Texas Physician License Defense Attorneys
Physicians throughout the United States are facing tighter regulations and ever increasing scrutiny. The Texas Medical Board (TMB) oversees the state’s medical profession and is often viewed as one of the toughest in the country.
Obtaining a license and keeping it untarnished can be a challenge in the current practice environment. Facing allegations of professional misconduct can be incredibly intimidating and overwhelming for even the most seasoned healthcare professional. At McDonald, Mackay, Porter & Weitz, LLP, we understand being a physician is a calling and not just a job. With your practice, reputation, and livelihood at stake, it is essential to have an experienced physician license defense attorney.
At McDonald, Mackay, Porter & Weitz, LLP, our Texas Medical Board defense attorneys have an in-depth knowledge of how the TMB operates and can help you address any challenge. Contact us today for a consultation.
Licensure Application Process
Whether you have recently finished medical school or have been licensed elsewhere for many years, getting licensed in Texas can sometimes be a long and challenging process. New graduates seeking a Physician in Training Permit (PIT) can often face delays which jeopardize their training start time. Physicians moving to Texas for a new job may likewise face delays in the regular licensure process. Officially, the Texas Medical Board reports that it takes approximately four months to obtain a medical license, but licensure can actually take much longer. Only upon receipt of all your application materials does the TMB begin to process your documents, review your application, and ask for any needed additional information. Malpractice histories, adverse peer review, drug or alcohol histories, and criminal records can cause longer processing times.
The official application is online and takes about an hour to complete the basic forms. In addition to these forms, you will most likely be required to submit various supporting documents. If you are thinking about applying for a Physician in Training Permit (PIT) or a regular license, consider the following:
- Be organized. Get your material together before you apply.
- Apply early. If you think you might want to work in Texas, start the process as soon as possible.
- Read the directions carefully. A minor mistake will derail your application for months. Do not think of attempting to mislead the Board or to try to hide information. Answering “no” when you should answer “yes” will lead to very serious issues should the Board discover the inaccuracy.
- Follow-up. The application requires some documents be sent by third parties. Follow-up on people and entities to ensure that documents have been submitted. It is also critical to follow-up with the Board on a regular basis.
- Retain Documents. Keep a copy of your application, material submitted to the Board and all the correspondence between you and the Board.
- If you have a problem, get help. If you have significant issues, you need to get professional legal assistance from someone with licensure experience before the Board. Some of the rules, the process, and just getting prepared, require the time and attention of an attorney who has in-depth knowledge of the system.
If you face difficulties getting a PIT or a medical license in Texas, contact the medical license defense attorneys at McDonald, Mackay, Porter & Weitz, LLP.
Defending Your Texas Physician License
Physicians across Texas are under increasing pressure on a daily basis. Providing quality care in a modern practice environment can take its toll. It is not uncommon for good physicians to make mistakes, have lapses in judgment, and be confronted with bad outcomes. Physicians can also be reported when they have done nothing wrong. When faced with resulting allegations and a complaint to the TMB, it is important to keep in mind that help is available from the Texas Medical Board defense attorneys at McDonald, Mackay, Porter & Weitz, LLP and you still have options.
Complaints, allegations, and concerns are filed with the Texas Medical Board (TMB) by colleagues, allied health care providers, disgruntled current or former employees, insurance companies, law enforcement agencies, ex-spouses, and of course patients and family members of patients. Complaints can also be made anonymously and are vigorously pursued if there is enough information to move forward.
Some of the most common complaints to the TMB include the following:
- Chemical dependency Issues
- Violating care standards
- Undisclosed or pending criminal cases
- Improper prescribing or dispensing narcotics
- Failure to comply with health and safety requirements
- Violating medical disclosures or confidentiality
- Failing to maintain proper certifications
- Improper patient referrals and solicitation allegations
What follows a complaint to the TMB is usually an exhaustive investigation and a protracted administrative process, primarily geared toward disciplining licensees. Finding the time to deal with complaint resolution on top of managing your practice and dealing with lifestyle demands can be stressful and difficult. McDonald, Mackay, Porter & Weitz, LLP relieves you of having to watch for deadlines, responding appropriately, and keeping up-to-date with any statute or rule changes.
The hope is always for a dismissal of the complaint, but if the board believes the physician has violated the Medical Practice Act or Board rules, agency actions will be the result. Agency actions can range from non-disciplinary remedial plans to a public reprimand, a fine, practice restrictions, drug testing, various conditions, license suspension, and revocation. The professional license defense attorneys at McDonald, Mackay, Porter & Weitz, LLP diligently seek out mitigating factors to present your case in the best light and if an agency action is the outcome, we negotiate for the least restrictive agency action. This is the best time to hire an administrative law attorney. You do not want to risk your career to an inexperienced lawyer, who practices another area of law or only practices administrative law occasionally. Picking an attorney from McDonald, Mackay, Porter & Weitz, LLP results in someone who has years of administrative law experience before the Texas Medical Board.
The investigative process typically starts out with an initial inquiry letter to the physician stating an allegation has been made and asks for an expedited response by a specified date. If no response is received by the TMB staff by the deadline, opening of an investigation is almost a certainty. 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 details in the inquiry letter are almost always vague, which makes drafting a response very difficult. Starting off with a well-written response helps to avoid creating additional problems. This is something you want legal assistance and advice for and not something you should handle on your own.
After the physician has responded to the inquiry letter, the case may be dismissed based on lack of evidence to show a violation. If concerns remain after the response to the inquiry letter, an investigation will be opened. The physician will receive a notice of investigation with the name and contact information of the assigned field investigator. This letter asks for a narrative explanation to general allegations even if one was provided in response to the initial inquiry. It also asks for completion of a medical practice questionnaire (MPQ) and for any pertinent records the physician chooses to provide along with corresponding records affidavits. Deadlines vary, but a physician can expect that they have only two to three weeks to provide this 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. Appropriate legal counsel at this stage is critical. The case materials eventually undergo physician or other expert reviews for possible dismissal or further processing. If the matter is dismissed, the physician will be notified in writing. If not dismissed, the case is typically set for either an Informal Settlement/Show Compliance Conference (ISC) or a Temporary Suspension/Temporary Restriction Hearing.
Informal Settlement / Show Compliance Conference
If there appears to be a violation, the physician will be notified in writing that an Informal Settlement/Show Compliance Conference (ISC) will be held. The ISC requires the licensee to meet with TMB representatives in Austin. These representatives have an advising attorney, who works for the board to help guide them, and another agency staff attorney presents the allegations and related evidence. If hired to assist you, the medical license defense attorneys at McDonald, Mackay, Porter & Weitz, LLP help you prepare for the meeting and would be present with you during the ISC to advise and support you during this very stressful proceeding.
After an exchange of information, questions, answers, and discussion, the ISC panel members will deliberate and issue a recommendation. The recommendation can be to defer a decision to get more information, refer the case to a temporary suspension/temporary restrictions hearing, refer to the State Office of Administrative Hearing (SOAH) for a contested hearing, or resolve the case through a non-disciplinary remedial plan or a disciplinary action by an Agreed Order. Most cases are resolved either by an agreed order or dismissal, but an experienced Texas Medical Board defense attorney can usually negotiate the best possible language in regard to findings of fact, conclusions of law, and the range of possible sanctions.
Temporary Suspension/Temporary Restriction Hearings
If a physician is thought to pose a continuing threat to the health and safety of patients, they can be subject to an expedited process that may result in a temporary license suspension or temporary restrictions on their practice. The process varies and the action can be imposed without notice or hearing if the case is serious enough. Thereafter, the physician and their Texas Medical Board defense attorney can litigate the matter through the agency and the State Office of Administrative Hearings (SOAH). Unfortunately, the physician usually remains restricted or suspended during this process. In some instances, a physician is given advance notice and is permitted to attend and respond at a temporary suspension/restriction hearing. Due to the extremely serious ramification of this proceeding, it is critical you choose a Texas Medical Board defense attorney who is experienced and knowledgeable.
If the case is not resolved at an earlier stage, it will be transferred to the State Office of Administrative Hearings (SOAH), which is an independent state agency tasked with holding trial-like proceedings before an Administrative Law Judge (ALJ). While there is the possibility of being fined and assessed hearing costs, the case is more about whether the physician violated the standard of care, their ability to continue to practice, and, if so, under what terms and conditions.
It is very difficult to represent yourself or to have a non-administrative/medical license defense attorney represent you at this hearing. There are certain discovery actions that take place at the beginning of the case which necessitates well-constructed responses and what discovery items to request, so you obtain critical information for your defense. Discovery is initiated much like in a malpractice suit or other civil litigation, including depositions, interrogatories, requests for production of documents, requests for admissions, and requests for disclosures. The actual contested case hearing involves not only TMB statutes and rules, but also the procedural and evidence rules. There are also strict deadlines impacting the hearing. There have been numerous physicians who have lost the case at SOAH because either they or an inexperienced attorney did not understand the process and requirements.
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. The Board is represented and advised by their lawyer, so you should also have legal assistance to adequately protect your interests and answer questions you may have.
Once under a disciplinary order from the TMB, the licensee must cooperate with the agency’s Compliance Department. This department has officers who function much like probation officers to check up on physicians to make sure they are living up to the terms of the order (i.e., drug screens, record keeping, chaperones, prescribing limitations, etc.). Probation appearances require the physician to appear before a Board panel in Austin on a periodic basis. Additionally, the physician may be able to ask for modifications or early termination of the order depending on their situation.
Most disciplinary actions, with very limited exceptions, are reported to the National Practitioner Data Bank (NPDB) and the Federation of State Medical Boards. Reports are also generated for the public through the TMB website and TMB newsletter, and notifications are provided to hospitals where privileges are held and other medical licensing boards. Related press releases are often routed through the media and frequently end up in newspapers or various postings online.
Dependency Assistance & Available Treatment Options
Chemical dependency and mental impairment are growing concerns for Texas physicians and can lead to serious allegations that can possibly have career-ending ramifications. While chemical dependency and mental health issues are difficult challenges, it is important to know that a physician does not need to go through the related regulatory process alone. For physicians in Texas, help with the underlying issues is available through the Texas Medical Association (TMA), the Texas Osteopathic Medical Association (TOMA), and the Texas Physicians Health Program TXPHP). For help with the regulatory impact of these issues, contact McDonald, Mackay, Porter & Weitz, LLP.
Contact a Texas Medical Board Defense Lawyer Today
Given the procedures and regulations involved with proceedings before the Texas Medical Board, it is best advised to obtain help from a physician license defense attorney with specific experience in handling TMB matters. The Texas Medical Board defense attorneys at McDonald, Mackay, Porter & Weitz, LLP. have the necessary experience. Contact us today for a consultation.