VOTE NO ON SB 524

From Jeffrey Kaufman, M.D.
CUA Director of Legislative Affairs

Honorable Assemblymember:

PLEASE STOP THE DEPRESSION CME MANDATE. I represent the California Urologic Association which speaks for all of California's urologists. We are opposed to SB 524 (Torlakson) which would mandate continuing medical education courses for any doctor who treats depressed patients or prescribes the medications used for depression.
California law already mandates at least 25 hours of continuing medical education per year in addition to requiring a growing number of specific areas of education that apply to most practicing physicians. These special requirements include 12 hours training in pain management and end of life issues, ongoing 10 hours per 2 year cycle on radiologic related issues for any doctor performing or supervising imaging studies and continued education in other niche areas of medicine. There is already considerable education material in place regarding the diagnosis and treatment of depression for any doctor whose practice addresses these issues. In addition, there are "black box" warnings on most medications used to treat depression required by the FDA to educate providers. pharmacists and patients. This information already includes all that would be additionally (and redundantly) required in the Torlakson bill. Continuing Medical Education is intended to allow physicians to keep current in all the areas pertinent to their fields of practice. To make additional, irrelevent and redundant mandates takes away from the time better spent learning about new areas of research, new therapies and new techniques in those areas that are important and relevant to each doctor.
Pretty soon, the mandated hours of niche education requirements will leave no time available to learn more important information in the doctors area of specialization.

More important to our specialty of Urology is the fact that many of these "anti-depressant" drugs are frequently used by urologists for off-label but legal purposes. Drugs like Elavil and Tofranil are routinely used for urge incontinence, overactive bladders and patients who frequently urinate at night or have bed-wetting problems with excellent, time-honored results.
Drugs like Elavil are also used for chronic pain conditions such as those that are caused by chronic bladder inflammation. Drugs like Anafranil, Paxil and Zoloft are often used for premature ejaculation with excellent results. In other words, California's urologists often utilize the drugs normally considered used for depression for other reasons and are therefore very familiar with their pharmacology, usage, risks, side effects and potential complications. We do not need further education on "depression" to use these drugs for our purposes. The Torlakson bill would simply be a waste of our time and leave less time to study those issues of greater importance to our patients.

CME requirements should be flexible and adjusted to the areas of expertise and fields of practice of individual physicians. Each doctor knows the areas he needs to study to keep current in his particular field. The state legislature should refrain from micromanaging physician education. If a new mandate to study every new politically correct or faddish area of concern is placed on our state's doctors, we will never have the time to study what is really important.

To find your area assemblymen click here.
Please vote NO on SB 524 (Torlakson) and preserve flexible quality medical education for California's physicians.

Jeffrey Kaufman MD, FACS
Chair, Government Relations Committee
Past President
California Urologic Association

If there are any further questions, please contact the CUA by email at info@cuanet.org
or by phone at 714-550-9155.