At least that's Gov. Arnold Schwarzenegger's hope; in September he signed into law two bills that put some teeth into patient privacy rules and give doctors good reason to comply.

Under the new laws taking effect Jan. 1, 2009, the state has significantly increased fines not only for the illegal use of medical records but also for unauthorized access of records. The laws also open the door for patients to sue doctors when their records are accessed, even if there is no damage.

Other states have privacy laws that require notification of a breach, but the California bills are thought by experts to be the first to place a strong focus on enforcement.

Experts predict California's actions will lead to more states following suit, as well as tougher enforcement of HIPAA privacy and security rules, which have gone largely unenforced since they took effect in 2003 and 2005, respectively.

For physicians, "the idea behind all this is don't wait until the 500-pound gorilla is pounding on your door," said attorney Peter MacKoul, president of Sugar Land, Texas-based HIPAA Solution, a consultancy that helps practices become HIPAA-compliant. "It's called preventative action."

About the same time the California governor signed the two patient privacy bills into law, a report published by the California Health Dept. found snooping incidents at the UCLA Medical Center were much worse than initially thought. The study found that since 2003, hospital workers inappropriately accessed the electronic medical records of 1,041 patients, including those of California first lady Maria Shriver. Some of those employees were feeding celebrity information to the media, the report said.

How much of the premiums their constituents paid was going to CEO salaries, overhead and efforts to maximize profits, rather than to doctors and patient care?

At least 15 states have passed laws requiring insurers to spend a minimum percentage of premium dollars on care, and disclose those figures. Other states are considering similar legislation -- despite insurers' protests that they already more than meet those minimums.

California, the source of much of this year's news about insurers dropping sick patients and paying huge fines for other alleged misdeeds, was one state where health care spending drew legislators' criticism and scrutiny.

In February, Sen. Sheila Kuehl introduced a bill to raise the medical-loss ratio -- the percentage of each premium dollar an insurer must spend on health care -- to 85%.

"It's not acceptable for us to ignore such massive waste in the insurance industry when Californians are being bankrupted by rising health care premiums and gutted benefits," Kuehl said in a statement released in June.

Her statement accompanied a report from the California Medical Assn. detailing what managed care companies spent on medical care in the fiscal year ended June 30, 2007.

In CMA's report, Great-West Healthcare of California, since acquired by Cigna, reported a medical-loss ratio of 69.4%, the worst rate in the state.

MD on Call, an Atlanta-based, self-described "boutique practice," entered into a partnership with City Centre Properties LLC of Atlanta to provide residents of The Mansion on Peachtree hotel and residence with a basic services package that includes much of what a family medicine physician would do in the office, from a throat culture to wellness care to an ECG.

The cost to the developer is $15,000 per year per unit, said Clark Butler, co-founder and president of City Centre Properties, said.

While hospitals have partnered with hotels to offer health care packages, no real estate experts or medical groups contacted knew of another time when medical service was offered as a real estate perk.

Whether other developers will follow suit is debatable. Executives at City Centre see it as a nice amenity and would consider offering the perk at future developments.

But a real estate professor calls it a gimmick that won't catch on.

"There's a reason for these giveaways -- developers don't want to post lower prices. But developers aren't in the business of selling health care. I haven't seen this type of perk before, and I don't expect widespread adoption of it," said Morris Davis, PhD, assistant professor of real estate and urban land economics at the University of Wisconsin School of Business in Madison and former economist with the Federal Reserve board.

Medical societies across the country have been advocating health IT adoption in recent years. But generally that involvement has been limited mostly to offering practical advice or tips on choosing the right system. MSMS Connect will be the first network sponsored by a statewide medical society. It will be offered free to its members. Nonmembers will be charged a yet-to-be-determined fee.

"This will give all physicians who are members and some who are not the opportunity to move into a world of information technology in as big of a way as they want," said Greg Forzley, MD, chair of the MSMS board of directors. Dr. Forzley is also the medical director of informatics for Saint Mary's Health Care and Advantage Health Physicians Network in Grand Rapids, Mich.

Dr. Forzley said the network will meet each physician where they are in technology adoption and create a one-login network to which several systems can be connected. Through the system, which he describes as a portal, physicians can access applications including lab results, e-prescribing, patient registries and regional health information exchanges. Physicians can also message one another through a secure communications system.

Dr. Forzley said this is a first step to full access of online health information and that other services will be added as they become available. Physicians can pick and chose which applications they would like to have access to.

Specialty: Emergency physician

Location: Newport Beach, Calif.

Company: Precision Medical Devices, LLC. It makes the T-Ring, a thin, flexible disc surrounded by a hardened outer plastic ring that acts as a tourniquet for digital injuries, both fingers and toes pmedcorp.com/.

Intended for use by emergency physicians, hand surgeons and dermatologists, the T-Ring was a 2008 finalist in Business Week's annual International Design Excellence Awards competition.

Annual revenue: None yet. First shipments will be available in February or March 2009. T-Rings come in either adult or pediatric sizes and will cost about $10 each.

Why he started the business: "I was amazed at how many articles written about digital tourniquets contained the warning not to forget the tourniquet." Brightly colored and the size of a poker chip, Dr. Green's device is visible enough not to be forgotten. He said another advantage to his T-Ring is the pressure is the same for everyone, no matter how small or large the digit is.