San Antonio and the surrounding areas, like Kerrville and New Braunfels with its unique German culture, are an excellent place to build a healthcare career. Physicians have so many options ranging from research and university hospitals to independent private practice and large medical groups, such as Southwest Research Institute, Baptist Health System, Methodist Healthcare, the University of Texas Health Science Center, and many more. With the Lackland Air Force Base and other military facilities nearby, military physicians and veterans transitioning to medical careers in their civilian lives also frequently build their lives and careers in vibrant San Antonio.
Whether you plan to grow your physician career with one of these large employers or start a private practice in Fiesta City, the greater San Antonio area has a strong demand for physicians, and you won’t have issues finding a quality job. However, you may run into administrative inquiries, bureaucratic challenges, or miscommunication in the workplace that can pose a threat to your hard-earned physician license.
The LLF National Law Firm advocates for medical professionals nationwide. Our experienced Professional License Defense Team aids physicians throughout San Antonio and environs in navigating threats to their licenses and negotiating with the Texas Medical Board for lesser disciplinary measures. We can represent you even if you have a complex case. Call us at 888-535-3686 or fill out our online intake form to tell us about your case.
Who Presides Over San Antonio Physicians?
Physicians in Texas are governed by the Texas Medical Board (TMB), a state agency headquartered in Austin. The Board consists of 19 members appointed by the governor, of which 12 professional members are doctors and surgeons across various specialties, and seven public members from a range of backgrounds that include healthcare administration, public service, and organizational management.
The TMB governs several other medical professionals who practice in Texas. Due to Texas state law that grants the general public the right to access non-confidential government records, the TMB maintains one of the largest and most-requested sets of open records on its licensees, which can be viewed through the Texas Medical Board Open Records Self Service Portal (ORSSP). Personal data, information used by security systems, and investigation files are confidential under Texas state law and not visible to the public.
Threats to Your Physician License in San Antonio
The State of Texas imposes rigorous standards of practice and professional conduct. Physicians are crucial to the San Antonio area’s numerous healthcare organizations. Texans trust you with their lives and well-being, so the TMB takes complaints very seriously. You may be accused of professional misconduct, run into bureaucratic issues, or face administrative challenges under the numerous Texas laws and regulations that govern physicians.
Allegations of Unprofessional Conduct
An employer, patient, insurance company, or other party may file a complaint that asserts you were unprofessional when performing your duties. These allegations are serious and they include, but are not limited to:
- Failure to Keep Patient Records and Contact Confidential: In addition to HIPAA at the federal level, Texas also has state laws regarding physician-patient confidentiality and records. There are exceptions to this law, such as civil and criminal proceedings brought by the patient and medical boards. If a patient alleges that you violated their right to privacy, you may face disciplinary action.
- Inappropriate Behavior: Your patients are in a vulnerable position when they seek care. If they feel violated, dismissed, or intimidated by your bedside manner, they could file a complaint. Medical boards often act with extreme caution if a complaint is filed, even if there was a misinterpretation of your words or actions.
- Drug or Alcohol Use: In Texas, you may be ineligible to apply for or renew a physician license if you have felony convictions for drug or alcohol use, particularly under the Texas Controlled Substances Act. While recreational drug and alcohol use does not necessarily constitute professional misconduct per the TMB, substance use that affects your performance on the job can result in sanctions. However, the Texas Physician Health Program (TXPHP) is an independent and confidential support program for physicians and other Texas medical professionals dealing with substance use disorders, mental and physical illnesses, and other issues. Participation in the program is designed to help you avoid severe sanctions while receiving necessary treatment.
- Being Convicted of a Crime: Under the Texas Occupations Code for physicians, your license is at risk if you are convicted of a felony or a misdemeanor involving moral turpitude. Misdemeanors of moral turpitude tend to include DUIs, sexual assault, and similar charges that would constitute a threat to the public.
Administrative Challenges
Texas’s physician laws and overarching regulations are vast. This can result in countless opportunities for administrative bottlenecks that inadvertently put your license at risk, even if you are an intelligent and competent physician who caused no physical harm.
- Documentation Issues: Many of the largest employers in Texas are healthcare organizations, and there are small, medium, and large medical groups in the San Antonio area as well. If you have admitting privileges at multiple facilities or practice in several different offices, TMB may open a probe if they deem that you have an unusually large amount of administrative inquiries.
- Continuing Education Requirements: All Texas physicians must receive a certain number of continuing education credits throughout the year, with a few exemptions. If you have a valid exemption, you need to file the correct forms or risk sanctions. Failure to report proof of your continuing education credits poses a serious risk to your license.
- Correct licenses and permits. In addition to the standard full physician license, there are other licenses available through the TMB for physicians in training and temporary licenses for international medical students that place restrictions on practice. There are also additional permits required in Texas for telemedicine and specialties that you will need to remain in compliance with state regulations. Lacking these permits can be deleterious to your professional future.
Bureaucratic Challenges
Medical practice in Texas is more than just taking care of your patients in one of the largest states in the U.S. It’s also near-infinite paperwork and compliance checks on the federal, state, and local levels, in addition to TMB regulations.
- Out-of-State Compact: Texas is one of 37 states that participate in the Interstate Medical Licensure Compact (IMLC). The IMLC is a voluntary organization designed to address healthcare shortages throughout the United States and provide a unified and expedited pathway to portable physician licenses. The process for applying for this compact is different and separate from your standard process of obtaining a Texas physician license. If you did not obtain your license in Texas but practice medicine within the state anyway, you may face discipline from the board if your compact membership is not in order.
- Military Physician Compliance: Texas offers an expedited pathway for physicians who are veterans, members of the military, or military spouses but received their physician license in another state. Participation in the IMLC is not required, but if you do not have the correct military and civilian paperwork completed, it can impact your ability to practice in Texas.
- Filing Errors: The TMB and numerous other regulatory agencies that Texas physicians interact with are staffed by humans, and humans can make mistakes. Even if you file all of your applications, permits, requests, and other communications in a timely manner, there’s always the chance that these items will be lost or processed incorrectly. A mistake on a medical board staff member’s part can impact your career and necessitate an appeal down the line, even though the mistake wasn’t your fault.
Physician Discipline Process in San Antonio
The TMB takes public safety and adherence to the Texas Medical Practice Act seriously. There is a thorough process that begins with formal complaints. The TMB evaluates all complaints, but only proceeds with complaints against physicians and other professionals under TMB jurisdiction. A complaint may escalate to a full-blown investigation that can result in disciplinary action.
- Complaint: An individual or entity files a complaint. Complaints cannot be made anonymously, but the TMB does not release the complainant’s identity, with the exception of insurance and pharmaceutical companies. It is estimated that the TMB reviews about 9,000 complaints per year.
- Preliminary Evaluation: The TMB reviews complaints within 45 days of the filing date. Depending on the severity of the allegations, TMB staff may contact you and/or the complainant for more information. TMB attorney-investigators evaluate administrative complaints, and physician-investigators review complaints regarding medical care. If the TMB finds that the information provided by you and the complainant does not constitute a violation of the Medical Practice Act, the complaint is dismissed. If a violation is evident, an investigation is opened.
- Investigation: The TMB strives to complete all open investigations within one year, with most investigations concluding within six months. You will be asked to provide information about the complaint, and information may be subpoenaed from hospitals, pharmacies, and other relevant providers. For administrative violations, information may be gathered from your practice or employer. If the complaint is regarding medical care violations, all relevant information will be reviewed by TMB’s expert panel in the same specialty as you. Depending on the expert panel’s report, the case may be moved to litigation or dismissed with a Letter of Concern, providing that the standard of care was met. When the investigation concludes, the case may be referred for dismissal to the Board’s Disciplinary Process Review Committee (DPRC) or for further evaluation by a Quality Assurance (QA) Panel. You and the complainant will receive status updates every 90 days, unless the updates would jeopardize the investigation.
- QA Panel Review: If your case is not dismissed, sent to discipline, or litigation at this stage, QA will review your case further. They may request an additional investigation, refer the case to litigation, offer a non-disciplinary remedial plan, or dismiss the case. Depending on the nature of the case and what could appear in the public record, you may want the remedial plan offer to take the Informal Settlement Conference/Show Compliance (ISC) hearing before the disciplinary panel.
- Informal Resolution: The TMB estimates that 90% of all disciplinary actions taken are resolved through the informal resolution process. This process kicks in once a case is moved to litigation and assigned to a staff attorney. You are given an ISC hearing date before a disciplinary panel comprised of two representatives from the TMB, which will be one physician and one public member, unless you waive this requirement. If this panel finds that there was no violation of the Medical Practice Act, they will refer to the DPRC for consideration of dismissal. If they do find a violation, they may offer a remedial plan or an agreed order of sanctions. Sanctions may include requiring your participation in the Texas Physician Health Program, restricting certain procedures, additional medical training and education, issuing a public reprimand, and more.
- Formal Resolution: If the case cannot be resolved through an informal process, a formal hearing is assigned to a TMB staff attorney and held at the State Office of Administrative Hearings (SOAH) and heard by an administrative law judge. The judge will then present a Proposal for Decision to the TMB. Upon reviewing the judge’s proposal, the board may dismiss the case or issue an order that includes sanctions.
- Final Orders: Once the TMB enters a final order, you can appeal their decision. In highly specific circumstances, the TMB can also appeal. In addition to potential disciplinary orders pursuant to the hearings, TMB can also immediately suspend your license temporarily if they deem that you pose a threat to the public. Temporary suspension hearings don’t require you to be notified, but you will be notified of follow-up hearings.
While it is relatively rare for Texas physicians to have disciplinary hearings before an administrative law judge, informal process sanctions can still have devastating impacts on the career you worked so hard to build. Once you are aware that a complaint has been filed against you, you should have representation arranged well in advance in case the matter escalates. The LLF National Law Firm can advocate for you at every step of the TMB’s disciplinary process.
How the Professional License Defense Team Can Protect Your Physician License
You do not want to represent yourself if your Texas physician license comes into question. You are not guaranteed justice, or even fairness, when it comes to medical boards and administrative law judges. Professional license defense is a highly nuanced practice area that helps protect physicians like you from threats to your license. Having experienced representation on your side increases your chance of reaching a more favorable outcome if your case is not dismissed.
The LLF National Law Firm provides comprehensive representation at every step of the disciplinary process, from your written response to the initial complaint to representing you at your formal resolution if your case cannot be resolved at the informal level.
If you are a physician in San Antonio, the LLF National Law Firm is ready to advocate for you and achieve the best outcome for your case. Call the LLF National Law Firm today at 888-535-3686 or reach out via our online contact form.