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Texas Medical Board Defense

Understand how the TMB Affects Your Medical Doctor or Doctor of Osteopathy License

What is the Texas Medical Board (TMB)?

The Texas Medical Board (TMB) exercises regulatory oversight over the practice of medicine under the authority granted by the Texas Medical Practice Act. This authority empowers the TMB to both issue and enforce discipline on the medical licenses held by medical doctors (MD’s) and Doctors of Osteopathy (DO’s).

It is responsible for regulating the practice of medicine in the state with the primary mission to protect and promote the health and safety of the people of Texas by ensuring that physicians and other medical professionals meet and maintain high standards of competence and ethical conduct.

How does the TMB affect my Medical Practice?

The Texas Medical Board has several key functions and responsibilities, including:

  • Licensing: TMB is responsible for granting licenses to physicians, physician assistants, and other healthcare professionals who meet the educational and examination requirements set by the state. It ensures that individuals seeking to practice medicine in Texas have the necessary qualifications and credentials.

  • Discipline: The board investigates complaints and allegations of misconduct or violations of medical practice laws and regulations. If it finds evidence of wrongdoing, it takes disciplinary actions, which can include license suspension or revocation, fines, or other sanctions, to protect the public.

  • Rulemaking: TMB establishes and enforces rules and regulations related to the practice of medicine in Texas. These rules cover various aspects of medical practice, including licensure requirements, medical ethics, and standards of care.

  • Continuing Medical Education (CME): The board may set requirements for continuing medical education to ensure that licensed healthcare professionals stay current with medical advances and maintain their skills and knowledge.

  • Public Education: TMB may provide educational resources to the public to help individuals make informed decisions about their healthcare and understand their rights and responsibilities when receiving medical treatment.

  • Monitoring: The board may monitor physicians and healthcare professionals who have been subject to disciplinary actions to ensure compliance with the terms of their discipline.

The Texas Medical Board plays a crucial role in regulating the practice of medicine in Texas, with a focus on ensuring the competence and ethical conduct of healthcare professionals and safeguarding the well-being of patients.

Types of TMB Cases

The Phan Law Firm may handle a variety of cases related to the practice of medicine in the state. These cases can broadly be categorized into several types based on the nature of the allegations or issues involved. Some common types of Texas Medical Board cases include:

  • Ethical Violations: Cases involving allegations of ethical misconduct by physicians, such as breach of patient confidentiality, improper relationships with patients, or other violations of medical ethics.

  • Standard of Care Violations: Cases where a physician is accused of providing substandard medical care, which may include misdiagnosis, surgical errors, medication errors, or other instances where the standard of care was not met.

  • Prescription Drug Violations: Cases related to improper prescribing or dispensing of controlled substances, including allegations of overprescribing, inappropriate prescribing, or diversion of prescription drugs.

  • Fraud and Billing Issues: Cases involving allegations of fraudulent billing practices, insurance fraud, or other financial improprieties related to medical billing and healthcare reimbursement.

  • Licensing and Credentialing Issues: Cases related to the initial licensing or renewal of a physician’s license may involve issues with educational qualifications, examination performance, or background checks.

  • Substance Abuse and Mental Health: Cases involving physicians with substance abuse problems or mental health issues that may impact their ability to practice safely and ethically.

  • Sexual Misconduct: Cases involving allegations of sexual misconduct by healthcare professionals, which can include sexual harassment, abuse, or inappropriate relationships with patients or colleagues.

  • Boundary Violations: Cases where physicians are accused of violating professional boundaries with patients, which may include issues like dual relationships or improper personal involvement.

  • Board Compliance: Cases related to non-compliance with TMB regulations, including failure to meet continuing medical education requirements or other administrative violations.

  • Criminal Convictions: Cases where a physician has been convicted of a criminal offense, which may have an impact on their medical license.

  • Patient Complaints: Cases initiated by patient complaints regarding various aspects of their medical care or interactions with healthcare providers.

These are just some examples of the types of cases that the Phan Law handles. The specific details and outcomes of each case can vary widely, and the board’s primary goal is to ensure the safety and well-being of patients while upholding the standards of the medical profession.

Understanding the TMB Complaint Process

Physician licensing defense encompasses the legal representation of medical doctors in Texas. These doctors may find themselves facing scrutiny from the Texas Medical Board, often initiated by a complaint letter, which marks the commencement of the defense process before the TMB. The Texas Medical Board holds authority over the licensing procedure for medical doctors. It is responsible for imposing penalties and sanctions when a doctor is found to have violated the law.

Contained within the complaint letter are the facts and legal arguments that support the TMB’s contention that a physician has breached Texas law. These alleged violations can range from ethical misconduct to charges of negligence. To mount the most effective defense against these complaints, a physician requires the expertise of a seasoned attorney.

 

Disciplinary cases involving a physician’s license and the Texas Medical Board can be broadly categorized into two distinct areas: substantive and procedural. Substantive matters pertain to the nature of the allegations or the type of issue at hand, while procedural aspects concern the specific steps and processes involved in the disciplinary case.

Types of Complaints

Complaints arrive at the Texas Medical Board from different sources, but the primary source of complaints is based on those that the physician knows well, either a former patient or a current patient.

In the firm’s daily practice, the firm sees complaints involving documentation or record-keeping, non-therapeutic prescribing, failure to complete continuing medical courses as required, prescribing to known abusers, criminal conduct, and treatment that failed to conform to the minimum standard of care.

Do I Need to Hire an Attorney? What Type of Attorney Should I Hire?

Mr. Phan is familiar with the many types of alleged violations facing a physician and the different issues presented with each of the alleged violations of practice. Mr. Phan fully understands the disciplinary process during all phases, having prosecuted countless thousands of violations against other health professionals.

Physicians provide meaningful care to patients. Their standing in the community, both to the public and among peers, is unmatched and has been earned, rightfully so, through hard work and determination. Thus, even physicians who exercise the utmost care in practice may find themselves facing a complaint. The firm understands and appreciates the feelings of disbelief, anxiety, anger, and fear of the process associated with receiving a Texas Medical Board complaint letter alleging serious allegations of misconduct.

The firm understands that a physician’s reputation, good standing, and livelihood are at stake. Due to this appreciation, the firm recognizes that the exposure to disciplinary action has concrete effects on real people, affecting the physician’s ability to practice as it diverts the physician’s valuable resources away from what he or she wants to do to safely practice and care for patients. As such, the firm takes each and every case it handles with the utmost seriousness that each case exacts.

The Initial Texas Medical Board Complaint Letter

Physicians in the State of Texas, once a complaint is received at the Texas Medical Board, receive a notice of complaint letter from the Texas Medical Board. The complaint letter notifies the physician that he or she is being investigated by the Texas Medical Board.

The complaint letter contains the allegation(s) against the physician. The complaint letter requests the physician, within a certain time period afforded, to respond to the allegation(s) contained in the letter. It is critical that this letter not be ignored as the Texas Medical Board is empowered to proceed with the complaint regardless of whether the physician responds with severe consequences to the physician if the initial complaint letter is not responded to or ignored altogether.

The Formal Investigation Phase

After a physician responds to the complaint letter, the Texas Medical Board will continue to conduct its investigation. The Texas Medical Board may continue to reach out to the physician for any necessary follow-up or to request additional information.

The complaint, at this stage, may be dismissed if there is insufficient evidence. If the Texas Medical Board determines that the complaint has merit, the case proceeds.

Under the Texas Medical Board rules, the investigation phase is required to be completed within 180 days of the complaint being filed and the investigation being opened.

The Informal Settlement Conference

If the Texas Medical Board determines that there is a violation(s), the physician will receive written communication that the Texas Medical Board intends on setting an Informal Settlement Conference with a location, date, and time for this Informal Settlement Conference to be held. This Informal Settlement Conference affords the physician, along with his or her attorney, who is allowed to attend, an opportunity to appear before Board members, Board staff, and Board staff attorney(s) to visit about the matter in a one-on-one setting. This process is referred to as an Informal Settlement Conference. Although it is referred to as “informal,” it is anything but informal as this is a procedure that requests the physician to appear to answer questions from Board members and staff and to defend his or her conduct. Prior to the Informal Settlement Conference, the Medical Board will have provided the physician with written information as to its proposed findings and areas it believes have been violated. It is critical for a physician to know how this process works and, most importantly, how best to respond in defending against the claims of violations. The decisions as to appearance, what to present, and how it should be presented are determined with the assistance of the Phan Law Firm, P.C., prior to this conference.

Following the Informal Settlement Conference and after deliberation by the Board members, a recommendation is made and shared with the physician. The recommendation may dismiss the matter, table the complaint (i.e., put on hold) in order to obtain additional information or visit about additional issues that may have surfaced at the Informal Settlement Conference, refer the matter to a temporary suspension hearing, or refer the matter to a contested case hearing at the State Office of Administrative Hearings. The Texas Medical Board may also, if the matter warrants, recommend resolution through a non-disciplinary remedial plan. As part of the Informal Settlement Conference, the panel may conclude that the physician committed violations. In this case, the panel may make a recommendation to the physician regarding its proposed discipline as contained in a proposed Agreed Order.

The Proposed Agreed Order for Disciplinary Action

To the extent that the Informal Settlement Conference panel concludes that the physician violated a statutory provision or one of its rules, it is most likely to recommend disciplinary action against the physician. This disciplinary action, proposed in this setting, takes the form of a document known and referred to as an Agreed Order. The Agreed Order sets out each finding of violation and the statutory or Board rule for that violation. The Agreed Order will also contain the terms of the discipline against the physician, including the mark of discipline (e.g., Warning, Reprimand, etc.) against the physician. If the physician accepts the proposed Agreed Order, this will result in permanent and public discipline against the physician.

The Formal Resolution Process

If the proposed Agreed Order is not accepted, settlement negotiations with the Board staff attorney may continue in order to discuss terms the licensee will agree to. If an agreement cannot be reached, Board staff can then file a formal complaint at the SOAH and proceed to a formal contested hearing.

A Contested Case Hearing at the State Office of Administrative Hearings

In this formal proceeding, the Texas Medical Board files a complaint, making the complaint public. This filing will list each allegation of wrongful conduct and is the basis for which the Texas Medical Board will attempt to persuade the ALJ, in a contested case hearing (i.e., trial) with the evidence it has accumulated, that the physician is in violation.

Because the physician is a party to this proceeding, he or she will assuredly be called as a witness to this proceeding. One must know that a physician who enters this phase of the proceedings will be afforded due process, but one must understand the process of this formal proceeding and not ignore it. If the Texas Medical Board is successful in persuading the ALJ, the ALJ will issue a decision called a Proposal for Decision with findings of fact and conclusions of law. If there are findings of violations found, the physician (with few exceptions) will receive discipline on their license from the Board.

Under the application of administrative law, the ALJ determines findings of fact and conclusions of law and may make a recommendation for discipline. However, if there are findings of fact that support a violation(s), the final power to enact discipline lies with the Texas Medical Board. There are, of course, continued remedies available to the physician if he or she, even after a final determination by the Texas Medical Board to appeal that decision in State District Court.

Mediations (also at the State Office of Administrative Hearings)

One possible avenue for resolution is mediation, which is also conducted by an ALJ at the State Office of Administrative Hearings. This proceeding allows for an impartial mediator (the ALJ) to understand each party’s position and work with each party during mediation to facilitate an acceptable resolution to both parties. The mediation process is confidential and cannot be used against the parties if the case fails to result in an acceptable resolution. In this case, the matter proceeds to a contested case hearing.

Temporary License Suspension Hearings

The Texas Medical Board has the power to conduct these proceedings where the central issue will be to determine, based on the alleged conduct, whether the physician’s ongoing practice will serve to harm the public interest. If the answer is in the affirmative, a physician loses his or her ability to practice medicine until final resolution at a contested case hearing at the State Office of Administrative Hearings.

Applicants Making Application With the Texas Medical Board Who Face Issues That Impair and Hinder Their Ability to Obtain a License

Applicants may face uncertainty when considering making an application with the Texas Medical Board as to whether circumstances they currently face or have in the past may impact and/or impair their ability to become a licensed physician in the State of Texas. There are numerous examples, such as educational background (e.g., foreign-based school), whether they are coming from another jurisdiction with disciplinary action in that jurisdiction, and whether they have had the loss of privileges at a facility in another jurisdiction, to name a few. The Phan Law Firm, P.C., is knowledgeable about these issues and can assist applicants as they weigh the possibility of whether issues they have will negatively impact their ability to become fully licensed in the State of Texas.

Texas Medical Board Defense Lawyer

The above is a brief overview of the disciplinary process for a physician faced with a Board complaint or an applicant seeking licensure to practice as a physician in the State of Texas. Both of these processes are well known to Mr. Phan. In private practice, Mr. Phan has defended physicians against Board complaints and disciplinary proceedings and has assisted physicians or applicants seeking licensure in the State of Texas. 

As one can see, the above process is daunting, and each step requires an attorney who can guide a physician through that process and provide sound, thoughtful legal advice at each step so that the physician is in the best position to understand the consequences of each action and make the best decision for him or her depending on his or her unique facts and situation.

Candidly, the decision to hire an attorney is critical and important, one that is not to be taken lightly. Given the years of education and training by physicians, the firm expects that each potential physician client will continue to do his or her due diligence in researching an attorney and finding an attorney and firm that can best obtain the right result for him or her. Thus, one of the key considerations, the firm believes, is whether that attorney has experience with the licensing boards and has defended physicians before the Texas Board of Medicine. The Phan Law Firm, P.C., is this firm.

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Texas Board Defense Lawyer

Former Texas Board of Nursing (BON) Assistant General Counsel, former Texas State Board of Dental Examiners (TSBDE) General Counsel, and former Texas State Prosecutor with an intimate understanding of the board complaint process, disciplinary proceedings, licensure issues, and SOAH contested case hearings.