Texas Dental License Defense Attorneys
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Becoming a licensed dentist in Texas requires a tremendous amount time, patience, and commitment.
When faced with allegations from the Texas State Board of Dental Examiners, a practitioner is well-advised to get legal counsel. The process can move quickly. Missed deadlines and poorly prepared responses can complicate what would otherwise be a simple matter.
The professional license defense attorneys of McDonald, Mackay, Porter & Weitz, LLP have many years of hard-earned experience representing health care licensees of all kinds. They have successfully represented a number of dentists before the Board on a wide range of issues, and are well-acquainted with the agency staff and procedures. Given the complexity and often impersonal nature of the legal process, it can help to have a Texas dental license attorney’s guidance and assistance.
Contact us for an initial consultation today.
About the Texas State Board of Dental Examiners
The Texas State Board of Dental Examiners (TSBDE), also known simply as the Texas Dental Board, is the governing body for monitoring and regulating dentistry in the state. The Board itself is made up of dentists and members of the public. With the daily efforts of in-house attorneys, investigators, and administrative staff, The Texas Dental Board oversees oral health professionals, including dentists, dental hygienists, dental assistants, and dental laboratories. They enforce strict standards to protect the health and safety of the public. Complaints and concerns about licensees are investigated and handled by the agency as specified in their enabling statute and rules.
Investigations, Hearings & the Disciplinary Process
Complaints against dentists and other allied professionals can come from any number of sources. Some of the most common complaints are from former patients, family members of patients, insurance providers, past and current employees, subsequent treating providers, and law enforcement agencies.
Once received, a complaint is typically assigned a priority classification depending on the nature and severity of the issue. The process can move quickly, and in some cases, action can be taken in just a matter of days if the licensee appears to pose an imminent threat to the health and safety of patients.
If the issue involves impairment, licensees should be aware of and consider peer assistance programs. These are available in Texas and help professionals struggling with chemical dependency or other health problems, adversely impacting their ability to safely practice.
Disciplinary actions against dentists can be based on various grounds and in several combinations. Among them are criminal convictions, boundary violations with patients, billing fraud, breaches of confidentiality standards, substandard care, rule violations, prohibited advertising, and unprofessional conduct of all kinds. Complaints are generally divided into six categories:
- Quality of Care: failure to treat a patient according to the standard of care in the practice of dentistry or dental hygiene.
- Sanitation: failure to maintain the dental office or dental laboratory in a sanitary condition.
- Professional Conduct: violations arising out of the day-to-day practice of dentistry, not including purely administrative requirements.
- Administration: failure to follow the administrative requirements of the Dental Practice Act and the Board’s Rules.
- Dental Laboratories: violations of the Dental Practice Act and/or the Board’s Rules pertaining to the operations of dental laboratories.
- Business promotion: violations arising out of efforts to obtain business, such as advertising and referral schemes.
Each complaint is reviewed to determine whether the Board has jurisdiction, or the authority to act. If the allegations raise an issue addressed by the Dental Practice Act and/or the Board’s Rules, then the Board has jurisdiction and an investigation must be initiated.
Initiation of Complaint
The investigative process typically starts out with a complaint filed with the Board or due to a Board audit or inspection. A notice letter to the licensee is sent, stating that an allegation has been made or concerns have arisen from an audit or inspection. This letter usually explains the basic issues and asks for an expedited response by a specified date. If no response is received by the agency staff by the deadline, the staff can be expected to more aggressively pursue the matter. Responding on time and in a meaningful way is important to show respect for the process and to hopefully set out your side of the case in an understandable and persuasive way. Unfortunately, the allegations can often be non-specific which makes drafting a response very difficult. An experienced dental license defense attorney can sometimes navigate the agency’s system to get a more detailed explanation, but many times information will be limited. Ultimately, the response must be carefully drafted to show good faith cooperation, clarify the case to the extent possible, and at the same time avoid creating additional problems.
After the licensee has responded to the initial letter, the case may be dismissed based on lack of evidence to show a violation. If concerns remain after the response to the initial letter, the case will be further investigated. The agency staff will typically ask for records and case-related documents during the investigation and may seek an in-person or telephone interview. Deadlines vary, but a licensee can expect that as a practical matter they will have only two to three weeks to provide information. While the investigator can sometimes provide more detail and grant an extension, some licensees tend to say too much when talking to the investigator. Counsel from a Texas medical license defense attorney at this stage is recommended. The case materials eventually undergo expert review for possible dismissal or further processing. If the matter is dismissed, the licensee will be notified in writing. If not dismissed, the case is typically set for an Informal Settlement/Show Compliance Conference (ISC).
Informal Settlement / Show Compliance Conference
If there appears to be a violation, the licensee will be notified in writing that an Informal Settlement/Show Compliance Conference (ISC) will be held. Notice times can be short, but even with mail delays, the licensee usually has over a month to prepare. The ISC requires the licensee, with or without counsel, to meet with agency representatives in Austin. Board representatives have an advising attorney to help guide them, and an agency staff attorney to present the allegations and related evidence. After an exchange of information, questions, answers, and discussion, the ISC panel member and senior staff will deliberate and issue a recommendation. The recommendation can be to defer a decision to get more information, refer to the State Office of Administrative Hearings (SOAH) for a contested hearing, or resolve the case through an Agreed Order. Most cases are resolved either by an agreed order or dismissal, but an experienced dental license defense attorney can usually negotiate the best possible language in regard to findings of fact, conclusions of law and the range of possible sanctions.
If the case is not resolved at an earlier stage, it will be transferred to the State Office of Administrative Hearings (SOAH). Discovery is initiated much like in a malpractice suit or other civil litigation to include depositions, interrogatories, requests for documents, admissions, and disclosures. While the Texas Dental Board’s disciplinary actions mean there is the possibility of being fined and assessed hearing costs, the case is more about whether the licensee violated the standard of care, their ability to continue to practice, and, if so, under what terms and conditions. An Administrative Law Judge (ALJ) is assigned and the proceeding is like a bench trial without a jury. Witnesses are called to testify, records are put into evidence, and legal arguments are made. After the hearing, the ALJ will issue a Proposal for Decision (PFD), analyzing the evidence and recommending a decision to the TMB. The parties may exchange additional pleadings advocating their respective positions after receiving the PFD. The Board will then hold a hearing and counsel for both sides will be allowed short oral argument. The Board either votes to adopt the PFD, adopt a proposal from one of the parties, adopt something different of their own creation, dismiss the case, or appeal some aspect of the PFD to the district court. If a disciplinary order is issued, the licensee has a very short time to file a motion for rehearing to exhaust administrative remedies and preserve the right to appeal. If the motion for rehearing is granted, the case is reconsidered by the Board at the PFD presentation level and another appealable decision is rendered. If a motion for rehearing is denied, the licensee must act quickly to timely file an appeal in district court. During the appeal, the licensee usually remains subject to the Texas Dental Board’s imposed disciplinary action until the appeal is final.
It is possible to resolve a SOAH case through SOAH mediation rather than going through the contested process. Mediation usually occurs very early in the SOAH process.
Once under a disciplinary order from the Board, the licensee must cooperate with the agency’s Compliance Department. This department has compliance staff to check up on licensees to make sure they are living up to the terms of the order. Probation appearances are typically called for and require the licensee to appear before a Board panel in Austin on a periodic basis. Additionally, the licensee can also ask for modifications and early termination of the order. These requests are heard and ruled on by ISC panels. Apparent violations of an order can result in an expedited ISC can also lead to SOAH hearings as well. Sometimes the order itself provides for the additional disciplinary action to be imposed if the order is violated.
Defend Your License with our Texas Dental License Defense Attorneys
Dental care is an extremely specialized field, and not to be undertaken without considerable education, training, and experience. If you need effective legal representation when your license is in jeopardy, you are best advised to retain a Texas dental license defense attorney.
Contact us today for an initial consultation.