Richard Kipling's blog

 The California Medical Association is no wallflower in the conversation about the state’s health reform future. A power in the halls of the Legislature for decades, the CMA certainly doesn’t plan to sit out the important discussions now taking place in Sacramento about the shape of Obamacare in California.

As one of several blogs I’ll be penning on the players in California health reform, I talked recently to Dustin Corcoran, the association’s CEO, about the CMA’s role.

Without hesitation, he pointed to “change” as the organization’s biggest issue. How does the organization help its members grapple with “the rapidity of change that is coming at physicians, and helping them through the most significant change in decades – at least since Medicare.”

To the greater public, CAPG could be a sports team, a medical procedure or a test to get into college. But take a closer look at the California Association of Physician Groups and you'll find an increasingly powerful player in the state's new world of health reform.

CAPG doesn't look important, with only 160 members. Then you do the math and discover that it represents huge organizations like Kaiser Permanente health plans that employ thousands of California doctors. In fact, says CAPG's president and CEO, Donald Crane, his members' coordinated care model serves around 20 million California patients, more than half the state's population.

Over the past month, in a front-page series of stories, the Los Angeles Times has exposed how the state of California’s Medical Board has “failed to protect patients from reckless prescribing by doctors.” The result, the paper found, has been at least 30 patient drug overdose deaths since 2005.

The paper’s investigation points to serious problems in the board’s oversight function, which the Times says is limited by its investigations process and also by the reduced ranks of Medical Board investigators.

There it is, right on the California Department of Public Health home page. It’s listed there -- no irony intended, I suspect -- under “Other Hot Topics.”

The headline reads: “Extreme Heat Guidance: Preventing and Preparing for Climate Change.”

Now, it sounds like another in the endless string of reports and studies looking at what climate change might do. But this report gets frighteningly close to home, as in WHERE WE LIVE.

Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for our adult health care?

In this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.

These safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.