TMB Investigations Overwhelmed

Investigations Overwhelmed – Notes from the June 2008 Texas Medical Board Meeting

According to the staff of the Texas Medical Board (“the Board” or “ TMB”), there was an increase of 1,600 complaints in 2007 and another 1,600 increase in complaints this year fiscal year (September 1, 2007 until August 31, 2008). The TMB’s Investigations department is overwhelmed and this is manifesting itself in the Disciplinary Process Review Committee (“DPRC”) and in the Informal Settlement Conference (“ISC”) system. Each member of the DPRC was assigned over 100 cases that Board staff recommended be dismissed to review and over 30 appeals. Members of the DPRC expressed concerns that they were unable to fairly evaluate all of these cases. A possible short term solution for this problem was to assign two more Board members to the DPRC for the next meeting in August.

However, to address the long term complications from this case load an Ad Hoc committee was formed to study this issue. One of the ideas for this new committee to consider is that of assigning 10-20 dismissal cases to each Board member whenever they came in for an ISC day. Dr. Price was put in charge of the committee and Mrs. Southard, Dr. McNeese, Dr. Arambula, and Dr. Kalafut joined in. The ISC system is also feeling the affects of the increase in complaints. There will be around 570 ISCs scheduled for this fiscal year, which is the most in a single year yet. Any more ISCs and they would have to require 10 ISC days per Board member adding up to 22 working days a year for each member of the Board. Cases coming in at the end of June are being scheduled for November. A short term solution for this problem is to start keeping an attendance list of all DRC members. Those found not participating more than once a year are going to be talked with and may even be asked to resign. The new Ad Hoc committee will also look into options for allowing the ISC system to adjust to the mounting case load.

My Thoughts: Part of the problem is on the front in. The Board staff is opening the vast majority of cases that are sent into the agency. Moreover, the TMB staff should given more time and analysis to the initial complaint process. Should they weed more on the front end, the numbers would not be as great.