August 10, 2017

Palm Springs Desert Sun: SB 349 is dangerous for patients and our community

SB 349 is dangerous for patients and our community August 9, 2017 Dr. Bryan Stone

As a local doctor, I wear many hats including patient advocate, kidney specialist, medical executive committee member, member of the California Medical Association, father and educator. I consistently reach out to politicians and medical leaders in our community in an effort to inform them about the needs of patients we see with worries about medical problems, out-of-pocket costs and access to empathetic quality care.

Above all else, our community needs elected representatives who listen and vote for the needs of patients including a focus on value-driven high quality care, attainable access to care, and assistance with getting medications.

That’s why I’m actively speaking out against a bill in the state legislature, Senate Bill 349, which I believe would be very dangerous for some of the most vulnerable patients in our community. Senate Bill 349 would mandate strict staffing ratios for nurses, technicians, dieticians and social workers working in dialysis clinics. The bill would also institute a new 45-minute “time out” between patient treatments.

While increasing staff may seem like it would be beneficial, it actually will result in reduced access to care for dialysis patients in our community. Under SB 349 clinics have two choices: They must hire additional staff to treat their current patients; or they will have to reduce the number of patients they see with their current staffing levels. In our community, SB 349 will force many dialysis clinics to reduce the number of patients they see because it will be financially infeasible to hire significant numbers of new workers. We also face a significant shortage of qualified nurses and dialysis caregivers.

The California Dialysis Council projects that, statewide, more than 15,000 patients could have their access to dialysis appointments disrupted if SB 349 is adopted. These patients need this treatment to survive.

SB 349 collapses access to care, drives up costs and offers no proven quality benefits. Demand for dialysis in our region is growing rapidly, and our ability to find clinics to serve new patients is already strained. SB 349 will result in reduced access, force patients to drive long distances to find dialysis care or, worse, they could be forced to dialyze in the hospital.

And for what benefit? States that have adopted similar plans have shown no significant improvement to care quality. California already outperforms other states in clinical quality, lower infection rates and better patient satisfaction – including states with mandatory ratios like those imposed by SB 349.

Rather than focus on arbitrary laws that are not proven to improve quality, we need to focus on actions that will actually improve care. As a medical director for dialysis centers in my area, I have embraced and designed many programs that require intense education of our staff members to improve quality indicators, offer education to multilingual patients and reduce costs. As dialysis is so complicated and yet distinctly life-saving, we use a series of data-driven indicators that are monitored by the physicians, the state and the federal government. Dialysis centers invite teams of federal and state representatives to do deep internal audits annually or more often if results are sub-par. These reviews are critical, exhaustive and thorough.

SB 349 only gives the appearance of benefiting patients. This bill is driven by a union with an agenda that does not align with that of our patients or dialysis caregivers. SB349 is not the answer, merely a distraction.

Our local legislators, including Assemblymember Eduardo Garcia, must protect patients when they vote on this bill. We urge Assemblyman Garcia and all legislators to put patients first and reject SB 349.

Dr. Bryan Stone has been practicing nephrology and internal medicine in the Coachella Valley for nearly 20 years. He is a medicine department chair at Desert Regional Medical Center. 

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