Donda West Law signed by California Governor

This week, California Governor Arnold Schwarzenegger signed the Donda West Law, which requires anyone undergoing plastic surgery in the state to receive a mandatory physical examination first.

The bill was written in response to the death in 2007 of Kanye West's mother, Donda, 58, who died following cosmetic surgery. West underwent several cosmetic procedures without medical clearance, and her coronary disease, diabetes and other postoperative factors are believed to have contributed to her death.

While I am 100% behind anything that improves patient safety, it's not clear to me that this bill as it is written will save lives, even though it "feels good". For example, there are no requirements in this bill about:
- how detailed the physical exam needs to be,
- any pre-operative lab testing or EKG testing.

It's already a requirement at my office to do a history and physical, as one part of the comprehensive AAAASF standards that we follow. Everybody over 40 years old gets an EKG and lab tests, unless they have been done recently. We get medical clearances from specialists (cardiologists, etc.) for anyone with major medical issues. Some people are just not healthy enough to have cosmetic surgery without significant risks, and get turned down. After all, it's still surgery, even though it's "cosmetic".

What might have been more helpful for patient safety would have been to either:
1) have all cosmetic surgery performed in accredited surgical facilities, which follow national safety standards set down by JCAHO, AAAASF or AAAHC.
2) restrict cosmetic surgery to those surgeons that have formal training and credentialling in it.

Such measures would have caused a huge outcry from the "wanna-be cosmetic surgeon" groups. Perhaps that would have been too politically unpopular...