TMB Schedules Additional Meetings

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Perhaps hearing the complaints about the remote locations for its initial town hall meetings, the Texas Medical Board has finally agreed to hold one in Texas’s largest city, Houston, and hold others in additional central locations.

Despite the out-of-the way location, the meeting in Midland/Odessa attracted some 45 physicians. The board officials there reportedly dodged a question about doctors not coming because they feared retaliation.

In Fort Worth, about 65 persons attended. In response to a question from a recently retired family physician, Mari Robinson, director of enforcement for the Board, indicated that she felt, in her own mind, that the process was fair to physicians. The doctor responded that Texas physicians don’t think so (Fort Worth Star-Telegram 7/3/08).

A physician who attended the Fort Worth meeting said the atmosphere was charged, but the TMB maintained control. The minutes that the TMB secretary was writing, which were projected on a screen but apparently not available for review, bore no resemblance to the proceedings, the physician reported. While doctors were asking about unfair, inquisitorial hearings by the TMB, the secretary was writing: “Over concerns of patients being led to the bathroom undressed.”

Board members could not explain why there had been an explosion of complaints, 1,700 more in 2007 than in 2006. According to documents obtained by AAPS, the next largest source of complaints, after patients and their friends and relatives, is the TMB itself. Newspaper reports are one source of TMB-generated complaints.

A physician complained that the Board’s “experts” are less qualified than targeted physicians. The secretary typed: “Doctors want to have the nonmedical person of the board be trained and become an expert opinion.”

To a question about competitors of a targeted physician recusing themselves, the Board responded that this did not occur; competitors would know more about the case. The secretary typed: “The competition is welcomed by doctors as expert witness.”

This physician attendee concluded that “TMB never got the message.” Physicians are fearful of Board injustice, evidently with good cause.

The additional meetings are scheduled for:

July 15/16 Houston. The Town Hall will be in Room MSB 1.006 (first floor lecture hall) at the University of Texas Medical School, 6431 Fannin St.

July 29/30 Lubbock. The Town Hall will be at Texas Tech University Health Sciences Center, 3601 4th Street (4th St and Indiana Ave), Room ACB100.

Aug 5/6 Tyler. Biomedical Research Auditorium, UTHSC, 11937 U.S. Highway 271.

Aug 12/13 Dallas. T Boone Pickens Biomedial Building Auditorium, Room NG3.112 on the third floor, UT Southwestern Medical Center, 6001 Forest Park Rd.

Aug 19/20 El Paso. Auditorium B, second floor, Administration Building, Texas Tech University Health Sciences Center, 4800 Alberta Ave.

Aug 25/26 San Antonio. The Town Hall will be in Lecture Room MED 309L, School of Medicine, Joe R. and Teresa Lozano Long Campus, UTHSC, 7703 Floyd Curl Drive.

Sept 3/4 Galveston. University of Texas Medical Branch, TBA.

Sept 9/10 Amarillo. Texas Tech University Health Science Center, TBA.

Town Halls are at 7 p.m. the first date. Time and location of seminars may vary. Check www.tmb.state.tx.us under “News,” or call (512) 305-7030.

It would be desirable for as many physicians as possible to attend for mutual support, and take notes. You may wish to make a lawful tape recording. We are interested in your report on the meeting: how many attended, who was there from the TMB, any press coverage, questions or answers of note.

Here are some of the questions that have been suggested:

Which board members resigned and why?

Why do you think the board is perceived as being hostile, abusive, and disrespectful to physicians, and what might be done to change this?

How are board members chosen? What effort is made to avoid conflicts of interest? What is considered to be a conflict of interest? Serving as expert witness for plaintiff in malpractice cases? Working for insurance companies that may wish to remove doctors who submit “too many” claims?

Are board members who are competitors of a targeted physician asked to recuse themselves from investigating, presenting, or voting on a case?

Why should defense against a complaint by a patient who paid $15 for an office visit cost $100,000, even when there is no evidence of harm to the patient?

Why should the process be so complex, so opaque, and so threatening that physicians feel they must hire high-priced counsel at the outset? Why is there not a preliminary process to settle most cases quickly and efficiently, without compromising the doctors’ rights?

Is there any penalty for complainants who lie to the board? If not, why not? Is there some process to determine the plausibility and veracity of complaints before the doctor has to spend time and money defending himself against malicious or frivolous complaints?

What are the qualifications of investigators? How much authority do they have?

If the Board delays processing an application does the physician end up having to pay another fee and start all over again after a certain time has elapsed?

If a complaint is eventually dismissed, can the Board reopen it at any time, or keep using it against a physician? Are dismissed complaints expunged from the record made available to the public?

Has a sitting Board member ever been disciplined?

If an administrative law judge or a court rules that the Board ruled inappropriately, does the Board have to change its disposition of a case? Has it ever undone a sanction based on the findings of a court or a judge on appeal?

 

13 Comments

  1. Are these townhall meetings or sham “concensus building” ventures? Is the TMB’s conclusions already written and their meetings are going to be “proof”? I recommend an article from the Eagle forum 1998
    best found by going to eagleforum, and putting “Delphi Techinque” in the search. The Delphi is a common” strategy of central planners and “is used to give the appearance of local decision-making when none exists.” There are some articles at Eagle forum pertaining to this Delphi Technique. One describes its use by the Missouri board of education to support “school to work” . redefining education to meet the needs of the state and labor market, and “correct” attitudes and values that will fit into the global marketplace. Sounds Fun!
    http://www.eagleforum.org/educate/1998/nov98/focus.html
    also a book by B K Eakman dealing with concensus building called “How to counter group manipulation tactics” $16 + $4.60 postage 301/946-2412
    http://www.beverlye.com

  2. Dear friends: Thank you for keeping us informed, I am so glad that there is going to be a meeting in Houston, with God’s help we will attend. I hope someone from your association will be there. Because without you Texas justice for the medical professionals is just a myth. God bless you. Doris

  3. I’ve had an informal “hearing” with the board. The PHYSICIAN member for the board actually FELL ASLEEP during my hearing. ASLEEP!! My license, future practice of medicine and livelihood is being discussed and this guy is head back, snoozing!! It was unbelievable!! Extremely, extremely unprofessional, inconsiderate and inappropriate. Can I step forward and talk about this at this town hall meetings?? ARE YOU KIDDING ME? There is absolutely fear of retaliation by the TMB. You would think a fellow doctor would have the decency to stay awake and feel that his duty to the public and to the professional was important enough for him to sleep amply before a day of hearings, but I guess he is just such a powerful guy that he can do what he wants. Apparently that’s been the philosophy for many of the board members and hopefully they’re soon going to experience the consequences of misusing this power.

    And regarding Jeff’s comment above, knowing the board, yes! these are almost certainly sham meetings intended to create the illusion that the board is actually going to listen to any of the doctors. And I can assure you, MOST of the doctors that need to go and have something to say (like me) won’t go because of FEAR of retaliation. Guaranteed. I truly salute the docs that are brave enough to go to the meetings and speak up. So hopefully, someone in the legislature will read this. And realize that even though these meetings are intended to bring doctors forth to give complaints they are being held by EXACTLY the people that we are complaining about. This is a huge miscalculation! How about the LEGISLATURE hold hearings and let us talk to them?? Exclude medical board members!!! They are the problem!!

  4. The Texas Medical Board is an example of pure, abusive power. Board members should be disciplined and disciplined severely. The total breakdown of any semblance of proper, legal and fair order is disgusting. Texas is a great state. It has contributed to tort reform. Patients and physicians alike deserve something better than this.

  5. I attended the July 2nd, meeting in Fort Worth . I am not a doctor nor in the medical profession. I have worked in the oil & gas industry for 30 years and decided to attend this meeting only for confirmation of what I believed to be true about the TMB was correct. Not to my surprise the TMB only confirmed what I already suspected. In my life I had not seen a state appointed agency that the only thing I can compare its tactics to is Hitler. It appears the doctors are presumed guilty and have to prove their innocence. The
    state Representative that attended the meeting in Fort Worth asked; Why is it that a doctor being disciplined for a “standard of care violation” (determined by the board) is found guilty even if there are “8” other well known published physicians (not just physicians but ones you will find quoted in medical journals) in agreement with the standard of care that the doctor being disciplined gave? Mari Robinson, director of enforcement for the Board, answered with a well rehearsed answer to most of the questions, because the board determined “standard of care” was violated. As I stated before, I am not a doctor nor presume to know the medical profession but when did medicine become “standard” and no longer an art or science? What exactly is “Standard of Care” and who has the paten on determining what Standard of Care is? One more item I would like to address is the frivolous complaints of the person checking the charts for TMB. Hand writing? Not enough history for a patient the physician has seen for 20+ years? Well, I have to say the doctors that are just now coming out of medical school starting practice are definitely covering themselves with the computerized system for fear of the TMB. I went to one of those physicians that the TMB is forcing to do such tactics and this doctor typed on his computer with his back to me during 75-80% of time during my office visit. As we talked or rather I talked and he covered himself by typing as many notes as he could in this system. Another scenario; In July, 2007 I had C4-C5 fusion, later after reviewing my chart by the physician who performed surgery on me there were items on the system generated report in my file that were not discussed with me by the physician. Just because it is in my file (what the TMB pushes) does not make it correct. The system printed report covered everything possible in regard to my surgery that a physician should (or was suppose to) review with his patient prior to surgery. Again, because it is in the file does not make it correct but physicians have been pushed and beaten like a broken horse by the TMB they fear leaving anything out that the TMB may see fit to discipline them with standard of care violations they are losing the once so called bedside manner/human compassion and becoming almost mechanical.

    Hopefully for the sake of physicians, the patients and the public, our representatives will step forward and make the necessary changes to discipline the Texas Medical (Nazi like dictator ship) Board.

    Joann

  6. I have gotten some good feed back from various state reps and senators but much more must be done. Talk is cheep and meanwhile Good Doctors all over Texas are being run out of practice and their lives destroyed. At the current rate of action it will most likely be too late for me and others like me, but this is about much more than just me. I am a good doctor, not perfect but I care deeply for my patients and give 110% as many of us do. We all sacrificed a lot of our lives and our families’ lives to EARN the privilege of being call Doc. I probably need to document more but my records or for me not anyone else. I can read my writing fine. The TMB is trying to apply ridged legal standards to the Art of medicine. No two patients or treatments are exactly alike; we practice an Art not science and defiantly not LAW! Just because 1 or 2 of the board’s paid doctor assassins’ disagree with diagnosis or treatment does not make them right. Who are they to say want is stand of care? It is easy to take pot shots at a bunch of hard working, deeply caring and old fashion Family doctors. We have little or no funds to fight or pay excessive fees for minor infractions the truly warrant no action at all. We still hand write our notes the way we were taught by our older wiser trainers and care more about taking care of patients like family than a number. My eyes are on my patient not a computer when they visit me.

    I was planning a Big meeting open to everyone on June 25, 2008 with retired state representative Ray Allen, now a lobbyist in Austin. We had a meeting room at Charlton Methodist hospital but it had to be canceled because the hospital has threatened not once but twice to fire the docs that get involved and they pulled our meeting room. I had hoped to pool some support and money to hire the lobbyist and his team to get something done in Austin. They had previously helped the Dentist with similar board problems. I have tried to get the AOA, TOMA, TMA and other medical organizations to help to at least spread the word or give us a web page on there site to post and receive feed back. None will get involved.

    I have lost more than half of my income. BCBS, Cigna and others dropped me when the TMB action became public. I have damaged no one. I refuse to be bullied by the TMB. One mentally unstable patient, who as far as I know is still in jail on drug and attempted murder of her Ex husband charges, caused this whole mess.

    I received last week the notice of the board filing a SOAH hearing via fax on Monday July 30, 2008 with no date of hearing. The TMB is trying to take my license. I want to take this to court and take this case back to the very beginning but I fear I am against a stacked deck. NONE of this should have ever happened if they had not inappropriately attacked me over the initial frivolous complaint. I have never harmed anyone, Never done any IV anesthesia as they continue to insist and only because of the Boards actions have all the rest of the charges occurred. I have been set up and they are creating a monster that I can not stop. They have damaged me massively over nothing!

    If the TMB takes my license then I will have to find other work. I can’t believe they can do this to me after 21 years in practice and so many years of school and so many happy patients over a single complaint. But at the Fort Worth town hall meeting I saw I was not alone once again.

    I want to form a national organization of physicians and their patients to combat this nation wide problem. If you agree please contact me. If we can get Doctors and their patients to stand together we will be able to command much power.

    Running out of rope,
    Michael Williams, D.O.
    513 Straus Rd suite A
    Cedar Hill, TX 75104

    [email protected]
    Office 972-299-6045

  7. Dear Jane,

    I am very concerned over the capacity of physicians to have the TMB suspend their inquisitorial activities until the system of “justice” they apply is reviewed and improved under a new insight and inspiring light.

    The TMB has no right to destroy physician’s lives. Especially when no harm has been caused to the public. This they do by distorting reality into a bureaucratic “legalese”.

    Is the mission of the TMB to kill doctors to save the public from “our poor training or stupidity”? Certainly the TMB believe doctors are criminals and that they must be hunted down, punished and have them displayed naked on the streets to be scorned by society. They play the terror game with us very much successfully.

    The governor has to be approached directly as he is the person with full powers over the TMB. The members of the TMB are just peons of the big players and they play the part but they have no power over the action as they are obliged to carry on the orders from above.

    How do we approach the governor?

    How do we approach the senators?

    They are the responsible party for the way the TMB runs.

    Should doctors and patients pay the governor a visit… or sit in front of his house until he allows us to fix this nightmare we endure.

    j

  8. It’s all about Big Pharma, the AMA, and the government “controlling” medicine and not tolerating anything less (just as they’re “controlling” the country and making this clear to anyone who is not totally deceived and unaware). It’s not the definition of a “free” country when you need “permission” from the government, and a license to do anything and everything including getting married, owning a dog, etc. We live in a country that has rapidly become a fascist dictatorship, and the average moron believes we’re “free”. Cicero, Rome’s poet laureate basically wrote (in Latin):

    The masses
    Are asses

    I now understand why he was Rome’s poet laureate, not only because of his profound insight into the “human condition”, but also because he was able to make it rhyme, in English, 2000 years into the future.

  9. The Board has definitely changed over the years.When have you heard that the Board has requested medical records from a patient,and after
    thorough review by the boards experts,the case was dropped.To my amasement the Board requested the same medical records again!!!
    When have you heard
    that during an Informal Hearing the Board MEmber and ONLY MD
    was asleep,while the ATTORNEY of the Board Mr Heiser was asking me questions.
    When have you heard that the Board Members take the opinions of their Experts into cosidera-
    tion and dismiss opinions of three specialists in the fields,which have
    much better qualifications than the Experts of the Board.

  10. I had the pleasure of actually being exonerated by the board. I underwent a bad faith or sham peer review at my hospital and as a result was invited to discuss my situation with the board. After 18 months of waiting to discuss my case I was finally informed of a date and given the state’s report and findings a mere 5 to 7 days prior to having to present. Fortunately I had very competant help in provoding professional opionions.

    The anonymous medical reviewer made statements about my care that were inflammatory and revealed a FRIGHTENINGLY ignorant understanding of the physiology of medicine. It appears that the board experts should be reviewed!!!! In my particular case, if the board expert is practicing the way he said I should be practicing then I am sure that the citizens of Texas are suffering at the hands of these self-proclaimed experts.

    In several months I will be leaving Texas to practice at a major medical school and be putting this all behind me.

    If the board REALLY wanted to improve medicine in Texas they would have investigated the bad faith peer review I suffered and reviewed the incompetant, lying physicians who initiated the sham peer review in the first place!!!!!!!!!!!!

  11. The Town Hall meetings that the Texas Medical Board is conducting at locations around the state this summer are intended to collect input and feedback into the way medical professionals are regulated in Texas, both from medical professionals themselves and the public. While TMB will continue to vigorously protect patients, Board members believe there may be ways to perform this duty that would be less burdensome for doctors. We are open to any suggestions.

    As comments are collected at the Town Hall meetings, they are projected onto a screen visible to everyone in the room. This is to allow participants to see how their comments are recorded and to allow those making the comments to make any changes so that the recorded notes will accurately reflect their thoughts.

    TMB wants this to be a transparent process, and the comments collected are public documents that are available to everyone. Because of that, TMB has created a page on its website (http://www.tmb.state.tx.us/townhall/meetings2008.php) that contains a list of cities in which the Town Hall meetings will be, or have been, conducted. If you click on a city in which a meeting has already occurred it will take you to the document listing the suggestions and comments that were recorded at that meeting. These suggestions have not been edited or altered since they were typed at the meetings and projected onto the screen.

    I call special attention to the suggestions from the Fort Worth Town Hall meeting (http://www.tmb.state.tx.us/townhall/2008/FtWorth_07-01-08.htm). None of the comments listed in this story were made or recorded.

    Patrick Shaughnessy
    Community Relations Coordinator
    Texas Medical Board

  12. I was an expert Board reviewer. I had no idea what they were like. I thought I could help innocent physicians. When I disagreed with Mari Robinson, I was “counseled” about needing to “conform” to the decision that had been made about the physician in question. I was told that the Board didn’t need experts like me. When I said there wasn’t enough evidence for Mari’s allegations, the Board flunkies said they would go into the patient’s travel, medical, and pharmacy records until they “found what they needed.” The patient never even made the complaint and, in fact, wrote a number of letters and affidavits in support of the doctor. Obviously, I’m terrified about releasing my identity, and I’ll never do another review, but when I retire …..

  13. I was a practicing physician in San Antonio. After answering to anonymous allegations at a local hospital my priveleges were returned. Despite a good local outcome the TMB still decided to investigate me as to possible violations of the Texas Medical Practice Act. I’ve been subjected to three psych evaluations, a medical exam and a neurologic exam. I’v had my liscence suspended now for six months awaiting another ISC. One was supposedly scheduled for Jult 17th, but the board couldn’t come with a panel so it was postponed until possibly October. It seems as though the board is on a witch-hunt. I will be at the San Antonio meeting!!!!