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The Texas Medical Board is the state agency responsible for the licensure and discipline of Texas physicians. The Board's mission is to protect the public's health, safety and welfare by regulating the practice of medicine and by ensuring quality health care for the citizens of Texas. The TMB also serves as staff for the State Board of Acupuncture Examiners and the Texas Physician Assistant Board.

Got a complaint letter from the TMB? Unsure of the investigative process? Confused and concerned on how to proceed? The following is a quick guide to the administrative disciplinary process. Click here to get more information from the Texas Medical Board. Allegations to the TMB come from many sources including health care providers, other physicians, current and former employees, insurance companies, law enforcement and other state agencies, and patients and their family members. Complainants' names are kept confidential from the physician unless the complainant waives this confidentiality. If you have any questions or concerns, please contact us for a confidential consultation at 888-210-9693; we are the Medical License Defense Attorneys.

Inquiry Stage The administrative process starts with a letter of notification to the doctor stating that an allegation has been made of wrong doing. This letter usually comes from the Director of Enforcement indicating that a complaint has been made and asks for a quick response. If no response is provided, an investigation is triggered. Responding is extremely important to explain your side of the allegation for the TMB. Do not ignore this inquiry letter.

Investigation Stage After the physician has responded to the inquiry letter, a formal investigation is started. The doctor will receive a notice of investigation, this letter will ask for a narrative explanation to general allegations and a two-page Medical Practice Questionnaire (MPQ) is provided. The MPQ will ask questions about CME hours, privilege status and other possible infractions. A records affidavit is also provided for attaching to any medical records that the doctor provides. There is a deadline, the doctor has two to three weeks to get this information in.

At this stage of the investigation it is important to get to experienced attorney as quickly as possible. A physician should check to see if the inquiry or investigation has triggered mandatory reporting to malpractice carriers, managed care plans, hospitals, or other state licensing boards. Attention should be taken in filling out hospital re-credentialing forms or other licensing forms including DEA and DPS documents. Candid disclosure should be given of the impending investigation because inaccurate or false answers can have a negative domino effect on the licensure, current and future employment.

Informal Settlement Conference Doctors under investigation are notified by letters that the investigation is in process. Frequently the physician can be contacted for additional information or is asked to respond to expert reports produced by a reviewing panel in the same practice area retained by the TMB.

If during the investigation a determination is made that no violation has occurred, the agency staff can route the matter to the Disciplinary Process Review Committee (DPRC) for dismissal. And the matter ends.

If there appears to be a violation, the physician will be notified that an informal settlement/show compliance conference (ISC) will be taking place. The doctor will get a notice letter that confirms the time and date, specifies the allegations, explains the process, and contains a computer disk with the relevant documents on it.

The doctor has to present himself in Austin to meet with TMB representatives on a two to three person panel which will always include a public member and physician from either the full Board or a Board District Review Committee (DRC). These representatives have an advising TMB attorney to help them, and another TMB staff attorney presents the allegations. The doctor and any accompanying attorney will have an opportunity to refute or challenge the allegations. The complainant can show up in person or via phone conference to give a statement.

After an informal exchange and discussions of the allegations, the panel members deliberate. After deliberation, the panel makes a recommendation. The recommendation can be to dismiss, defer to get more information, refer to a temporary suspension hearing, refer to SOAH for a contested hearing, or an entry into an agreed order of discipline. Most cases are resolved either by an agreed order or dismissal.

If dismissal is approved by the DPRC, the doctor will receive a notice letter to show that the case was dismissed. If dismissal is rejected, another ISC is held or staff is directed to make an offer for an agreed disciplinary order. If action is deferred, more information is gathered and a recommendation is presented after it has been deliberated upon. If an agreed order is recommended, findings of fact and conclusions of law are presented in writing along with the terms of discipline. The full Board considers and approves such orders at its next meeting. Sometimes orders are rejected and other terms offered or another ISC is required. If the ISC panel cannot agree on what to do or the doctor rejects any proposed agreed order the case is referred to SOAH for a full contested hearing. If the ISC panel considers that the doctor is a danger to patients, a temporary suspension hearing may be convened.

Suspension Hearings If a doctor is considered to pose a "continuing threat to the public welfare," a temporary suspension of their license or temporary restrictions on their practice is ordered. The temporary action can be imposed without notice or hearing if the matter is serious enough. Then the physician has to contest the decision through the agency and SOAH to have the matter litigated. Typically the doctor is given advance notice and is permitted to attend the temporary suspension hearing before a panel of three TMB members. If the doctor is successful in not getting suspended or restricted, the case goes through the regular investigation channels. If the doctor is suspended or restricted, an agreement can sometimes be achieved, and if unsuccessful the physician must litigate at SOAH or the Travis County District Court.

Contested Hearings If an ISC does not lead to a satisfactory conclusion or a doctor is temporarily suspended or restricted with no chance of an agreed resolution, the case goes to the State Office of Administrative Hearings (SOAH). A formal legal complaint is filed with allegations. The doctor has to file an answer or risk a default judgment. At this stage the case is about whether the doctor violated the standard of care and the ability to continue to practice and under what terms and conditions if any. An administrative law judge (ALJ) is assigned and the proceeding is like a judge-alone trial. After the hearing, the ALJ issues a Proposal for Decision (PFD) analyzing the evidence and recommending a decision to the TMB. The full 19 member Board will hold a hearing on the PFD in which the ALJ presents the PFD and attorneys for both sides present their positions. The Board either votes to adopt the PFD, adopt something different than the PFD, or dismiss the case even if the PFD recommends action. The doctor then usually becomes subjected to disciplinary action, however the doctor does have a chance to request a rehearing, and if that is denied, to appeal the case in Travis County District Court. All administrative remedies must be exhausted before the case goes to court.

Call us at 817-900-8439 or toll free 888-210-9693  or send us an e-mail to schedule a free initial consultation about a medical doctor license case.

Our law firm’s principal office is in Southlake and we have offices in Fort Worth and in Dallas, Texas, and we represent people across Texas, for Texas Medical Board issues, in cities and areas including the following:  Abilene, Albany, Alice, Alpine, Amarillo, Angleton, Arlington, Austin, Bay City, Baytown, Beaumont, Benavides, Big Spring, Boerne, Bonham, Bowie, Brazoria, Brownsville, Brownwood, Bryan, Buffalo, Carthage, Centerville, Childress, Clarksville, Cleburne, College Station, Commerce, Conroe, Corpus Christi, Corsicana, Crockett, Daingerfield, Dalhart, Dallas, Decatur, Del Rio, Denton, DFW Metroplex, Dumas, Eagle Pass, Eastland, Edinburg, El Paso, Emory, Ennis, Fairfield, Falfurrias, Fort Stockton, Fort Worth, Freer, Gainesville, Galveston, Garland, Gatesville, Gilmer, Granbury, Grapevine, Greenville, Groom, Harlingen, Henderson, Hillsboro, Houston, Huntsville, Irving, Jacksboro, Jasper, Kaufman, Kerrville, Killeen, Kingsville, Kingwood, Laredo, Liberty, Livingston, Llano, Longview, Lorena, Lubbock, Lufkin, Mansfield, Marathon, Marshall, McAllen, Mesquite, Midland, Mineola, Mineral Wells, Mount Pleasant, Mount Vernon, Nacogdoches, New Braunfels, Odessa, Orange, Ozona, Palestine, Pampa, Paris, Pasadena, Pearland, Pecos, Pharr, Plainview, Port Arthur, Quinlan, Raymondville, Richland, Rio Grande City, Rio Grande Valley, Sanford, Sonora, San Angelo, San Antonio, San Marcos, Seguin, Shamrock, Sheffield, Sherman, Spring, Stephenville, Sulphur Springs, Sweetwater, Tawakoni, Temple, Terrell, Texarkana, Texas City, Thurber, Tulia, Tyler, Van Horn, Vernon, Victoria, Waco, Waxahachie, Weatherford, Wharton, Whitesboro, Whitewright, Wichita Falls, Wills Point, The Woodlands, and Woodville, Texas. Doctor-Attorney Shezad Malik also represents doctors throughout Texas and the entire United States.

Call 888-210-9693 now for further information and a confidential consultation.

Useful Links:
TMB Board Rules
Texas Occupational Code

Physicians - Chapters 151-165
Physician Assistants - Chapter 204
Acupuncturists - Chapter 205
Surgical Assistants - Chapter 206
TMB Disciplinary Process

Please contact us 888-210-9693 for a confidential consultation we are the Medical License Defense Attorneys.