Texas Medical Board Procedures and Regulations

What are the Most Common Complaints to the Texas Medical Board?

The TMB is in charge of overseeing the actions of various medical professionals, and they receive thousands of malpractice complaints against these practitioners annually. The Board often receives complaints from aggrieved patients, family members, and other medical professionals. The most common complaints are concerning poor treatment or violations of care standards, professional incompetence, unprofessional conduct that endangers the public, and mental or physical impairments that interfere with the capacity to practice medicine. Other reasons for complaints include: 

• Practicing in a field of medicine where the doctor is underqualified
• Disclosing sensitive patient information without authorization
• Failure to properly retain medical records.
• Allegations of unethical patient recommendations and solicitation, etc.
  
  

What are the Texas Medical Board Disciplinary Actions?

TMB disciplinary actions are corrective measures imposed in response to medical misconduct, rule violations, or poor performance. Depending on the nature of the offense, disciplinary action may take the following forms:

• Restrictions on treating particular patients or performing certain operations and procedures
• The requirement for additional education or training
• Imposing a professional practice chart or monitor
• Requiring the professional to abstain from alcohol and drugs
• Periodic drug testing
• Participation in drug rehabilitation, treatment, or behavioral health programs.
• Public reprimand 
• Suspension or revocation of medical license in severe cases.
• Administrative fines.
  
  

Complaints and disciplinary actions against medical practitioners can result in various consequences. Although these sanctions vary depending on the specifics of the complaint. Some sanctions may affect a physician's ability to continue working in the medical field. It is also vital to highlight that the TMB's disciplinary actions are open to the public. Furthermore, the Board reports all obligatory disciplinary actions to the National Practitioner Data Bank(NPDB). The names and summaries of all orders granted by the Board are also disseminated in media releases, published in the TMB Bulletin, and included in the licensee's profile, which is viewable via the TMB website. This exposure has the potential to harm a physician's credibility and reputation. As such, Texas medical professionals being investigated for medical malpractice should take all complaints seriously and seek urgent legal counsel from a qualified medical license defense attorney.

State law requires the TMB to consider specific factors when considering suitable medical professional disciplinary actions. These elements include:

• Whether the respondent is being punished for numerous violations
• Whether they have a history of disciplinary actions
• Whether the offense involves patient care or just administrative issues.
  
  

Typically, an administrative penalty or punishment will be imposed for a single, first-time administrative infraction. Administrative infractions in a medical environment are infractions involving management and support responsibilities in a medical office. On the other hand, multiple infractions, a history of previous violations, or offenses involving patient care, will result in severe sanctions.

Administrative Penalties

According to Texas law, administrative penalties are limited to a maximum of $5,000 per offense. However, each day a violation happens or continues is a new infraction under state law. As a result, administrative fines for recurring or ongoing offenses might easily exceed $5,000. The TMB is obliged by Texas Occupation Code to consider the following elements when establishing the amount of the administrative penalty to assess in a disciplinary proceeding:

• The gravity of the offense, including its nature and the danger it poses to the public's health, safety, and welfare.
• Financial losses associated with the conduct
• Prior disciplinary actions
• Attempts to make restitution for the violation
• Other relevant criteria that may apply.
  
  

If the Board decides that a medical practitioner violated the law and should face an administrative penalty, the individual will be notified in form of an order. The order will specify the nature of the offense and the monetary penalty to be imposed. Following receipt, the respondent (the medical professional against whom the complaint was filed) can pursue specific courses of action concerning the TMB order within thirty days. They have the option of:

• Paying the penalty
• Paying the fine or submitting a judicial review petition challenging the complaint, the fine amount, or both.
• Preventing the court from executing the penalty by paying the fine to the court, depositing it in an escrow account
• Petitioning the court to delay the penalty's execution by submitting an affidavit to the court and the executive director of the TMB. The petition will claim that the professional cannot pay the fine with their present financial condition.
  
  

Will a Doctor Lose Their License for Medical Malpractice in Texas?

It is unlikely for medical practitioners to lose their license for medical malpractice in Texas. However, in the highly uncommon case that the Board determines that a physician's conduct poses an urgent risk to the general public, the Board has the authority to take immediate action against the doctor without first informing the doctor of its intention. The TMB has the right to revoke, suspend, or limit a doctor's license to practice medicine if it finds these after an inquiry:

• The physician poses a threat to society's health and safety.
• The physician has a history of professional misconduct claims and accusations
• The physician displayed excessively negligent and reckless behavior
  
  

Consequently, the actions that may cause a healthcare professional to lose their license include:

• Sexual misconduct: Inappropriate sexual behavior and sexual contact with a patient can result in the loss of a doctor's license. Making inappropriate sexual advances toward patients or employees, or harassing members of either group, are also improper conduct that might cost a physician their license.

• Substance abuse: Texans and the TMB expect physicians to be attentive and sober when providing medical services. As a result, if the Board discovers that a physician has a drug or alcohol issue, it is quite likely that their license will be suspended or revoked. Medical licenses are revoked frequently in Texas for unlawful drug use. However, the state runs the Texas Physician Health Program (TXPHP), which provides education and therapy to physicians who struggle with substance abuse.

• Insurance fraud: Physicians are always required to operate ethically and honestly, especially when engaging with insurance companies. A physician may face severe consequences with the licensing Board if they use fake insurance codes, fabricate medical records, or charge uninsured patients different fees than insured patients.

• Patient abuse: A physician's profession entails high trust from patients. However, if it is established that they have mistreated their patients and exploited their trust, they will be summoned before the Board. In addition, physicians may unknowingly commit patient abuse if they are ignorant of a patient's physical limits, especially while caring for infants and the elderly. Nonetheless, acts of verbal, physical, or sexual abuse are among the fastest ways to lose a medical license.

• Prescription Violations: A medical license allows doctors to treat their patients with helpful medications. However, the prescription pad is also a significant responsibility. Texas' Prescription Monitoring Program (PMP) regularly collects and records prescription data. If the medical licensing Board discovers through this program that a health care provider is prescribing unnecessary medication, operating a pill mill (a business in which practitioners prescribe drugs indiscriminately for money), or otherwise abusing their authority. In that case, the Board has the authority to revoke the medical Professional’s license. 

• Unethical or unprofessional behavior: Physicians must treat all of their patients fairly and equally. A  health professional found to have discriminated against some patients based on factors such as their gender, race, or religion will likely face serious consequences from the licensing Board.
  
  

What is Medical License Reinstatement and Re-issuance

The TMB guidelines allow restoration of suspended medical licenses in Texas, provided the doctor satisfies specific standards. These standards differ based on if the license was suspended or revoked. While a license suspension is a temporary suspension of a medical license's privileges and rights, revocation is a total termination of such rights. Hence, a physician may request a license reinstatement after a suspension or re-issuance after a revocation.

Medical License Reinstatement

An applicant must fulfill the conditions for reinstatement to petition TMB to restore their suspended medical license. They must present documentation that all requirements for the probationary term of the suspension have been satisfied. They must then wait at least one year from the day the suspension took effect before applying. It is also worth noting that, unless otherwise stated in the Board’s order, a reinstatement request following a suspension can only be examined once every year, regardless of how many times it is submitted.

After determining eligibility for reinstatement, the physician must then attend a compliance session and submit a written request to the TMB's Compliance Division. 

Medical License Re-issuance

When applying for a new license, a physician whose prior medical license was revoked must complete the application, including paying the application cost. To be eligible for re-issuance of a medical license after it was revoked, the applicant medical professional must demonstrate compliance with the most current standards for licensure eligibility and must also appear in front of a Board committee so that a decision on issuance of the license may be made. 

To be eligible to apply for re-issuance after having one's medical license revoked, the medical professional must wait at least one year after the effective date of the revocation. Applicants are advised to seek the assistance of a Texas medical license defense attorney to navigate this procedure effectively.

What is Physician License Defense?

Physician license defense entails the representation of doctors. When a medical doctor violates the law, the Texas Medical Board is responsible for overseeing the doctor's licensure procedure. They are also responsible for implementing and enforcing sanctions against the doctor. 

As a result, when a physician receives a TMB complaint, the first step in defending their practice is to hire an attorney with experience as a medical license defense lawyer. The complaints may have repercussions that jeopardize a physician's ability to continue working. As such, they must retain legal representation to protect their license and their future capacity to earn a living. Medical license defense attorneys who defend physicians' licenses can help their clients throughout the disciplinary and post-disciplinary procedures, including protecting the physician's license.

What are the Stages of a TMB Investigation or Disciplinary case?

The TMB has a team of staff analysts who, upon receiving a complaint, determine whether or not the accusation is "jurisdictional." A jurisdictional complaint is filed against a TMB-licensed medical professional, such as a doctor or medical assistant. They will also determine whether the Medical Practice Act relates to the alleged violation of the law. Complaints that are beyond the scope of this TMB's power may be sent to another Agency.

If the Board concludes that it has jurisdiction over the complaint, it will determine whether there is evidence to support the allegation. The steps involved in the TMB's enforcement procedure include:

• Preliminary Evaluation. The Board is obligated to conduct a preliminary inquiry within forty-five days of receiving a complaint. During this period, the Board may attempt to contact the complainant and the respondent. 
  
  An attorney-investigator handles complaints involving administrative concerns (such as requests for medical records) for the TMB. On the other hand, complaints involving medical care issues are investigated by a physician-investigator. If the complaint or supporting evidence does not reveal a specific allegation against the medical professional that would constitute a violation of the Medical Practice Act, no investigation is launched, and the complaint is marked as "Jurisdictional, not Filed."

• Investigations. If the TBM determines that the Medical Practices Act may have been violated, the matter is classified "Jurisdictional, Filed," and the process of formally launching an investigation begins. At this stage, the respondent will be advised of the complaint and requested to provide any further information that may be necessary. At this point in the process, medical practitioners being investigated for medical malpractice are highly advised to hire an experienced medical license defense attorney. This is because the initial answers to the complaints have a crucial impact in deciding the case's eventual outcome.
  
  Furthermore, suppose the investigation is looking into alleged violations of the standard of care. In that case, the complaints and evidence will be evaluated by at least two TMB expert panel members who are Board-certified in the same or a similar medical specialty as the respondent in the issue. After an investigation, possible outcomes include:

  • The complaint is submitted to the Board's Disciplinary Process Review Committee (DPRC) for dismissal consideration
  • The complaint is sent to a Quality Assurance (QA) Panel for further examination
  • The respondent may request that the Board issue a remedial Plan, an example of non-disciplinary corrective action.
    
    

• Quality Assurance Panel. The investigations department refers matters to the Quality Assurance Panel, which comprises up to five Board representatives. After its inquiry, the Quality Assurance Panel may: 

  • Request that an additional investigation be undertaken 
  • Refer the matter to the Litigation Department for an Informal Settlement Conference
  • Refer the case to the Board's disciplinary procedure review committee for dismissal. 
  • Refer the matter for formal resolution at the State Office of Administrative Hearings (SOAH)
    
    

• Informal Settlement Conference (ISC). When a matter is transferred to the Litigation Section, it is assigned to a Staff Attorney and scheduled for an Informal Settlement Conference (ISC). A hearing for an ISC will be held in front of a panel comprised of two appropriate Board members. The hearing aims to provide a platform for the panel to conduct a review of the facts and for the respondent to show compliance with the Medical Practices Act.
  
  Because the informal procedure resolves most TMB disciplinary matters, a licensee should not attend an ISC without being represented by a counsel. If the panel concludes that there was a violation, they will either issue an Agreed Order. This proposed agreed order will state the respondent's fines and conditions. It is necessary to consult a physician license defense attorney about the suggested agreed order so that it may be thoroughly examined and go through the proper negotiating procedure with the Board. On the other hand, if the panel finds no infringement of the Medical Practice Act, the matter will be referred for consideration of dismissal.
  
  Furthermore, the panel may propose that the respondent participates in a Remedial Plan. A remedial plan is not an official form of disciplinary action. Instead, the TMB uses it to correct minor administrative offenses. Respondents that opt to engage in a remedial plan may avoid harsher disciplines like license revocation, suspension, limitation, or restriction. They will also not have to pay any administrative fees. 
  
  On the other hand, an agreed order is a disciplinary action that includes official disciplinary sanctions. As disciplinary procedures, it will probably involve revocation, suspension, or other encumbrances.
  
  Overall, if a solution cannot be established via the use of an agreed order or a remedial plan, the case will be sent to the State Office of Administrative Hearings (SOAH) for a determination on the case's final disposition 

•  State Office of Administrative Hearings (SOAH). A SOAH hearing is conducted in the same way as a trial is conducted in a courtroom. However, in this case, the hearing is presided over by an Administrative Law Judge (ALJ). When the matter is presented before the hearing officer, respondents will have the opportunity to present their defense, provide evidence, and question witnesses. Following the end of the SOAH Hearing, the ALJ will submit a Proposal for Decision to the TMB. The TMB will then issue an order, following which the matter will be dismissed, or disciplinary action will be taken. Still, respondents that are not satisfied with the TMB’s final order may file an appeal with the District Court to contest the ruling.

• Compliance. TMB Compliance Officers are in charge of monitoring licensees who have been placed under Board order to ensure that they follow the terms. If any of the order's terms are broken, the TMB may take extra disciplinary action against the perpetrator. 
  

It is worth noting that respondents have several opportunities to defend their practice throughout the disciplinary process.

How Can a Texas Medical Board License Defense Attorney Help?

Medical practitioners who want to defend their legal rights must consult with an attorney. A Texas medical Board license defense attorney can give effective counsel, and assistance to physicians facing disciplinary action or whose application for a medical license has been refused.

Medical professionals can improve their chances of a favorable outcome by hiring an experienced license fefense attorney who is familiar with the TMB's comprehensive requirements and the necessary documentation and processes. General practitioners and defense attorneys may not be familiar with certain Texas Medical Board’s legal processes and regulations. A skilled medical license defense attorney on the other hand has both the requisite skills and experience that will make a difference between a successful and failed case resolution.

What is Physician Complaint Representation?

Physician Complaint Representation entails assisting healthcare workers in dealing with complaints, claims, and critiques from the medical Board.

How do Referrals to the Texas Physician Health Program Work? 

The Texas Physician Health Program (TXPHP) provides confidential early intervention, evaluation, and post-treatment monitoring for some health professionals regulated by the Texas Medical Board. These include medical practitioners that may not practice safely due to an impairing or potentially impairing health condition. A healthcare provider or physician licensee is considered impaired under Texas law when they are unable to practice with reasonable skill and safety to patients due to a physical or mental illness, such as deterioration caused by the natural aging process or a loss of motor skill, or excessive use of drugs or alcohol. This includes 

• Wear and tear caused by aging
• Substance abuse problems
• Syndrome or mental disorder
• Disruptive conduct
• Impairment in both the body and the mind.
  
  

The TXPHP's primary objective is to protect Texans' health and promote the greatest medical care standards. The TXPHP achieves this goal by providing information, recognition, and assistance in diagnosis and treatment for the participants (medical practitioners) suffering from drug use disorders, physical disease and disability, and mental issues. 

The TXPHP can help practitioners to design a structured rehabilitation or monitoring program based on suggestions from certified medical and mental health practitioners. Physician Health Program does this through the use of case management, monitoring, and documentation, all of which allow a PHP to provide proof of compliance to regulatory bodies, employers, and the general public as necessary. This aid is accessible to physicians who satisfy the program's standards. Participation in PHP is often anonymous and is not reported to the NPDB, hospitals, insurance networks, or other credentialing authorities. The NPDB is a database operated by the United States Department of Health and Human Services. It is designed to keep track of medical malpractice settlements and disciplinary proceedings taken against health care practitioners.

A reference may be obtained from various sources, including hospitals, businesses, employers, coworkers, friends, and family. Every recommendation is handled with the greatest privacy. Individuals that believe that a licensed practitioner is impaired, or have concerns about their safety or the safety of their patients may refer them to PHP for treatment. The TXPHP can be accessed through these means:

• Applicant or Licensee (Self-report). The TXPHP welcomes and encourages self-reporting because prompt reporting combined with careful monitoring can improve the physician’s well-being and lessen the likelihood of future disciplinary action and malpractice claims. Self-reports are kept confidential.

• Health-care Institutions. The TMB requires healthcare employers to report licensed healthcare professionals whose work poses a persistent risk to the general public. If the professional suffers physical or mental impairment, they may refer them to the TXPHP.

• Concerned Healthcare Professionals. Healthcare providers are often reluctant to ask for help for themselves or their colleagues. However, other professionals can refer their colleagues to TXPHP monitoring, and assistance when they abuse drugs or suffer from another disorder.

• Family and Friends. Family and friends that are concerned about a healthcare professional that is struggling with drug usage, mental illness, or a potentially crippling physical condition can refer them to TXPHP. The reference is kept private, which means that neither the individual being referred nor the TMB will be made aware of the referee’s identity. 

• Texas Medical Board. The TMB may refer some complaints that deal solely with physical or mental impairment issues to the TXPHP. This may occur at any point during the investigative process.

Get more information on the Texas Medical Board procedures and regulations from a qualified medical license defense attorney in Texas. Such an attorney understands the complex rules of the Texas Medical Board and can help in providing high-quality legal representation. To find a  Texas medical license defense attorney, concerned individuals may either search online for terms such as "medical license defense lawyer near me" or use the state bar association directory to obtain the contact information of qualified physician license defense lawyers in Texas. Interested parties may also visit the lawyer referral websites of professional bar associations within their area or ask for referrals from family and friends.