John McDougall MD authored a bill in the California legislation, SB 380. This bill would require all medical doctors in the state of California to include a course on nutrition as part of their continuing medical education.
The bill was strongly opposed by the California Medical Association, on the grounds that the legislature should not be telling doctors “how to practice medicine.” A version of the bill modified from the initial draft passed the committee on Monday, May 2, 2011.
BILL NUMBER: SB 380 AMENDED BILL TEXT AMENDED IN SENATE APRIL 27, 2011 AMENDED IN SENATE APRIL 7, 2011 AMENDED IN SENATE MARCH 23, 2011 INTRODUCED BY Senator Wright FEBRUARY 15, 2011 An act to add Section 2190.7 to amend Section 2190 of the Business and Professions Code, relating to medicine. LEGISLATIVE COUNSEL'S DIGEST SB 380, as amended, Wright. Continuing education: nutrition course. medical education. Existing law, the Medical Practice Act, provides for the licensure and regulation of physicians and surgeons by the Medical Board of California. Under that act, the board is required to adopt and administer standards for the continuing education of physicians and surgeons. Existing law requires physicians and surgeons to complete a mandatory continuing education course in the subjects of pain management and the treatment of terminally ill and dying patients, except that it does not apply to physicians and surgeons practicing in pathology or radiology specialty areas. This bill would require specified physicians and surgeons to complete, by December 31, 2016, or as otherwise specified, a mandatory continuing education course in the subject of nutrition and lifestyle behavior for the prevention and treatment of chronic diseases, except that it would not apply to physicians and surgeons practicing in pathology or radiology specialty areas or who do not reside in California authorize the board to also set content standards for an educational activity concerning chronic disease, as specified . Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2 percent of the nation's gross domestic product; this is among the highest of all industrialized countries. Expenditures in the United States on health care surpassed $2.3 trillion in 2008, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 1980. (b) It is estimated that health care costs for chronic disease treatment account for over 75 percent of national health expenditures. (c) Seven out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer, and stroke account for more than 50 percent of all deaths each year. (d) The last major report from the World Health Organization in March 2003 concluded diet was a major factor in the cause of chronic diseases. (e) Dramatic increases in chronic diseases have been seen in Asian countries since the end of WWII with the increase in the gross national product and change to the western diet. (f) Only 19 percent of students believed that they had been extensively trained in nutrition counseling. Fewer than 50 percent of primary care physicians include nutrition or dietary counseling in their patient visits. (g) Practicing physicians continually rate their nutrition knowledge and skills as inadequate. More than one-half of graduating medical students report that the time dedicated to nutrition instruction is inadequate. SEC. 2. Section 2190.7 is added to the Business and Professions Code, to read: 2190.7. (a) All practicing primary care physicians and all other physicians and surgeons who provide care or consultation for chronic diseases shall complete a mandatory continuing education course in the subject of nutrition and lifestyle behavior for the prevention and treatment of chronic diseases. For the purposes of this section, this course shall be a one-time requirement of seven credit hours within the required minimum established by regulation, to be completed by December 31, 2016. (b) All physicians and surgeons subject to subdivision (a) who are licensed on and after January 1, 2012, shall complete this requirement within four years of their initial license or by their second renewal date, whichever occurs first. The board may verify completion of this requirement on the renewal application form. (c) This section shall not apply to physicians and surgeons practicing in pathology or radiology specialty areas or who do not reside in the State of California. SEC. 2. Section 2190 of the Business and Professions Code is amended to read: 2190. In order to insure ensure the continuing competence of licensed physicians and surgeons the Division of Licensing board shall adopt and administer standards for the continuing education of such those licensees. The board may also set content standards for any educational activity concerning a chronic disease that includes appropriate information on the impact, prevention, and cure of the chronic disease by the application of changes in nutrition and lifestyle behavior. The division board shall require each licensed physician and surgeon to demonstrate satisfaction of the continuing education requirements at intervals of not less than four nor more than six years.