As submitted to, on September 24, 2010, at 06:05 AM

         Subject:  VETO AB 1235 - Jay Garfinkle MD 


                  Re: Corporate Control of Medical Peer Review


         To the Honorable Governor of California, Arnold  Schwarzenegger,
         Dear Governor Schwarzenegger, 
         On August 30, 2010, Jay Garfinkle MD wrote the following e-mail to Professor Sharon Winer MD MPH,
         with copy to CMA's Executive Committee, staff and leadership, enclosed.
         Jay Garfinkle, MD, is a member of CMA's Board Of Trustees, BOT.
         Dr. Garfinkle is a Board Certified General Surgeon, specialized in Cancer, in Hayward, CA.
         He did his Residency at the Ochsner Foundation Hospital & Kaiser Hospital- Sunset.
         Professional interests: Breast Cancer Surgery conservation techniques and sentinel lymph node biopsy. 
                                                 Gastrointestinal Cancer Surgery including laparoscopic procedures. 
                                                 Thyroid Cancer Surgery. 
From:  Jay Garfinkle, MD
Subject:  RE: AB 1235 - Was CMA taken over by CHA ?

Date:  August 30, 2010 8:15:02 AM PDT

         I don't think you're the only one feeling betrayed.  The two peer review
         bills which are of major importance to many of us rank and file members 
         have been under consideration by the legislature for several months.  
         And, given the obvious need to modify them, especially AB1235, 
         in order to protect our rights in peer review actions, a reasonable 
         person would have expected CMA's Board Of Trustees, BOT, to be 
         heavily involved in the process.  A review of the minutes of the last BOT 
         meeting which was only a few weeks ago, however, does not indicate
         that there was any discussion re this issue.  
         It would appear, therefore, that this has been entirely a Staff project 
         without any meaningful input by the BOT.  
         And as a result, we have what many of us consider to be misguided support 
         for what is clearly a bad (as currently written) bill.  And equally as important, 
         we have a widespread and growing feeling of discontent and betrayal among 
         those members who are paying attention and trying to participate in the CMA's 
         My conclusions may be entirely incorrect, but I have been given no clear
         reason to believe otherwise.
         Jay Garfinkle
From: Sharon Winer
Subject:  Re: AB 1235 - Was CMA taken over by CHA ?
Date:  August 30, 2010 3:19:59 AM PDT
         Hi Dustin and Francisco:
         I have been following the email discussions regarding SB 700 and AB 1235 with increasing anxiety, concern and sense of betrayal.  
         Please  comment and explain the CMA rationale for supporting both of these bills if this is still the case.  It would be nice to have this 
         clarified and resolved before the HOD where it would become a dominant issue.
         Sharon Winer
         Dear Governor Schwarzenegger,  
         To date, CMA has not responded to Professor Sharon A. Winer's e-mail.    
         In view of the above, you MUST VETO  AB 1235, as it is still a "work in progress",     
         Respectfully submitted,     
         Gil Mileikowsky MD - President and Founder of     

Subject:  AB 1235 - Was CMA taken over by CHA ?

Date:  August 29, 2010 3:35:11 AM PDT

       Dear Mr. Corcoran,
       Thank you very much for your e-mail dated, August 27, 2010, whereby you admit that you do have the power to withdraw 
       forthwith AB 1235, 
      Subject: Healing arts: peer review.
      Authored by: Hayashi,
       Accordingly, one has to wonder why you refuse to withdraw this bill and insist on passing it, when the HOD clearly directed 
       you to pass a bill that is the exact opposite to AB 1235 ? 
       Following, please find, copy of the e-mail I received from Dr. Weinmann, Past President of the Union of American 
       Physicians and Dentists, UAPD, that ponders over your possible ulterior motives.
From: Robert Weinmann
Subject:  Re: AB 1235 - Was CMA taken over by CHA ?

Date:  August 27, 2010 7:53:09 PM PDT

   Ordinarily, when an organization loses control of a bill because opposition forces have
   rammed through unfriendly amendments, the organization withdraws from support of the 
   bill and, if they're sponsoring it, cancels the sponsorship. If that doesn't happen, 
   it's fair to ask why, e.g., were the amendments actually OK'd by the sponsor or other
   supporters, is there a proposed trade-off in the works, etc. Usually, it's the "et cetera."
       I note that AB 1235 includes a most unusual and dangerous clause, whereby physicians who are employees of hospitals or 
       medical groups, are treated differently from physicians who are not employees. Why would CMA do such a thing ?
      SEC. 2. Section 809.04 is added to the Business and Professions Code, to read: 
      (b)  To ensure that the peer review process is not circumvented, 
            a member of a medical or professional staff, by contract or 
            otherwise, shall not be required to alter or surrender staff privileges, 
            status, or membership solely due to the termination of a contract 
            between that member and a health care facility. However, with 
            respect to services that may only be provided by members who 
            have, or who are members of a medical group that has, a current 
            exclusive contract for those identified services, termination of the 
            contract, or termination of the member’s employment by the 
            medical group holding the contract, may result in the member’s 
            ineligibility to provide the services covered by the contract.
            Page — 6 —  AB1235
           Enrolled- 08/24/2010 HTML- 22730 bytes PDF- 101232 bytes,
           Unfortunately, as written at the present time, AB 1235 would not protect any physician that CMA purports to protect, 
           such as Dr. Sharon Siegel, see: 
           176. Retaliation Against Sharon Siegel, M.D.,

Retaliation Against Sharon Siegel, M.D.

  • Horty & Springer - Medical Staff Leader - December 2002 Excerpts

  • California Medical Asoociation's (CMA) Perspective

  • Amicus brief filed in support of Sharon Siegel, MD by CMA

    Neither law nor public policy tolerates:

    1. retaliation against physicians who advocate for appropriate medical care for their patients and protest policies which undermine quality health care

    2. any termination of the physician/patient relationship for an improper reason.

      The physician-patient relationship, and the advocacy role of physicians are critically important to the provision of high quality medical care and to the health and safety of the public. Espceially in the current economic environment, which may not give appropriate weight to the importance of the physician/patient relationship, the laws protecting the practice of medicine must be interpreted as the Legislature intended.

      Read Brief



Respectfully submitted, 

 Dear Governor Schwarzenegger,  
                        To date, CMA has not responded to Professor Sharon A. Winer's e-mail.    
                        In view of the above, you MUST VETO  AB 1235, as it is still a "work in progress",     
                        Respectfully submitted,     
                        Gil Mileikowsky MD - President and Founder of