CMA Highlights in Health and Medicine 1856-2006

Public Health: CMA established the second state public health department (just after Massachusetts) in the nation in 1870 under the direction of Thomas Logan, M.D. Dr. Logan also was a CMA president, the state's first meteorologist, and the first AMA president from the West. The state's department of public health was dissolved in the 1970s under Governor Ronald Reagan, and a bill now pending before the state legislature, supported by CMA and authored by Senator Deborah Ortiz, aims to bring it back.

Access to Care: CMA studied the effects of lack of access to care for the poor in the 1930s, and tried to get legislation passed in the state and nation that would establish compulsory health insurance (they later changed their position to advocating for voluntary participation). The CMA continues today to seek numerous solutions to health-care access through legislation, policy and the courts.

Limited English Proficiency: CMA was at the forefront of calling for the need for physicians to speak various languages. In the annual session in February 1857 the Committee on Education suggested that modern languages are essential to a medical education: "In no country in the world is there such a national mixture of languages as in this State, and consequently, none in which the necessity is so forcibly suggested." It was suggested that German, French and Spanish, in particular, was "almost an essential qualification of a man in medical practice" in California. In February 2006, CMA was given a grant to study the effects of limited English proficiency on patient care and continues to work toward helping physicians and patients communicate across ethnic lines.

Women: Admitted women in 1875 after five women physicians, led by Euthanasia Meade, M.D., applied for membership. Vote to admit them was a tie, and then-president Dr. Alexander B. Nixon cast the deciding vote.

Elected the first female president of any state medical association in 1971—Roberta Fenlon, M.D., who also was the first female president of the San Francisco Medical Society in 1960. (Many county societies elected their first women presidents as early as the 1800s).

Tobacco: On March 27, 1963—before the Surgeon General issued its famous opinion that smoking was hazardous to health—the CMA voiced its concerns about the harmful effects of cigarette smoking in a resolution at its House of Delegates. News soon spread around the world of this CMA "first," and CMA's crusade against tobacco continues.

Immunizations: CMA members in the State Department of Health proposed law in 1883 that no student in any public school district across the state may enter school without a small pox vaccination, the penalty being forfeiture of state support. Dr. Frederick W. Hatch, an early Sacramento and CMA medical leader, as Secretary of the Board of Health, determined that such a law, "rigidly enforced, would afford us, in a comparatively few years, a population so nearly exempt from liability to small pox as to render a sweeping and disastrous epidemic of that disease quite impossible." The law passed in 1889. Small pox vaccinations continued for school children until 1972. CMA continues to be active in seeking immunizations for children and adults, and supports legislation making immunizations more available to all.

Membership: In the early 1900s, Charged $10 a year for dues, which included malpractice coverage.

Recommended in the 1930s that all members use the "M.D. instead of Dr. on literature, signs and other matter, to distinguish from other cult."

CMA started in 1856 with 75 members, and today has more than 35,000 members.

Insurance: House of Delegates in 1939 created a pre-paid medical service plan, a nonprofit corporation, California Physicians Service, which later became known as Blue Shield.

Transplants: Successfully sought a law in the 1940s to establish one of country's first cornea banks. San Francisco area professor, surgeon and ophthalmologist Dr. Max Fine was a pioneer in the field, performing more than 10,000 corneal transplants in his life (He died in 1989).

CMA sponsored in 1957 the first and model law for legalizing the right of an individual to donate his body or part of it for transplants. (The first organ transplant had only occurred a few years before.) A similar law wasn't nationalized until 1972 -- The Uniform Anatomical Gift Act establishing the Uniform Organ Donor Card.

Malpractice and Liability: Working with the California Hospital Association in 1959, CMA got legislation passed commonly known as the "Good Samaritan" law. The law, to this day, protects physicians from liability if they help someone in an emergency.

Was instrumental in malpractice reform and helped formulate the bill in 1975 creating the Medical Compensation Reform Act (MICRA), setting a $250,000 cap on noneconomic damages in medical malpractice lawsuits. The law was formulated after a malpractice crisis beset California, with high rates that led insurers out of the businesses. This left physicians uncovered and patients without care. Author of the bill was Assemblyman Barry Keene, and CMA was highly involved in its construction. The law was tied up in court battles until it was finally declared constitutional in 1985. It has remained a national model for medical malpractice reform.

Diversity: Elected its first African American CMA President, Clarence Avery, of Oakland, in 1985.

Elected its first Hispanic president, Ralph Ocampo, in 1994.

Elected as president its first Permanente physician in that office in 2005 - Dr. Michael Sexton, an emergency physician at Kaiser Foundation Hospital in San Rafael. In 1934, the creators of one of Kaiser Permanente's precursors, Ross-Loos Medical Group, were kicked out of membership. Now Permanente Medical Group makes up 12% of CMA membership statewide.

Elects first Sikh physician of Indian origin, Anmol S. Mahal, as president-elect in 2005. He is slated to be president in 2006-2007.

See "Women" entry above, too.