Unveiling Arizona H.B. 2312: A Closer Look at Doctor Misconduct

By Kyndal Pirtle Calhoon. 

Imagine that your doctor, unbeknownst to you, had once operated on the wrong limb during a surgery. Or, showed up to the office while intoxicated. Or sexually harassed, fraudulently billed, or violated the privacy of a patient. Would you, as a member of the general Arizona public, deserve ready access to such information? According to one Arizona legislator, perhaps not. In the ever-evolving landscape of healthcare legislation, Arizona has recently made headlines with the introduction—and subsequent stalling—of House Bill 2312 (H.B. 2312). The bill addresses a critical aspect of the medical field: exposing doctor misconduct.

H.B. 2312, introduced by Representative Patty Contreras and co-sponsored by nine other Representatives, aims to enhance transparency and accountability within the medical profession. Specifically, the bill seeks to extend the period during which a physician’s misconduct could be posted to the website of a health profession regulatory board (HPRB). The bill would also require HPRBs to publicly publish the advisory letters it issues to physicians. 

Representative Contreras introduced the bill after the Arizona Republic conducted an investigation that uncovered records of misconduct by different physicians, including: removing a patient’s ovaries without consent, inadequately removing a brain tumor, operating on the wrong knee, showing up to work under the influence of alcohol, soliciting an act of prostitution, and taking inappropriate photographs of a patient on a personal cellphone.

Most of this went undiscovered due to Arizona’s current regulatory regime governing the exposure of doctor misconduct. However, under H.B. 2312, information about doctor misconduct would be more readily available to Arizonans, and Governor Katie Hobbs’s budget plan is prepared to implement these measures by adding two investigators to the Arizona Medical Board’s staff.

Existing Regulatory Framework: A.R.S. § 32-3214

H.B. 2312 was proposed as an amendment to Arizona’s existing statutory framework on board actions and public access to records—A.R.S. § 32-3214.  Section 32-3214, in relevant part, provides that all disciplinary actions and final nondisciplinary orders or actions issued by an HPRB upon a doctor shall be accessible on the HPRB’s website for no more than five years. 

Both advisory letters and letters of concern are non-disciplinary actions issued by the Arizona Medical Board. An advisory letter notifies a licensee that they have “committed either a minor technical violation or that there is not enough evidence to take a disciplinary action or that, while the licensee has made substantial efforts for remediation or rehabilitation, repetition of the activities that led to the investigation may result in further Board action.” Similarly, a letter of concern notifies the licensee that “while there is insufficient evidence to support disciplinary action,” the board believes the licensee “should modify or eliminate certain practices and that continuation of the activities that led to the information being submitted to the board may result in action against the person’s license, certificate or registration.” 

Under § 32-3214, HPRBs are expressly prohibited from posting advisory letters and letters of concern on their websites, “but a copy of such letters [is] available to the public pursuant to section 39-121 and shall be provided to any person on request.” Further, if an HPRB does have a website, “it must display on its website a statement that a person may obtain additional public records related to any licensee or certificate holder, including dismissed complaints and nondisciplinary actions and orders, by contacting the board directly.”

Advisory letters and other instances of misconduct, although technically matters of “public record” under the statute, proved difficult to find for individuals seeking such details. As currently codified, § 32-3214 constrains the visibility of disciplinary actions to a mere five years on an HPRB’s website. This restricted timeframe may not adequately reflect a healthcare professional’s track record, potentially leaving gaps in the public’s awareness of their conduct. The exclusion of advisory letters and letters of concern from online accessibility further compounds this issue, making it burdensome for concerned individuals to acquire a comprehensive overview of a healthcare professional’s history. 

H.B. 2312: Health Professionals, Websites, and Time Limitations

H.B. 2312 amends A.R.S. § 32-3214 to make disciplinary actions against a licensee or certificate holder publicly available for not more than twenty-five years. And, if an HPRB issues a final nondisciplinary order or action, that order or action, including letters of concern and advisory letters, should be made available on the HPRB’s website for not more than twenty-five years. In other words, H.B. 2312 changes the availability of disciplinary information in two ways: (1) it extends the period in which disciplinary information is available from five years to twenty-five years; and (2) it requires a wider array of information—including letters of concern and advisory letters—to be made available on an HPRB’s website.

By extending the duration of visibility for disciplinary actions and final nondisciplinary orders to twenty-five years, H.B. 2312 acknowledges the importance of providing a more extensive and comprehensive historical context for healthcare-seekers. The bill’s expansion of the timeframe aligns with the growing expectation for transparency in the healthcare sector, where the public’s right to information is paramount.

Preliminary Reactions

While H.B. 2312 aims to fortify accountability within the medical profession, it has been met with some opposition. Despite widespread support, including a recent 150-person rally supporting the bill at the state capitol, Representative Laurin Hendrix has stoutly opposed the bill, asserting that he does not “see the bill solving the problem.” Notably, Representative Hendrix has not provided a hearing for the bill, nor any reasoning for his lack of support.

Alternatively, proponents of the bill feel it exhibits a “significant stride in the right direction, toward public transparency.” Moreover, the Governor’s Office has expressed support for Contreras’s bill, especially given Governor Hobbs’s concerns about “a lack of transparency and accountability.” Even some Arizona physicians agree with the changes, explaining that standards for doctors “are very high and they should be.” Insurers have also backed the bill, claiming that “easier access to that information could . . . be helpful” as they do “due diligence in researching the background on doctors” before selecting physicians for their network. Nevertheless, the bill was introduced less than two months ago, and more commentary—supportive and unsupportive—may be forthcoming.

H.B. 2312 Compared With National Standards

H.B. 2312 brings Arizona in line with other healthcare-conscious constituencies. Several states publish full disciplinary history, regardless of when the misconduct occurred. For instance, Alabama has elected for a full transparency method, digitally publishing the physician’s name and license number, the latest action taken, and a downloadable attachment containing every document filed by the Alabama State Board of Medical Examiners during its investigation of the physician. Although at least ten states do not make doctor misconduct history accessible online whatsoever, a number of those states—such as Oklahoma—make reports of all disciplinary action available to the public upon request without time limitations. Additionally, many states, such as Colorado, make HPRB-issued letters of concern, advisory letters, or their equivalents publicly available on HPRB websites. Therefore, if the Arizona legislature were to pass H.B. 2312, Arizona would not be alone in prioritizing comprehensive and fully accessible disclosure. 

While other states have time limitations or other content-related limitations as to what is made publicly available, few states rank higher than Arizona in yearly doctor disciplinary rates. Given that Arizona ranks fifth in average number of serious disciplinary actions per every 1,000 physicians, legislation like H.B. 2312 proves especially valuable to the public, and justifications for visibility limitations become less sensible. 

The Waiting Game

Arizona’s H.B. 2312 grapples with the complexities of healthcare legislation, seeking to navigate the intricate terrain of physician misconduct. In the words of Representative Contreras, “[t]here are millions of doctors out there that haven’t done anything bad, but the few bad apples are the ones we really want to make sure of.” As the bill progresses, it will prompt a fundamental examination of the balance between transparency, accountability, and the protection of individual rights within the healthcare sector. The bill has undergone two House reads thus far, and it is unclear when an official decision will be issued. In the meantime, H.B. 2312 should be on the watch list of all Arizonans who are invested in making well-informed decisions when selecting healthcare professionals.