The California Medical Board hearing that could result in the revocation or suspension of Beverly Hills fertility doctor Michael Kamrava's license to practice resumes today in Los Angeles.
Damning details have already come out, including the admission by the in-vitro fertilization "internationally recognized leader" that he implanted 12 embryos into imbalanced Octomom Nadya Suleman of La Habra because she wouldn't consent to anything else. Still, it's amazing there have been proceedings against Kamrava at all.
The state board rarely takes action against a doctor and it's rarer still for physicians to lose their medical licenses. As reported by the San Francisco Chronicle:
- Out of 6,539 complaints in fiscal year 2009, only 276 "accusations" (medical board jargon for charges) were brought against doctors. And less than 2 percent of those lead to the loss of medical licenses.
- It takes about 2 1/2 years for a complaint to be resolved--and potentially dangerous doctors continue practicing in the meantime.
- California ranks 43rd among states in taking serious disciplinary action against doctors, according to Washington, D.C.-based Public Citizen consumer advocacy group.
Compared to other cases facing the board, the action against Kamrava has moved fairly quickly, taking about 10 months for the investigation to wrap up. On average, the Chronicle reports, it takes about a year to complete an investigation and another 18 months to resolve a complaint. An appeals process adds more time.
Needless to say, California disciplines fewer doctors than the national average. And a 5-year-old law aimed at speeding the process has only shaved a month off the average completion time, which is 878 days. The state has a new plan to trim the timetable to 540 days by 2013, but it depends in part on adding new positions during a hiring freeze.
Former state Sen. Liz Figueroa, the Alameda County Democrat who sponsored the 2005 legislation, called the medical board "the ultimate good old boys" network that over the years has used its influence within state government to beat back efforts to more strictly regulate and penalize doctors.
Meanwhile, the Boston Globe editorial board says the California Medical Board "should take the harshest disciplinary action" against Kamrava--while warning the physician and even Suleman are only symptoms of a larger problem: the $3 billion in-vitro fertilization industry.
Kamrava's testimony that he implanted a dozen embryos into Suleman because she would accept now fewer "speaks to the very real impact that patient pressure can have on how many embryos a doctor implants during IVF," according to the Globe. "Every doctor in the fertility industry knows patients can push very hard to have more embryos implanted than is recommended, especially when they're paying out of pocket for the expensive procedure."
The Beantown daily pointed to a recent Yale University study that found states without mandated insurance coverage of IVF have higher rates of embryos implanted and twin and triplet pregnancies. Also worth noting: more embryos are implanted on average in the United States than in many European countries, where stricter policies and laws exist.
"U.S. fertility guidelines are, at the moment, just that," the Globe finds, "and have tended to be ignored by many physicians."
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"In a year when the father of IVF, Dr.Robert Edwards
, won the Nobel price in medicine for his breakthrough, the story of a barely capable mother of octuplets reminds us that even the best discoveries can do harm when the wrong incentives take precedent over what is best for patients."