Texas Medical Board - February 8, 2008
Texas Medical Board - February 8, 2008
Full Board Meeting
Pulled Agreed Orders Modified
A doctor charging a patient’s credit card even though it had been withdrawn had their case dismissed because the patient had been compensated.
A doctor, who wrote non-therapeutic prescriptions, had his Agreed Order changed from just a chart monitor to a revocation of 2’s and 3’s. The Board member who had participated in the ISC felt that this doctor was more a victim of circumstance than a bad actor. However, this was not enough for the board, his lack of documentation on dosage increases and “indiscriminate use of 2’s,” called for these modifications.
Following this order, Mari Robinson, Director of Enforcement, gave an update on the Board’s collaboration with federal authorities to crack down on “pill mills” in the Houston area.
A doctor performed a large volume liposuction and abdominal plasty in an 8 hour surgery. The patient’s vital signs were all low and after they arrested they were sent to the ICU. This case was originally pulled because a Board member wished to open an investigation on the anesthesiologist. But this one year Agreed Order was voted to be extended to three years with continuous monitoring, and 10 CME hours in Liposuction and 10 CME hours in Post Operation added for each year. The Board wished to send a message to all Plastic Surgeons that might think of taking on risky procedures.
Fast Track Discussions
Following the approval of all the proposed rules, Mari Robinson headed up a discussion concerning what violations would fall within the jurisdiction of the “Fast Track” system. These “traffic tickets” are meant to handle administrative violations. Any doctors receiving one of these tickets, merely has to write a check and send it back in within 30 days. Specific violators will not be mentioned in the newsletter, but all Fast Track violations will be listed aggregately. But, if one were to look up a specific doctor’s name, these violations would show up in their profile. A doctor may receive no more than one ticket concerning a specific violation, or three tickets all involving different violations. The Board decided that Peer Review cases would not fall under this new system. Minor violations of Board orders, and any misleading advertising will result in a $1,000 fine. Mr. Webb expressed a desire to have clearer definitions in place with consistent punishments. All other violations that are administrative will be included in this system.
TMA/Board Impairment collaboration report
Dr. John Jackson, Chair of the Texas Medical Association Physician Health and Rehabilitation Committee, came before the Board to present a possible collaboration between the Board and the TMA in dealing with impairment issues. Right now the Board handles all of these cases, but in many states there are systems which involve the community organizations as well as the state Board. The system proposed by Dr. Jackson would allow for the strengths of each organization to complement each other to help impaired physicians and protect the public. There would be a centralized organization that all parties would buy into, wherein the Board would retain ultimate authority.
The TMA would be able to act quickly and get to the doctors faster than the Board. If a doctor is cooperative, he will be able to recover in a confidential system under this centralized organization. However, if the doctor is not cooperative, they will be reported to the Board and the order will be made public. Rules and guidelines will be carefully placed so that the doctors who are willing to get help will be protected in a confidential system, and doctors who are a danger to the public will be prevented from doing so by the Board.
Drug testing would still run through the Board, but rather than having names, the Board would have ID numbers. If a test came back positive the Board would be able to investigate the situation through the centralized organization. This would provide a type of check on the confidentiality system for the Board.
The Board would have hiring authority for this organization and it could be funded by adding a surcharge to licensees. This new system is still in the preliminary stages and the vast majority of its actual applications and structure have yet to be decided. Dr. Jackson came before the Board to see if there would be interest in this collaboration. This kind of organization can not exist without support from the Board. If the Board approves of the possibility of this new system, then more meetings and liaisons between the Board and TMA will guide the creation of this new organization.
This is still in the “thinking” stage and no formal decision has been made to in regard to this program.
Thanks to Mr. Blair for taking notes.
Please send questions or comments to Jon Porter
