The Texas Medical Board (TMB) monitors Texas doctors and other healthcare professionals for compliance with the Texas Medical Practice Act and other applicable laws and rules. Failure to follow these laws can result in disciplinary action against doctors and other healthcare professionals. Disciplinary proceedings can sometimes lead to significant penalties, including losing your license. When facing adverse consequences due to a disciplinary proceeding before your licensing board, you likely need the advice and counsel of an experienced medical license defense attorney.
The TMB and Its Disciplinary Authority
The TMB has the authority to discipline medical professionals to protect the public, offer opportunities for rehabilitation, deter similar conduct, and punish violations as needed. Under Tex Occ. Code §164.001(a), the TMB can issue a reprimand, revoke or suspend a license, or place a person whose license is suspended on probation. Other options for sanctions include:
- Issuance of a public reprimand;
- Placement of limits or restrictions on the person’s license, including:
- Limiting the practice of the person to or excluding one or more specified activities of medicine; or
- Stipulating periodic board review;
- Revocation of the person’s license or other authorization to practice medicine;
- Requiring the person to submit to care, counseling, or treatment of physicians as a condition for:
- The issuance or renewal of a license or other authorization to practice medicine; or
- Continued practice under a license;
- Requiring the person to participate in an educational or counseling program prescribed by the Board;
- Requiring the person to practice under the direction of a physician designated by the Board for a specified period;
- Requiring the person to perform public service considered appropriate by the Board; or
- Assessment of an administrative penalty against the person.
The severity of the sanction must be appropriate to the severity of the violation or conduct at issue. Multiple violations of the law or rules or a previous disciplinary history can result in more severe sanctions.
Guidelines for Sanctions
Texas law provides specific guidelines for sanctions against medical professionals based on the nature and severity of the violation. Notwithstanding the guidelines, if the TMB determines that the physician poses a continuing threat to the public welfare by practicing medicine, the TMB must suspend or revoke the physician’s license.
22 Tex. Admin. Code §190.15 outlines aggravating factors that may affect the ultimate sanction that the TMB issues in a particular case. These factors may include the following:
- Harm to one or more patients;
- The severity of patient harm;
- One or more violations that involve more than one patient;
- Economic harm to any individual or entity and the severity of such harm;
- Increased potential for harm to the public;
- Attempted concealment of the act constituting a violation;
- Intentional, premeditated, knowing, or grossly negligent act constituting a violation;
- Prior similar violations;
- Previous disciplinary action by the Board, any government agency, peer review organization, or health care entity;
- Violation of a board order; or
- Other relevant circumstances increasing the seriousness of the misconduct.
The TMB also may consider the following mitigating factors in issuing a sanction:
- Self-reported and voluntary admissions of violation(s);
- Implementation of remedial measures to correct or mitigate harm from the violation(s);
- Acknowledgment of wrongdoing and willingness to cooperate with the Board, as evidenced by the acceptance of an agreed order;
- Rehabilitative potential;
- Prior community service and present value to the community;
- Participation in a continuing medical education course described in §161.35 of this title completed not more than two years before the start of the investigation if the Board is investigating the physician regarding the physician’s selection of clinical care for the treatment of tick-borne diseases;
- Other relevant circumstances reducing the seriousness of the misconduct; or
- Other relevant circumstances lessening responsibility for the misconduct.
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22 Tex. Admin. Code §180.5(h) outlines sanctions for each violation, which range from “Low Sanction” to “High Sanction.” The extent of each sanction is based on the existence of the mitigating and aggravating factors above.
For instance, for a breach of confidentiality, sanctions are as follows:
- Low Sanction – Remedial plan, completion of continuing medical examination (CME) and the jurisprudence (JP) exam
- High Sanction – Agreed order: low sanctions plus a public reprimand and an administrative penalty
A misdemeanor conviction connected with the physician’s practice of medicine can result in the following sanctions:
- Low Sanction – Agreed Order: Referral to a Physician Health Program (PHP) if appropriate; independent medical examination (IME/IDE) if appropriate; suspension, which may be probated with practice restrictions; completion of CME, compliance with criminal court order; administrative penalty
- High Sanction – Agreed Order: Lower sanctions except no probation of suspension and suspension until cleared by IME/IDE
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Prescribing or administering a drug or treatment that is nontherapeutic, more than one patient or prior history of disciplinary action for the standard of care or care-related violations, or prescribing, administering, or dispensing in a manner inconsistent with public health and welfare can result in the following sanctions:
- Low Sanction – Agreed Order: CME in the appropriate area; chart monitor for 12 cycles; administrative penalty; consider proficiency testing
- High Sanction – Agreed Order: Low Sanctions plus restrictions on practice, including prescribing and administering controlled substances and dangerous drugs; and administrative penalty. If there are aggravating factors, revocation should be considered.
However, minimum sanctions are generally reserved for first-time violations. Additionally, violations concerning patient care are always more serious than administrative violations, which can be handled informally in some cases rather than in formal disciplinary proceedings. The maximum sanction for all violations is license revocation. Administrative penalties range between $1,000 to $5,000, with a separation violation for each day the violation.
If the sanction includes a remedial plan, it includes a $500 enforcement cost fee. If a remedial plan contains a recommendation for CME, a minimum of four hours in each appropriate topic addressing the violation(s) is the recommended hour requirement. On the other hand, if an agreed order recommends CME, a minimum of eight hours in each appropriate topic addressing the violation(s) is the recommended hour requirement.
Get the Advice You Need About Your Medical License
Alleged violations of state and federal laws and TMB rules can lead to the potential loss of your license and career. When you are facing this situation, you cannot risk navigating this complex situation alone. The medical license defense lawyers at Bertolino LLP help professionals like you defend themselves against disciplinary proceedings by their licensing boards. We can examine your circumstances and help you devise the most effective strategy to protect your license. Call us today at (512) 980-3751 or get more information about us online.
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