ProPublica exposes union efforts to stymie nursing board reform

If the ProPublica experiment with nonprofit investigative journalism is teaching us anything, it is the importance of follow-through.

The ProPublica series, When Caregivers Harm, about dangerous nurses, was published in July. But the core reporting team of Tracy Weber and Charles Ornstein has continued to dog the story. Their recent follow-up story is one of the most crucial. It shows how labor unions have been working to disassemble the reform legislation now working its way through the California legislature, a reform that would put in place consumer protections covering nurses and a range of health care providers.

The effort to weaken the reform goes directly to the heart of why so many investigative stories sound like echoes of stories written 10 years earlier. Sometime between the stories being published, the public officials making promises and the reporters putting their latest awards on their shelves, the actual process of reform is too often derailed by lobbyists and interest groups.

ProPublica and the Los Angeles Times were declared Pulitzer finalists earlier this month for the series. Why not move on to another topic?

Luckily, the series' reporters, Tracy Weber and Charles Ornstein, do not ever let their focus stray. Based in New York, they have been covering the political maneuvering in Sacramento as if they were statehouse reporters.

Investigative stories that have revealed serious flaws in oversight by regulatory agencies around the country have led to some strong new consumer protections. They also have led to a lot of political sausage that hasn't helped anyone. Witness the National Practitioner Data Bank, a great idea in theory that is completely useless to the public and lacks the teeth necessary to actually stop dangerous doctors from bouncing from hospital to hospital and state to state.

Repeatedly, attempts to improve the Medical Board of California have been bent to the will of the California Medical Association. It's why, on the one hand, the board has some of the most transparent reporting of any medical board in the country, and, on the other hand, it removes so many of its disciplinary records from its Web site after 10 years. This same pattern could play out in California with the Board of Registered Nursing if reporters and the public don't pay close attention to what is happening.

Here is how this debate always goes. The consumer protection advocates – usually a group of patients who have been injured, a few nurses and an emboldened state senator – fight for tougher oversight. Then the nursing lobby or the medical lobby or other interest groups get a look at the legislation and declare that it is unfair to the licensed professionals or that it might dissuade people from entering the profession at all. This paragraph from the most recent ProPublica story is the type of sentiment that has been seen time and again:

Democratic Sen. Leland Yee said the bill may have an "overemphasis" on consumers at the expense of the rights of professionals. "Some people may say we can throw away" the due process rights of professionals, Yee said. "But that's not the way we do things in this country."

Yee, of course, makes a good point. Nobody's rights should be thrown away in the course of making new laws. But what is so often forgotten is that practicing as a nurse or a physician in any state is a privilege granted by the state, not a right. Physicians and nurses train hard, work hard and earn that privilege, and, in doing so, they agree to abide by certain rules.

Making the rules tougher does not have to violate anyone's basic constitutional rights. Patients can be protected – and are protected in other states – by the same types of reforms being proposed in California.

A shortened version of the ProPublica story ran in the Los Angeles Times and in the Fresno Bee. To read the union story on ProPublic's site, click here. And to read a related follow-up story, click here.