The opioid problem in our country has been deemed a public health emergency. In response to the crisis, the Department of Justice, federal and state law enforcement agencies, and medical boards have been targeting pain management doctors.
The Texas Medical Board (TMB) enforces stringent regulations on pain management clinics and medical professionals who work in pain clinics. Unfortunately, the increased enforcement measures against pain management clinics and practitioners can have negative unintended consequences for both patients and the practice of medicine. Further, the increasingly politicized climate surrounding prescription drugs and pain management clinics may put the medical licenses of innocent doctors in jeopardy.
Texas Rules for the Treatment of Chronic Pain
The TMB has Minimum Requirements for the Treatment of Chronic Pain to which doctors must adhere. Under the law, a "physician's treatment of a patient's pain will be evaluated by considering whether it meets the generally accepted standard of care and whether the following minimum requirements have been met:
- Evaluation of the patient.
- A physician is responsible for obtaining a medical history and a physical examination that includes a problem-focused exam specific to the chief presenting complaint of the patient.
- The medical record shall document the medical history and physical examination. In the case of chronic pain, the medical record must document:
- The nature and intensity of the pain;
- Current and past treatments for pain;
- Underlying or coexisting diseases and conditions;
- The effect of the pain on physical and psychological function;
- Any history and potential for substance abuse or diversion; and
- The presence of one or more recognized medical indications for the use of a dangerous or scheduled drug. 22 Tex. Admin. Code § 170.3.
The rules further mandate an in-depth written treatment plan for chronic pain, an explicit agreement with the patient for the treatment of chronic pain, informed consent, and other requirements pertaining to how medical records are kept, as well as other minimum requirements. 22 Tex. Admin. Code § 170.3.
Pain Management Clinic Certificate
Since 2010, all pain management agent clinics in Texas must obtain a certificate from the TMB. The Texas laws on the Regulation of Pain Management Clinics defines a "pain management clinic" as "a publicly or privately owned facility for which a majority of patients are issued on a monthly basis a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone." 3 Tex. Admin. Code § 168.001. The physician owner or operator of the pain management clinic must register with the TMB as well.
There are a few clinical settings that are exempt from the regulations regarding the registration of pain management clinics, including a facility operated by the state, a hospital, or clinic associated with a medical or dental school, among others.
If You Are Targeted by the Texas Medical Board
If you are a physician or owner/operator of a pain management clinic who is being targeted by the Texas Medical Board for violations of Texas Medical Practices Act or other malfeasance regarding your medical license, contact the medical license defense attorneys of BERTOLINO LLP.
Do not let the increased scrutiny of doctors treating patients with chronic pain jeopardize your Texas medical license. The attorneys at BERTOLINO LLP know how to build a compelling case to protect your license. We know how to navigate the TMB enforcement process, gather evidence, question witnesses, show a proactive approach toward compliance, and prepare powerful defenses against allegations of misconduct.
BERTOLINO LLP represents licensed professionals across the entire State of Texas. If you are facing disciplinary action from a professional licensing board, contact us today or call (512) 717-5432 and schedule a case evaluation.