"Pee in a cup" is a phrase you should prepare to hear frequently this election season. A requirement that doctors be subject to random drug and alcohol testing is the curb-appeal provision in a measure that will be on the California ballot in November.
The brains behind the initiative titled the Troy and Alana Pack Patient Safety Act -- named after two Danville children killed by a substance-abusing driver in 2003 -- clearly figured out that voters are more likely warm to the part that promises drug tests for doctors than the measure's more important provision, which would lift the state's $250,000 cap on medical malpractice awards to $1.1 million.
New York Times reporter Adam Nagourney wrote that political consultant Chris Lehane essentially admitted to him that the explosive notion of drug testing doctors came up, almost by chance, in a focus group. "Everyone in the room was flabbergasted that they weren't already tested," Lehane crowed.
"When you get to the point where you're writing ballot initiatives based on what polls well, you're solely putting things on the ballot because you know you can win them," observed Sam Singer, whose public relations firm is working for the opposition. As far as Singer is concerned, the measure is "a payday for the bottom-of-the-barrel of plaintiff attorneys."
There is an argument to raising the cap. It's been stuck at $250,000 since Gov. Jerry Brown signed it into law 38 years ago. But I object to the dishonest claims of the campaign.
Fact-checkers may want to examine 30-second spots on the Pack Act website. Three "pee in a cup" videos claim, "The CA Medical Board estimates 18 percent of doctors abuse drugs or alcohol." Oh, really?
The campaign sent me a March 2000 California Medical Board article that says that "many believe" that 15 percent of the general population has substance problems, while some experts believe "the lifetime risk for developing a problem of abuse among health care professionals may be as high as 18 percent." That's a guesstimate, not research. Also, it's a lifetime number. The paper also notes that, even with a lifetime risk of substance abuse of up to 18 percent, about 1 to 2 percent need treatment at any given time.
The California Medical Board wrote in January that it does not have "any empirical data" on the number of physicians with substance abuse problems.
Jamie Court of Consumer Watchdog, which supports the Pack measure, told me, "Even if it's 1 percent, it's too much." If there isn't enough data, blame the medical profession.
What's the matter with testing doctors because their behavior raises red flags? Court answered that random drug testing works because it serves as a deterrent. "Unless you have a serious problem, you're not going to be caught impaired." Any doctor who does test dirty, he added, clearly has a problem.
I might be open to Court's argument if the initiative didn't do such a dirty job on doctors. It's wrong to tell the public that nearly 1 physician in 5 likely is boozed up or high. The campaign throws out big numbers. Quoth Consumer Watchdog: "As many as 440,000 people die each year from preventable medical negligence." That number is based on extrapolation of other studies. It is supposed to represent hospital deaths, and includes death by contaminated equipment. It does not present hard numbers on deaths due to physician substance abuse.
I asked Court: Do you want to drug test nurses, too? He answered, "I think this is something we're starting with doctors because they're the ones who write prescriptions."
Troy and Alana's father Bob Pack told me that he had been working to put together this measure for years. He is the victim of prescription drug abuse; the ballot measure requires that medical providers consult a prescription-drug history database.
And: "The state valued my children's lives at $250, 000," said Pack. "I thought that was appalling. I never heard of that law. You can't even get to court for $250,000."
Pack blames doctors at Kaiser for prescribing painkillers to the nanny who plowed into his children.
For their part, the political consultants who are making merry with their "pee-in-a-cup" videos should know better. They have chosen to forgo an honest policy debate to take cheap shots at the healing class.
In the name of safety.
"There is a giant irony," said Singer, that Lehane, who represented cyclist doping king Lance Armstrong "turns out to be the No. 1 advocate of drug testing doctors. That's kind of evil."
Or it's pee in a cup.