Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
San Francisco Chronicle (SF); Wednesday, October 30, 1991
Sabin Russell, Chronicle Staff Writer
The prestigious Federation of State Medical Boards of the United States, a group of 66 medical boards across the nation, said states should require that doctors who perform "exposure-prone" procedures be tested for HIV, the virus that causes AIDS. Those infected would not be allowed to perform such surgeries except in restricted circumstances.
Although the federation would leave it up to state boards to determine how to mandate physician testing, it stressed that surgeons should know their HIV status and said that "failure to do so would be considered unprofessional conduct."
The proposed rules are stricter than the controversial guidelines for HIV-infected health care workers issued by the national Centers for Disease Control in July. State medical leaders, who have been campaigning against the federal policy, were stunned. "I feel blindsided," said Mark Madsen, director of physician education for the California Medical Association. "This is inappropriate. It is unscientific. We need to work with them to develop a reasonable policy."
Although federation rules are not binding on any state, the recommendations carry considerable authority.
In addition to calling for some mandatory testing of doctors -- a step rejected by the CDC -- the guidelines also would set up an unprecedented program of collecting names of HIV-infected doctors and monitoring their practices.
"This is Proposition 64 stuff. This is LaRouche language," said Madsen. Proposition 64, rejected by California voters in 1986, was backed by political extremist Lyndon La Rouche and would have added AIDS to the state roster of highly contagious diseases. It would have barred HIV-infected food handlers and school teachers from their jobs.
Wayne Sauseda, chief of the California Office of AIDS, called the federation rules "much more restrictive" than any others. "It is inconsistent with California's guidelines," he said.
The federation policy comes at a time when many medical organizations nationwide are refusing to cooperate with a CDC request to develop lists of procedures deemed too risky for HIV-infected doctors to perform. Two weeks ago, the California Medical Association declared that there was no scientific basis for creating such a list and called instead for doctors to adhere strictly to infection control procedures designed to avoid spreading AIDS from one patient to another.
Dale Breaden, associate executive director of the Fort Worth- based federation, acknowledged that there was "very little, if any" scientific basis for the fears about transmission of AIDS from an infected doctor. However, he defended the policy as a means of restoring public confidence in the medical profession. "This statement reflects a serious and thoughtful effort to address the public's concern," he said.
The policy was adopted on October 4 by the federation over the objections of Kenneth Wagstaff, executive director of the Medical Board of California, who has a nonvoting position on the national organization's board. Tom Heerhartz, assistant executive director of the California board, yesterday said the state group was angry that the federation released the policy before state boards had a chance to comment on it.
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