California's Proposition 46 and Mandatory Physician Drug Testing: A Cause for Concern
Authors: Yul D. Ejnes
Journal: Annals of Internal Medicine (2014)

In the Balance16 December 2014California's Proposition 46 and Mandatory Physician Drug Testing: A Cause for ConcernYul D. Ejnes, MDYul D. Ejnes, MDFrom The Warren Alpert Medical School of Brown University, Providence, Rhode Island.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-1866 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail California is one of 21 states that allow citizens to propose new laws by “ballot initiative” (1). This year, a California ballot initiative has potential national implications. Proposition 46, the Troy and Alana Pack Safety Act of 2014 (or the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative) (2), links 3 seemingly unrelated issues. “Prop 46” increases the cap on noneconomic damages in medical liability cases from $250 000, its level since the Medical Injury Compensation Reform Act (MICRA) was adopted in 1975, to an inflation-adjusted $1.1 million. It also mandates that physicians check the state's online Controlled Substance ...References1. What are ballot propositions, initiatives, and referendums? Los Angeles: Initiative and Referendum Institute, University of Southern California; 2014. Accessed at www.iandrinstitute.org/Quick%20Fact%20-%20What%20is%20I&R.htm on 7 August 2014. Google Scholar2. Troy and Alana Pack Safety Act of 2014. California Secretary of State; 2014. Accessed at http://vig.cdn.sos.ca.gov/2014/general/pdf/complete-vig.pdf#page=68 on 7 August 2014. Google Scholar3. Statewide Initiative Guide. California Secretary of State; 2002, revised January 2013. Accessed at www.sos.ca.gov/elections/ballot-measures/initiative-guide.htm on 7 August 2014. Google Scholar4. Mello MM, Kachalia A. Evaluation of options for medical malpractice. Report No. 10-2. Washington, DC: Medicare Payment Advisory Commission; April 2010:12. Accessed at www.medpac.gov/documents/contractor-reports/Apr10_MedicalMalpractice_CONTRACTOR.pdf on 14 August 2014. Google Scholar5. Nagourney A. California asks: should doctors face drug tests? New York Times. 2 August 2014:A1. Accessed at www.nytimes.com/2014/08/02/us/california-asks-should-doctors-face-drug-tests.html on 7 August 2014. Google Scholar6. Title 49: Transportation, Part 40. Procedures for transportation workplace drug and alcohol testing programs. Washington, DC: U.S. Department of Transportation; 2012. Accessed at www.dot.gov/sites/dot.dev/files/docs/PART40_2012.pdf on 7 August 2014. Google Scholar7. Opinion 4.05: Organized Medical Staff. In: AMA Code of Ethics. Chicago: American Med Assoc; 2004. Accessed at www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion405.page on 7 August 2014. Google Scholar8. Lemon SJ, Sienko DG, Alguire PC. Physicians' attitudes toward mandatory workplace urine drug testing. Arch Intern Med. 1992;152:2238-42. [PMID: 1444683] CrossrefMedlineGoogle Scholar9. Boisaubin EV, Levine RE. Identifying and assisting the impaired physician. Am J Med Sci. 2001;322:31-6. [PMID: 11465244] CrossrefMedlineGoogle Scholar10. Pham JC, Pronovost PJ, Skipper GE. Identification of physician impairment. JAMA. 2013;309:2101-2. [PMID: 23629590] doi:10.1001/jama.2013.4635 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Warren Alpert Medical School of Brown University, Providence, Rhode Island.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1866.Corresponding Author: Yul D. Ejnes, MD, Coastal Medical, Inc., 75 Sockanosset Crossroad, Suite 101, Cranston, RI 02920; e-mail, [email protected]edu.Author Contributions: Conception and design: Y.D. Ejnes.Analysis and interpretation of the data: Y.D. Ejnes.Drafting of the article: Y.D. Ejnes.Critical revision of the article for important intellectual content: Y.D. Ejnes.Final approval of the article: Y.D. Ejnes.Administrative, technical, or logistic support: Y.D. Ejnes.Collection and assembly of data: Y.D. Ejnes.This article was published online first at www.annals.org on 30 September 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCalifornia's Proposition 46: A Wolf in Sheep's Wool Julius Cuong Pham and Peter J. Pronovost California's Proposition 46: A Wolf in Sheep's Wool Julius Cuong Pham and Peter J. Pronovost Metrics 16 December 2014Volume 161, Issue 12Page: 911-912KeywordsAdverse eventsAlcoholsDisclosureDrugsHealth care qualityHearingMedical staffPatientsSafetySystematic reviews ePublished: 16 December 2014 Issue Published: 16 December 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...