Medical board reacts to report on docs

AUSTIN (KXAN) - The Texas Medical Board has sent a three-page letter to Gov. Rick Perry in response to a Public Citizen report made public Wednesday which said hundreds of doctors sanctioned for serious offenses by health care entities in the past two decades have never been disciplined.

The letter, signed by TMB president Irvin Zeitler, D.O., states its view that Public Citizen provided "neither a complete nor accurate assessment of the board's enforcement actions."

TMB acknowledged there was a backlog of cases before new appropriations and staffing levels were approved in 2011 by the Texas Legislature, and that the board is not currently on backlog of enforcement cases. TMB wrote that this information was made clear in the "2011-2015 Strategic Plan" submitted in June 2010.

With a focus on patient safety, TMB's letter states that in situations where the board believes a licensed physican poses an immediate threat, a temporary suspension can be put in place to protect patients.

TMB said the ranking system and summary of medical board actions that Public Citizen uses differ from that of the Federation of State Medical Boards, which places Texas in the top five scoring states for 2010 and 2011. This contrasts greatly with Public Citizen's ranking, which puts Texas in the high 30s among the states.

TMB wrote that Public Citizen's report fails to clarify that not all actions taken by specific hospitals against certain doctors would "necessarily result in an enforcement action by the board."

In defense of its processes, TMB stated that not all clinical privilege reports made by hospitals are sent to TMB. For the period 2005 to 2009, TMB found a total of 147 physicians had reports against them, but only 60 were reported to TMB.

"Since TMB is a complaint-driven entity, it would not be able to take action unless a report had been sent by a hospital," the letter states.

TMB clarifies that unless an action was a violation of medical board rule or the Texas Medical Practice Act, there would be no enforcement of sanctions. TMB noted that Public Citizen's report did not explain that actions taken by hospitals would not always result in enforcement action by TMB.

According to the letter sent to Perry, in January TMB opted into a new National Practitioner Databank. Thus, any report sent to NPDB is automatically sent to TMB.

As for statistics on the number of cases, the board's letter clarifies that of 454 cases listed in TMB's 2011 report on investigations that were more than one year old, 139 were consolidated into other cases for a total of 364. Of those, 219 were resolved or were in a formal litigation.

TMB's letter states that of the 219 cases:   of those 219 cases.

• 96 (26 percent) were resolved by the time the report was turned in
• 28 (8 percent) had completed investigations but were pending approval at the next board meeting
• 13 (4 percent) were waiting on the outcomes of criminal trials
• 82 (23 percent) were actively being prosecuted in a formal trial procedure at the State Office of Administrative Hearings.  

A majority of the remaining 145 complaints, at 83, underwent a full investigation and either set for a litigation hearing or are concluded.

TMB wrote that none of the complaints for fiscal year 2010 were sitting in a backlog, as reported by Public Citizen.

• Read the complete letter from Texas Medical Board to Gov. Rick Perry.

TMB's letters states in response to Public Citizens that, "The board is always focused, first and foremost, on its mission of public protection."