email him at

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. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.