Once physician signs an Agreed Order to settle an investigation that does not mean the investigation is actually settled. The full Board must vote and approve the order by a majority vote. Usually every meeting one or more orders are rejected or modified by the Board members. Those Agreed Orders are not passed. The Board members usually make amendments to the Agreed Order, which is essentially a counter offer. The problems with this are many. The top three issues I find are:
1) It creates ill will. The doctor and the Board have to go through a hearing and often negotiate this with the Board staff and Board members who the met with the Informal Settlement Conference. The rejection often creates anger from the doctor.
2) Recently, the Board has not done a good job following the law. According to Texas Occupations Code Section164.0031, the Board is to expressly state why they rejected the Agreed Order. When notifying the physician of this action, TMB staff frequently does not explain what happened and why. Sometimes, they do not even know the rationale to change the Agreed Order. This leaves the doctor in the dark. Sometimes, the Board members make assumptions on the basis of the action that may be wrong.
3) The largest frustration is it appears when the Board takes this step and that it appears, from the outside, to be an arbitrary decision. This is especially the case when a Board member who has not seen any of the evidence and did not participate in the decision makes the argument to change the Order.
It would be better, in my opinion, to have a mechanism whereby if Board members have an issue with an Agreed Order it be announced prior to the meeting so that the assigned Board staff attorney and the physician have the opportunity to discuss the proposed Agreed Order before the full Board and answer whatever questions or concerns the Board member may have. Also it will give the Board members who served on the Informal Settlement Conference a chance to refresh their memories and be able to explain why they decided the way they did. This will make the process more open, the parties will have less anger and may lead to less litigation.
1) It creates ill will. The doctor and the Board have to go through a hearing and often negotiate this with the Board staff and Board members who the met with the Informal Settlement Conference. The rejection often creates anger from the doctor.
2) Recently, the Board has not done a good job following the law. According to Texas Occupations Code Section164.0031, the Board is to expressly state why they rejected the Agreed Order. When notifying the physician of this action, TMB staff frequently does not explain what happened and why. Sometimes, they do not even know the rationale to change the Agreed Order. This leaves the doctor in the dark. Sometimes, the Board members make assumptions on the basis of the action that may be wrong.
3) The largest frustration is it appears when the Board takes this step and that it appears, from the outside, to be an arbitrary decision. This is especially the case when a Board member who has not seen any of the evidence and did not participate in the decision makes the argument to change the Order.
It would be better, in my opinion, to have a mechanism whereby if Board members have an issue with an Agreed Order it be announced prior to the meeting so that the assigned Board staff attorney and the physician have the opportunity to discuss the proposed Agreed Order before the full Board and answer whatever questions or concerns the Board member may have. Also it will give the Board members who served on the Informal Settlement Conference a chance to refresh their memories and be able to explain why they decided the way they did. This will make the process more open, the parties will have less anger and may lead to less litigation.
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