California Medical Association

On 12 March 1856, the Medical Society of the State of California held its first meeting at Pioneer Hall on J Street in what is now Old Town Sacramento. The society's first president, Benjamin Franklin Keene, M.D.—also a state senator representing El Dorado County—led the meeting of 1875.

After the 1850 cholera outbreak in Sacramento, the surviving physicians became close colleagues and friends, and began to found county medical societies. The first were founded in Sacramento and San Francisco. Each society kept in contact, and society secretaries Thomas Logan, M.D., (Sacramento) and Elias Cooper, M.D., (San Francisco)—historical figures in their own right—set up that landmark first meeting in 1856. Dr. Logan, a notable medical scholar, would later reform the CMA after years of strife, reorganizing the society in 1875 and eventually serving as the state's Director of Public Health as well as president of the CMA and then the American Medical Association. Dr. Cooper, an eye surgeon and co-founder of the Illinois Medical Society previously, would found the medical school that became Stanford University School of Medicine.

Controversy arose over which physicians were credible, and as a result a credentials committee formed to "prevent admissions of improper persons." Dr. Morse became the Medical Society's first Censor, a precursor to the Medical Board of California of today.

In the early years, travel was difficult, so that the society's focus remained in Northern California, and its counterpart, the Southern California Medical Society, was not created until 1898. County societies sprouted up throughout the late 1800s and early 1900s. In 1900, CMA membership cost $10 and included malpractice coverage. In 1923, the society renamed itself the California Medical Association to comply with name changes at other state medical associations and the American Medical Association.

John Frederick Morse, M.D., a historian and journal editor for the medical society who would form some of the first disciplinary and licensing terms for state physicians, is credited with starting the first journal of the Medical Society, starting with his own funds a short-lived publication called the California State Journal of Medicine. There were several revivals of publications over the years. In 1873, the society published the first Transactions of the Medical Society of California, a volume published annually until Volume 31, issued in April 1901. In that year it was recommended that, because the annual transactions were "an extravagant and unnecessary way of perpetuating the proceedings of the society, the more rational one of publishing a monthly journal" be adopted. Thus, The California State Journal of Medicine was revived. In 1924 its name was changed to California and Western Medicine, and in 1946 to California Medicine. Philip Mills Jones, M.D., is regarded as that journal's founder.

In 1974, the journal became The Western Journal of Medicine, in conjunction with a plan to create a regional medical journal for the West. For more than twenty years, The Western Journal served as the official journal for the state medical associations of Arizona, Idaho, Montana, Nevada, Utah, Washington, and Wyoming, and six research and specialty societies, in addition to the CMA. In 1998, the Journal was taken over by the British Medical Journal, and has since ceased publication.

In 1961, the CMA merged with the California Osteopathic Association.[1] At the time, the CMA consisted of 40 medical societies, which were organized by county; after the merger, the COA became the 41st medical society.[2] In 1975, full CMA membership was offered to qualified osteopathic physicians (D.O.).[3] In 1999, the CMA passed a resolution to work with the current osteopathic medical association, Osteopathic Physicians and Surgeons of California, on issues that concern both M.D. and D.O. physicians.[3] In 2005, the CMA opposed efforts to consolidate the D.O. and M.D. medical boards.[3]

The physicians who founded the Medical Society of the State of California were veterans in the fight against cholera, encephalitis, typhoid and smallpox—diseases that became prevalent in the newly minted lands of California after the Gold Rush of 1849. They dedicated their organization to "promote the science and art of medicine, protection of public health, and the betterment of the medical profession."

A deadly cholera epidemic struck Sacramento in October 1850. Despite their unfamiliarity with these diseases, physicians remained committed to helping their patients. About 5,000 people in Sacramento and the surrounding areas died of cholera, and thousands of others deserted the area in fear of the disease.

Dr. Morse noted physicians’ remarkable commitment: "Not one educated physician turned his back upon the city in its distress and threatened destruction." The dead in the cholera epidemic included seventeen physicians, a third of the physician population of California. They are memorialized in a plaque at the historic Sacramento City Cemetery, with only one of them buried in a marked grave.

The CMA also helped to establish some of the first blood banks and cornea banks in the West and helped create the California Tumor and Tissue Registry in 1947—what is today the second largest tumor and tissue registry in the world.

During the 20th century and beyond, the CMA has fought against tobacco use and smoking and insisted early on—in the face of criticism and fear of the newly found disease—that HIV and AIDS patients deserve needed health care. The CMA continues to advocate for patients on a broad range of health care issues, including broader immunization against disease and the implementation of the Affordable Care Act.

In 1975, the CMA preserved access to care for many when it forged ahead on a plan to keep medical malpractice rates affordable. Hearing the outcry of CMA physicians who had faced rate increases up to 400 percent, threatening practice viability, Governor Jerry Brown called together a special session of the legislature to discuss the malpractice cost crisis. They passed that year a collection of statutes called the Medical Injury Compensation Reform Act (MICRA), a model for national medical liability reform. At the insistence of CMA physicians, MICRA kept patients whole and ensured compensation for their injuries while setting a cap on non-economic damages, going a long way in keeping malpractice insurance premiums affordable. CMA continued the fight to protect MICRA against a ballot measure funded by trial lawyers, eventually contributing to the loss of Proposition 46 in the November 2014 general election.

By the 1960s, it was clear to the CMA that the managed care industry needed oversight and regulation. In the 1970s, the CMA sponsored a key piece of legislation, the Knox-Keene Health Care Services Act. The law instituted financial and quality standards for HMOs, set a basic minimum benefit package, required plans to ensure continuity of patient care, and protected the physician-patient relationship in health care decisions. In 2000, the CMA sponsored AB 1455, which gave the Department of Managed Health Care the authority to levy penalties and fines against health plans that engage in unfair business and payment practices.

While the CMA had made some progress in the Legislature, physicians were frustrated that despite three decades of legislative and regulatory efforts, health plans still ran roughshod over physicians and patients often could not get the care they needed. In 2000, in a historic action, the CMA filed a Racketeer Influenced and Corrupt Organizations Act (RICO) lawsuit against for-profit HMOs in California, alleging that they were using fraud and other illegal activities to interfere in the physician-patient relationship. Eventually, more than 800,000 physicians and 19 state and county medical association's joined the CMA as plaintiffs, becoming the largest class action health care lawsuit in U.S. history.

Of the 10 defendants, six settled (including the now merged Anthem/Wellpoint/Blue Cross), and three had their cases dismissed by the court. The settling health plans agreed to pay a combined $585 million in monetary damages. But of even greater value were the binding commitments made by the insurers to change the way they do business with physicians. These prospective commitments have been valued far in excess of the monetary relief, at well over $1 billion over four years.

The CMA continues to advocate on behalf of physicians and patients to make sure that health plans are complying with the laws and regulations of the State of California.

In 2015, the CMA co-sponsored California Senate Bill 277, authored by Senator Dr. Richard Pan, which removes the personal belief exemption from school vaccination requirements.[4] The bill was signed into law by Governor Jerry Brown on June 30, 2015.[5] The CMA was also a partner[6] in the Save Lives California coalition, which passed California Proposition 56 (2016) to raise tobacco taxes by $2 per pack. CMA, in conjunction with the California Dental Association, has announced it intends to run a sugary drink tax on the 2020 ballot.[7]

At the medical society's second annual session in 1857, the Committee on Education declared that at the very least German, French—but especially Spanish—should be part of a medical student's education, stating: "In no country in the world is there such a national admixture of languages as this State." CMA began on the principles that all patients of all ethnicities should be treated for their illnesses, and the CMA supplied the nation with some of its first ethnic medical leaders. Just as in 1857, the CMA continues to work toward bridging language and ethnic barriers with patients by placing new physicians in underserved areas of the state through the Stephen M. Thompson Loan Forgiveness Program, and studying the effects of limited English proficiency on patient care.

In recent decades, the CMA House of Delegates approved "mode-of-practice" forums to provide representation for physicians based on the type of practice they are in—solo/small group, medium, large and very large group, academic, hospital-based, or government employed. An ethnic physicians' forum also was established.

Today, the California Medical Association has more than 48,000 members in all modes of practice and specialties representing the patients of California.

• "CMA History". cmadocs.org. Retrieved 2013-02-14.