Texas Medical Board - New Updates
The Texas Medical Board recently updated their application process. This change will go into effect 10/01/07. The changes include the addition of Fingerprint Cards and an Increase in the licensure fee. Physicians who are going to accept Medicare/Medicaid patients will be given priority over those who are not. Physician who are seeking the Texas Medical License will expect to see licensure times between 3 to 9 months.
posted by Medical Mania @ 10:18 AM
5 Comments
5 Comments:
The Texas Medical Board has had a long history of autocracy. There are numerous accounts from physician and patients alike on how the Board has ignored patient confidentiality, disciplining good doctors for perceived misconduct (even after acquittal by judges and juries). They have ruled with an “iron fist” with no checks and balances. In fact, of late, the mice have started to scatter. Dr. Keith Miller, a physician board-member recently resigned due to intense scrutiny by his peers for accepting money as an expert witness while serving as a TMB member construed by all of us as a clear conflict in interest. Roberta Kalafut, D.O. likely committed perjury before the Texas State Appropriations Committee in a recent hearing held to allow testimony against the Texas Medical Board for egregious actions by them. Dr. Kalfut is accused of having her physician husband file an anonymous complaint against one of her competitors. Such anonymous complaints lead to lengthy and painful disciplinary hearings against any physician even if he charges are found to be frivolous with no penalty to the complainant for spending hard earned taxpayer dollars to investigate an allegation. This, in turn, keeps the doctors from focusing on their patients and impedes their ability to practice medicine without the fear of sanctions by the agency. It is unbelievable that this sort of behavior had existed for so long. I am very pleased that the Appropriations Committee, Regulatory Subcommittee led by Representative Fred Brown called this meeting. Hats off to them!
Amidst all the recent controversy, the Appropriations Committee met for 11 exhaustive hours. The meeting was inundated with numerous well-substantiated claims against the Board. There is no doubt that the Board has spent tons of tax-payer dollars disingenuously including those funds spent in preparing for this hearing. Due to the time required to prepare for the meeting in Austin, the Board, wirhout notice to applicants for medical licensure in the State of Texas, cancelled their October Licensure Committee Meeting. This precludes any doctors waiting in line for their license to be granted, if they need to appear before the board to do so, from obtaining their medical license. In my case, it has for many months now, kept me from starting a new job.
I am an oncologist who cares for those with cancer, specifically cancer of the breast. I am a native Texas who graduated from Texas A&M University and went on to Medical School at the University of Texas Health Science Center. After graduation, I left our great state to do my internship, residency, and fellowship in the leading centers of the world, including Yale Medical School and Cornell-Memorial Sloan Kettering Cancer Center. During my medical education and the eight-year training period, which followed, I managed to go into debt over $100,000 due to the prohibitive costs of higher education in our country. My husband worked to bring this debt down as I worked 90+ hours a week making little more than minimum wage during my post-graduate training. After this long and arduous twelve-year road, we were very happy to receive a job offer back in Texas. We accepted the offer to be close to family and give back to people of the state of Texas, despite having attractive offers around the country. A good friend of mine warned me about the lengthy process of the licensure division. I thought to myself, “How hard can it real be?” I had received my medical licenses in Connecticut and New York in 1 and 3 months respectively. So, I figured six months maximum. Knowing this, I applied for my Texas license before I actually accepted the job in Dallas. The rumors were absolutely true. The Texas Medical Board licensure division process was the worst I have ever experienced. The staff were rude, discourteous and would not spend any time speaking to you to discuss where the process was being held up with your file. They stated they were overburdened by the number of new applications, which are up considerably due to Tort Reform. So, I waited patiently.
Months later, I received an email stating that pieces of the application were missing or incomplete. The “missing” articles were missing because someone at the Board misplaced them. I only could prove this to them after several hours of phone conversations because I had sent it return receipt and it was signed for by the Board. This prompted an additional delay of several months to my application after I returned what they had “lost”. At this point, we had already moved to Texas, rented a home, and tried to settle in to our new life. However, I could not begin my employment with my practice group of other cancer specialists. As months passed with no contact from the board, I became disillusioned. I decided to travel to Austin from Dallas on weekday morning to faciliate some communication with Board. Rather than a welcome and how can we help you, I was met with resistance from their department. They gave me no information as to why my application had been held up for 7 months (Dr. Donald Patrick director of the agency claims they have improved their turn around time to 3 months). In fact, one of their directors, Jaime Garanflo, essentially threatened that if I didn’t stop “harassing” them, they could deny my application. Deny my application? Based on what? The fact that I am looking out for my career and the well being of my family? For the overwhelming affection we have for our great state of Texas and wanting to give back to our community by bringing in medical expertise to help sick patients? So, I left, asking myself why should a regulatory agency have the ability to control of the professional lives of those that the State has given the authority to protect patients and serve physicians and other health care practitioners. Was it worth coming to Dallas at all? Is it fair that I have to live in debt without the ability to earn a living waiting for the wheels of this corrupt and inefficient agency to do it’s job.
It was so ridiculous for someone from the Board to testify to Representative Fred Brown and the members of the subcommittee that the wait time for licensure applicants has come down considerably? Will the Board continue to lie in the face of adversity or try to accept their faults and correct them? Why should they care? Their lives and reputations are not being affected. I am sure there are other docs in similar and likely worse situations due to the inefficiency and tyranny of the Texas Medical Board. There is no doubt that the Board should be careful and methodical in researching the background of physicians wanting a medical license in this state. But, after subjecting oneself to the costs, time, and agony of complying with all of the measures stipulated by the Board, should we, the physicians, be penalized by having to wait 6 months to 1 year unemployed waiting for things to move along? Should we be met with the passive-aggressive behavior exhibited by people like Jaime Garanflo, Dr. Donald Patrick, and members of the Licensure Committee? Should we accept that our professional lives are being put on hold because the Medical Board has committed their time, energy, and money in the last few months preparing to defend their actions to the Appropriations Committee? Should be continue to allow them to hoodwink the legislators into thinking they are making the licensure process better and not worse? Let us hope not, or Texas will stand to loose a number of good docs.
I found this link about a Houston doctor who faced a similar ordeal. Her story was featured in the Houston Chronicle.
http://www.tapa.info/html/Newsroom/2007/Newsroom_Jan_25_2007.html
The house hearings can be heard at this link:
http://www.house.state.tx.us/fx/av/committee80/71023a02r.ram
we are experiencing the same frustrating ordeal we are now in month 10 of trying to obtain a medical license for my husband who is a well-respected experienced surgeon you would think TMB would welcome an experienced ortho trauma surgeon with impeccable references but NOT to be they are rude, difficult, and arrogant
The Texas Medical Board is out-of-control! I also experienced indifference, inefficiency, rude behavior, etc. Once you apply, they give you a case analyst. Mine "dissappered" after 3 months and left my file hanging. The next one came along and replied via e-mail, it will take me time to get to application and review it--backtracking in time. The worst is Monique Johnson--rude,unprofessional (ironic) and basically does not care about her job or you as the applicant. Bottom line--they see themselves as prosecutor, judge, jury, and punishner. (and little gods). They are not, but they use their non-elected state positions to somehow boost their egos. There is a small man on the board who sat at my hearing--"Dr." Jose Benavides a real zealot making preposterous statements--all false. But what do you do? Leave the state. I am a well-trained subspecialist who advises all good doctors leave--it is only getting worse. Best advise, if you have to meet the board--get a lawyer. Kind of revese tort reform.....
Donald Patrick, Executive Director is also resigning at the end of August. Keep supporting GOOD Texas Physicians.
Briefly. I own and operate an urgent care center, I am a double-boarded physician. I am not listed as a primary within the city for any patients. I saw a patient in fall of 2007 who had another physician as a primary doctor, she presented to me with an URI. She was one of the most disagreeable, argumentative humans I've ever met. She took exception to almost everything I suggested as manners of treatment regimens. I made a note in her chart. When she came in again 7 months later with another cough, she was briefly triaged and after noting who she was, she was advised that it would be better if should could go to the ER for evaluation. She demanded to speak with me but knowing her, and her confrontational nature, I declined to "get into it" with her. She made a scene at the clinic and then filed a complaint with the Texas State board claiming I terminated her without 30 days notice. No mention of termination was ever made or implied to the patient. It is now under investigation and after I presented my version of the case, the board added an extra charge of unprofessional conduct.
Okay, so let me get this straight, I'm being charged with unprofessional conduct for the manner in which I DIDN'T see a patient for whom I WASN'T the primary, who I referred to an emergency room! I had only gotten three hours of sleep the night before and was exhausted. How many doctors' offices refer patients to an ER everyday across America without the doctor evaluating the patient? You wouldn't think this complaint would even advance to a formal investigation but it is.
The Texas State Board is in a feeding frenzy, like sharks or a meat grinder, they're looking for any complaint at all and they will try and go with it. Why? This inquisition, McCarthyism lynch-mob behavior began after they were criticized by a newspaper reporter (Doug Swanson Dallas Morning News) who accused the board of not being tough enough. The reporter took the matter to the state legislature which in an attempt to appease the reporter and some complainants, also criticized the board. The doctor in charge of the Texas State Medical Board spinelessly caved-in and ever since then has devoted his life to cranking up a machine that now strives for quotas of doctors to be disciplined. The board is actually administered from within by a network of state government lawyers who are really calling all the shots! The physicians sitting on the board are basically puppets who are told what to do by these lawyers. To what extent these lawyers running the show contend with inner-suppressed resentments for physicians is questionable at least when we look at the vigor in which they are encouraging the complaint and disciplinary process. True enough, all of this makes jobs for more lawyers at the board but is this right? Doctors are reportedly threatened with full loss of licensure when they don't cooperate with the punishment the board wants to dole-out. The board is suppose to refer your case on to a regional judge if you refuse to accept their findings but it is reported that if you are leaning in that direction, then the board strives to suspend your license while you contest leaving you without a means to earn a living. It has also been reported that the board has plainly refused to respect the opinions of the appelate judge and rather sustained their own judgements against physicians. Some of these cases have been bundled into a type of class action suit against the board filed by the(American Association of Physicians and Specialists).
The board seemingly revels in delight at its disciplinary process but is wholly inadequate in propagating any kind of proactive role. They offer no pamphlets, guide books, or even letters to new practicing physicians on how to set up a practice so as to be in conformance with all the state's hidden laws and regulations. There is no regular mass communication to physicians of the state to call attention to manners of practice which the board is attacking. Nothing, nothing. Even the Web-site is nearly useless. Try and look up what the Texas laws have to say about the physician-patient relationship or termination and you'll find nothing.
The board has developed intentionally harmful and destructive terms and verbiage for rather simple problems and infractions so as to inflict maximum professional damage to the physician. They seemingly are emboldened by an image of themselves as the great puritanic purifiers who will "cleanse the earth and state of Texas of these defilements and wretches of righteousness." In fact, there is often nothing in writing spelled out about alleged offenses a physicians face. Rather, the infraction is clumped and lumped into the vague and broad accusation of "unprofessional conduct" which could be anything. In Texas, the lawyers running the board have had it written into law that if you don't fill out a form or document about a patient, then the infraction comes under the heading of "unprofessional conduct." And, guess what? That's right! You can have an "Order" cut against you in which your name is published in a circular as a doctor for whom disciplinary action was imposed. Isn't that a bit of a misnomer....charging a doctor with unprofessional conduct because he didn't adequately complete an office form. Shouldn't we reserve unprofessional conduct for the truly unsavory infractions like being intoxicated or having sexual relationships with patients? Shouldn't failure to complete a form be more like an "administrative infraction" but not in Texas. Do they not know how much of our lives we have given up to practice medicine? And yet the board brags at its website about how many doctors who have lost their licenses and how difficult the board has made the lives of doctors who have come to their attention. The physician (Dr. Patrick) who fathered all of this "lopping off of the heads" sadly reminds us of the british colonel in charge of building the Bridge on the River Kwai from the movie (Alec Guiness), who believed in his heart he was doing something noble when in fact he was killing his own kind.
My advice, stay out of the lime-light with this board while they're exposing they're fangs, at least until they have each and everyone of those fangs removed!!!
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