Opinion ID: 2608898
Heading Depth: 3
Heading Rank: 2

Heading: Prohibition Against Discrimination

Text: Section 1316.5 prohibits discrimination between physicians and clinical psychologists with respect to the health services both are authorized to perform. As shown above, the health services psychologists are authorized to provide and the health services physicians are authorized to provide are not coextensive. (See California State Psychological Assn. v. County of San Diego (1983) 148 Cal. App.3d 849, 853 [198 Cal. Rptr. 1].) The antidiscrimination clause does not address the issue of who has primary responsibility for a patient. It simply requires that when psychologists and physicians are both authorized to provide the health service, one may not be preferred over the other. Thus, if psychological services are required as part of the treatment of a patient, a physician may not be selected to perform the services over a psychologist. The clause neither says nor implies that psychologists are to be given overall primary responsibility for the admission, diagnosis, treatment and discharge of hospitalized patients. The majority asserts that the regulations violated the antidiscrimination language because a psychologist performing psychological services would be subject to the supervision of a psychiatrist. (Maj. opn., ante, at pp. 13-14.) The majority's unarticulated assumption is that primary responsibility for a patient necessarily entails physician control over a psychologist's performance of psychological services. It does not. Primary responsibility may encompass a physician's decision to refer a patient for psychological evaluation; it does not follow, however, that the reference therefore includes control over the psychologist's performance. A physician may also decide, for example, to refer a patient to a radiologist. The physician does not thereby assume control over the radiologist's performance of the radiology services. The regulations challenged in this case did not provide otherwise. ( Ante, at p. 22; maj. opn., ante, at p. 6, fn. 1.) Although the medical needs of a patient may require the psychiatrist to change the treatment plan, this court should not assume, as the majority does, that when a psychiatrist refers a patient to a psychologist for psychotherapy, the psychiatrist would exercise his or her authority to control the psychologist's performance. (Maj. opn., ante, at pp. 13-14, fn. 8.) Inherent in the concept of referral is a recognition of the particular competence and expertise of the health provider to whom the patient is referred. Heavy-handed supervision would be inconsistent with this recognition, whether the referral be to a radiologist or a psychologist.