Balboa Nephrology Medical Group, California’s largest nephrology practice, says VOTE NO on Proposition 23.


Proposition 23’s requirement that all dialysis centers in California must have at least one physician present during all operating hours would sharply reduce our ability to provide patient care.  Dialysis care is already heavily regulated and is, in general, exceptionally high quality in California.  This misguided Proposition would create many new regulatory requirements to be administered by the State of California which would increase health care costs across the board, would force the closures of some high quality clinics, and would place dialysis patients directly in harm’s way.


We believe these regulations would raise costs without delivering a meaningful improvement in the quality or access to patient care. Dialysis centers often operate up to 6 days a week and up to 20 hours per day. Our Balboa Nephrology physicians see patients and deliver patient-oriented care in dialysis centers across three counties in Southern California. It will be impossible to have one of our doctors in each and every dialysis center for every hour of every day the center is open. Furthermore, with Prop 23, our doctors would no longer have enough time to take care of hospitalized patients and see patients in our offices.  We refuse to shortchange our patients.


Prop 23 is the latest proposition sponsored by a large union targeted at dialysis companies. In the view of the union, patients and physicians are pawns to be played.  This is a poorly thought out proposition dictating when, where, and how doctors can provide care, without consideration of the consequences of this mandate and negative implications to patients.  Join us, the California Medical Association, the American Nurses Association of California, the California Dialysis Council, and several county medical associations across the state in saying VOTE NO on Proposition 23!