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Consumer seat at risk on state medical boards

A consumer seat on each of Florida’s medical boards would be taken away and given to a physician assistant under bills pending in budget committees in the House and Senate.

The change would leave just two consumers on the 15-seat Board of Medicine and just one on the seven-member Board of Osteopathic Medicine.

The low-profile bills haven't drawn much notice, but when patient advocates hear about them they disapprove. Florida already gets low rankings for serious physician discipline in annual reports by Public Citizen’s Health Research Group in Washington, D.C

“What would make more sense down there would be to remove one of the physicians rather than one of the consumers,” said the research group’s director, Dr. Sidney Wolfe.

Donald Mullins, a consumer member of the Florida Board of Medicine, said that three seats out of 15 already gives Florida a lower rate of consumer representation than most other states.  Florida’s 20 percent is below California (47 percent), Texas (37 percent), and New York (28 percent), he said.

Each of the consumer members is, in effect, representing 6.2 million Floridians, Mullins said. Taking away one of the non-physicians from the board would raise it to 9.5 million. Too many, he said.

“I want to make sure that the process protects the people,” he said.

Even if the change didn’t make a difference in the board’s decisions, he said, it might give the public the perception that it had.

The PA bills, 363 in the House and 774 in the Senate, passed unanimously through health regulation committees in both chambers last month. They now await action by health budget committees, since part of the bill reduces licensing costs to PA’s and thus would cut income to a state trust fund by more than $900,000.

It is unclear at this point whether the budget committees will give the bills a hearing and, if so, pass them.

The Florida Academy of Physician Assistants (FAPA) is lobbying hard and claims support from the Florida Medical Association, the Florida Osteopathic Medical Association, and the Florida Academy of Family Physicians.

But FAPA lobbyist Juhan Mixon got a cooler reception from the Board of Medicine’s Rules and Legislative Committee on Dec. 1, when he came to seek support.

“Until we have a seat on the board and we’re treated as equal partners, it’s like being a second-class citizen,” Mixon said.

He said PA's need representation on the board since it regulates them. But a physician on the committee, Zach Zachariah, said the board also regulates three other professions: electrologists, nutritionists and anesthesia assistants. Zachariah said that if PA’s win a seat, the other professions will demand one, too.

“PA’s make a significant contribution to health care in America,” Zachariah said, “but I can’t support them on this.”

He said he thinks the initiative is about “prestige.” In discussions with PA’s about the bill, Zachariah said, “they could not give me one credible reason why they need to have representation on the board.”

The committee voted unanimously to oppose awarding a board seat to a PA, but supported the part that reduces licensing costs.

PA’s, who do many of the same tasks as physicians, have considerable post-graduate academic and clinical training, although not as much as the doctors who supervise them.

There are about 5,100 PA's in Florida, according to a legislative staff analysis. By contrast, DOH reports say there are 62,000 licensed MDs -- 44,000 in active practice in the state -- and about 6,000 osteopathic physicians, of whom about 4,200 are active.

The three consumer members currently serving on the Board of Medicine are:

--Mullins, director of the Center for Operational Readiness, Response & Recovery at University of South Florida, a first-responder training program that designs and conducts Homeland Security exercises. He lives in Orlando.

--Brigitte Rivera Goersch, deputy executive director for administration, security and technology at the Greater Orlando Aviation Authority.

--Bradley Levine of Pompano Beach, an economist and MBA who worked in the financial services industry before creating, developing and later selling firms in internet broadcasting and insurance technology services.

 One of the consumer slots on the Board of Osteopathic Medical Examiners is currently vacant, according to DOH. The other, according to the agency website, is held by Rita Malan, a Medicaid eligibility expert at Tallahassee Memorial Hospital. (Editor's note: An earlier version of this article stated an incorrect number of vacant seats.)

Members of the boards are appointed to four-year terms by the governor, subject to Senate approval.

Two of the consumer members of the medical boards, Mullins and Malan, are former DOH employees, according to the agency's website.

--Health News Florida is an independent online publication dedicated to journalism in the public interest. Editor Carol Gentry can be reached at 727-410-3266 or by e-mail.