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plain about another physician, especially in their own town,” Dr. Anderson said. And at least one TMB member was herself accused of hav- ing anonymous complaints filed against competitors. That member is no longer on the board. Senator Nelson says the SB 227 provision giving the board


more flexibility to deal with minor violations should make the agency’s enforcement actions less adversarial. “The medical board had only two options for resolving a complaint: dismissal of the complaint or public disciplinary ac- tion. I filed SB 227, which allows complaints involving minor violations to be resolved with a nondisciplinary remedial plan,” she said. “My hope is that this bill will give the medical board a more corrective, rather than punitive, option for resolving minor cases, while also giving physicians an opportunity to learn and improve their practice.” Dr. Anderson agrees. He says that would have been a valuable tool when he was on the board.


“We’ve always wanted a corrective action plan that would be nonpu- nitive unless the physician failed to complete the corrective action,” he said.


The issue of anonymous com- plaints to TMB seems to have come to a head after the legis- lature passed Senate Bill 104 in 2003. SB 104 was a companion to the TMA-backed medical liability reforms. It gave TMB additional funding and tools to allow the board to focus more attention on physicians who were providing poor quality of care.


But some physicians grumbled that the board harassed them over minor administrative issues that had nothing to do with the standard of care. One political observer with knowledge of the board’s operations says the board was aggressively going after minor violations, essentially “cherry pick- ing” easily prosecuted violations to boost its disciplinary numbers. As chair of a House Appropria-


tions Subcommittee on Regula- tory Agencies, Representative Brown held hearings in 2009 on how TMB was using the additional funding it received under SB 104. Those hearings turned into a gripe


session for physicians who felt they had been unfairly treated in the board’s disciplinary processes. At those hearings, TMA urged lawmakers to maintain a


strong but fair TMB. “We believe all Texans should have confidence that they are


receiving the highest quality of care and that their physicians are qualified, competent, and adhere to the highest ethical and professional standards,” TMA Board of Trustees member (now board chair) A. Tomas Garcia III, MD, of Houston, told the sub- committee at the time. “To this end, we urge the Texas Medical Board to refocus its disciplinary efforts and to give priority to allegations of sexual misconduct, quality of care, and impaired


Most TMB complaints dismissed with no action


While some physicians may feel the Texas Medical Board (TMB) is gun- ning for them, the vast majority of complaints filed with TMB actually are dismissed with no action against the physician. According to TMB statistics for fiscal years 2006 through 2010, rough-


ly two-thirds of complaints are dismissed without action against the physician. Many are dismissed immediately because the board does not have jurisdiction or there is not enough information to identify who or what the complaint is about. The rest are dismissed within the first 30 days due to review by TMB staff or as a result of the response from the physician.


Only about one-third of complaints result in full investigation by


TMB staff, and even fewer actually result in disciplinary action against physicians. The chart below shows the number of complaints received between 2006 and 2010, how many were dismissed, and how many resulted in investigations and disciplinary action.


Practicing physicians Complaints received


Resolution No jurisdiction


Dismissed within 30 days Full investigation Disciplinary action


2006 2007 2008 2009 2010 42,885 44,752 46,476 47,890 48,897


5,211 6,923 6,514 6,968 6,849


1,158 1,425 1,929 1,690 2,028 2,021 2,905 1,860 2,405 2,160 2,032 2,593 2,725 2,873 2,661 335


311 351 411 534 July 2011 TEXAS MEDICINE 23


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