Another medical turf battle in California

By Dan Walters

Sacramento Bee

California has seen dozens of medical turf battles over the years, most notably a years-long duel between orthopedic surgeons and podiatrists over the legal right to operate on ankles, and no legislative session would be complete without at least one medical shootout.

Psychologists have fought with psychiatrists, nurses with doctors, optometrists with ophthalmologists, and veterinarians with dog groomers.

This year's biggie appears to be a late-blooming bill that would take sides in a power and money struggle between City of Hope, the world-famous Southern California cancer hospital, and the independent medical group that includes almost all of its physicians.

The hospital and the California Cancer Specialists Medical Group have muscled up by hiring veteran Sacramento political operatives as the bill faces its first test in the Assembly Health Committee this week.

Sen. Dean Florez, a Shafter Democrat whose ambitions for statewide office fell short and who will soon be forced out of the Legislature by term limits, is carrying a bill for the medical group aimed at preventing the hospital from severing its ties with the group and setting up its own ``foundation" that would employ doctors.

After City of Hope announced its intention to create its own not-for-profit medical foundation, the medical group's physicians refused to join it, and the two factions exchanged lawsuits.

Florez's Senate Bill 364 dealt with a different issue involving City of Hope when it moved through the Senate. Two months ago, he gutted the measure and inserted new language that would block City of Hope's action, without mentioning it by name, unless it gained clearance from the attorney general's office through a ``patient impact report."

The City of Hope medical group has hired Richie Ross, a sometime lobbyist and veteran campaign consultant (Florez is one of his clients) to gain enactment of the bill. City of Hope has retained former Republican Sen. Jim Brulte and Garry South, another veteran campaign consultant, as strategic advisers.

Ross and South are longtime rivals. Their clients have clashed in previous Democratic primary campaigns, so there's a personal element in their new duel.

Of course, both sides claim the moral high ground. City of Hope says its foundation would provide more responsive medical care. The 120-member medical group claims that the move is just a way around California law forbidding hospitals to directly employ doctors and is aimed at improving not patient care, but the hospital's finances.

The outcome, however, will not be settled on the basis of what's best for patients. Like all medical turf battles in the Capitol, it will be determined by which side mounts the most adroit political operation.

And that is, or should be, a little scary.

Dan Walters can be reached at dwalters@sacbee.com. For back columns, visit www.sacbee.com/walters. The article was distributed by Scripps Howard News Service (www.scrippsnews.com).