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dental practice actA complaint to the Texas State Board of Dental Examiners (TSBDE) can result in the suspension or revocation of your license to practice dentistry. It also comes with stress and uncertainty as a result of the potentially devastating consequences to your livelihood.

Dental professionals licensed to practice in Texas should be familiar with the Dental Practice Act and the TSBDE’s Rules and Regulations in order to guard against the filing of complaints. They should also be familiar with the six categories of complaints under the Texas Administrative Code, which include:

  1. Quality of Care: the failure to treat a patient in accordance with the dentistry or dental hygiene standard of care. This standard of care is generally defined as conducting a practice in the manner of a reasonable and prudent dentist under similar circumstances.
  2. Sanitation: the failure to maintain a sanitary dental office. This includes proper sterilization, disinfection, and infection control procedures.
  3. Professional Conduct: any violations arising in the daily practice of dentistry. Professional conduct includes honesty, integrity, and fair dealing.
  4. Administration: the failure to adhere to the administrative requirements imposed by the Dental Practice Act and the TSBDE’s Rules. This includes the maintenance of adequate patient records.
  5. Dental Laboratories: any violations of the Dental Practice Act or the TSBDE’s Rules in the operation of a dental laboratory. Specific rules, including registration and staffing requirements, are prescribed for the operation of a dental laboratory.
  6. Business Promotion: any violations relating to obtaining business, such as solicitation, referrals, or gift schemes, which are prohibited, or advertising, which may not be false or misleading.

Complaints are divided into two classes of priority. Priority 1 means that the allegations are more serious, including those involving patient mortality or morbidity, sanitation, or practice without a license. Priority 2 means that the allegations are less serious, and include record-keeping and advertising violations.

If you have been notified that a complaint has been filed against you with the TSBDE, you have the right to be represented by an attorney. Contact experienced Texas professional license attorney Oscar San Miguel to protect your license and your livelihood.

telepsychology policyTelepsychology—the use of communication technology to provide psychological services—has become widespread and commonplace in recent years. Psychologists should become familiar with the legal, professional, and ethical issues involved in the practice of telepsychology.

The Texas State Board of Examiners of Psychologists (TSBEP) issued a Telepractice Policy Statement in December 1999. According to that statement, concerns about telepsychology include the following:

  • Lack of awareness of a distant community’s resources in times of crisis;
  • Issues in obtaining informed consent;
  • Insufficient training standards, and special therapeutic considerations;
  • The inability to look for sensory cues, such as vocal or visual cues;
  • Possible technology failures, leading to patient anxiety, especially during times of crisis;
  • Patient difficulty with technology, especially during times of crisis;
  • The provider’s inability to fully disclose credentials;
  • Undefined professional relationships; and
  • Confidentiality and privacy concerns.

Under the policy statement, providers who practice telepsychology are required to undertake training, study, and/or consultation from others who are competent in the area before providing services.

The American Psychological Association issued guidelines in 2013 for the practice of telepsychology. These guidelines provide that psychologists who provide telepsychology services to:

  1. Take steps to ensure their competence with the technology being used and its impact on patients.
  2. Ensure that they continue to meet the ethical and professional standards of care while providing telepsychology services.
  3. Obtain and document informed consent, specifically addressing the concerns that are raised by telepsychology, while understanding applicable laws and regulations.
  4. Protect the confidentiality of client data and information, and inform patients of the increased risks to confidentiality due to the use of technology.
  5. Ensure that security measures are in place to protect patient data and information from unintentional disclosure.
  6. Dispose of client data and information, including the secure disposal of technology used in practicing telepsychology.
  7. Consider the impact on test instruments and assessments that are designed for in-person use.
  8. Be familiar with and comply with all applicable laws and regulations when providing telepsychology services across borders.
Special legal considerations come into play when the provider is treating a patient who is physically located in another state. In those situations, the provider is generally considered to be practicing psychology in the state in which the patient is located. State licensing laws generally prohibit out-of-state psychologists to provide telepsychology services unless they are licensed in both states.

Licensed Texas psychologists who wish to practice telepsychology within the state should periodically check for any updates in the state’s healthcare laws and regulations and the TSBEP policy statement. It is also a good idea to contact your malpractice insurance carrier to confirm that telepsychology is covered under your policy.

If you have run afoul of the Texas professional licensing laws or regulations, contact an experienced Texas professional license defense attorney for assistance. Oscar San Miguel, Attorney at Law, can help you protect your license and your livelihood.

pharmacy complaintWhen a complaint is filed against a licensed pharmacist, it can be one of the most stressful and upsetting occurrences in the pharmacist’s career. You should understand the complaint process and how it might impact your license and your very livelihood. You should also know how critical it is to have an experienced attorney at your side throughout the process.

According to the Texas State Board of Pharmacy (TSBP or Board), anyone may file a complaint, which is required to be in writing, with the Board. The TSBP reviews every complaint to ensure that the allegations, if proven to be true, pertain to a person or pharmacy that is licensed by the Board and to see whether the allegations would constitute a violation of the Texas Pharmacy Act or Texas Drug Laws. Complaints regarding billing disputes or customer service issues, such as rudeness, are not within the Board’s jurisdiction, and those complaints are closed without action.

Complaints that are within the TSBP’s jurisdiction are given to an investigator, who may contact the complainant for more information. However, the investigator does not represent the complainant and will never ask for money damages or restitution on behalf of the complainant.

If a disciplinary action is initiated, the TSBP must comply with the Texas Administrative Procedures Act. The licensee (pharmacist or pharmacy) has the right to be represented by an attorney.

The licensee has the opportunity to attend an informal settlement conference. Notice of the conference includes the date, time, and place of the conference, as well as the issues to be discussed. Licensees should be aware that if permitted by the Texas Pharmacy Act and TSBP Rules, the complainant may also be informed of the date, time, and place of the conference, and may attend the conference at his or her own expense. Under the law, certain informal settlement conferences are required to be kept confidential.

At the conference, the licensee may show compliance with the law. A panel of the TBSP, typically composed of Board staff and one Board member, makes a recommendation for settlement of the case. The recommendation may be dismissal of the case, a formal warning, or a disciplinary action. This recommendation is known as a proposed Agreed Board Order, or ABO. If the licensee agrees with the ABO, it is presented to the TBSP at its next regularly scheduled meeting. If accepted by the Board, the order is entered, and if public, it may be obtained by the complainant. If the licensee does not accept the proposed ABO, or if the Board rejects it, there is a public hearing on the case conducted by an Administrative Law Judge (ALJ). After the public hearing, the ALJ prepares a Proposal for Decision (PFD) containing the ALJ’s findings of fact, conclusions of law, and recommended disciplinary action. The PFD is presented to the Board, which will then make a decision.

Possible disciplinary actions include a verbal or written warning, reprimand (public censure), suspension, revocation, or retirement of a license, or imposition of a fine. Once an action has been taken, the licensee may file an appeal in the State courts.

The complaint process can be long and drawn out, and it is difficult to predict how long a particular case will last until it is resolved. The TSBP notifies the complainant when the case is closed, and if it is lengthy, will provide the complainant with status updates every 120 days until a final action is taken.

Since a pharmacist’s license and livelihood can be at stake after a complaint is filed, it is critical that the pharmacist be represented by an Austin professional license attorney as soon as possible. If you have been notified of a complaint against you, do not hesitate to contact Oscar San Miguel, Attorney at Law, as soon as possible.

advertising medical licenseFor a physician, the use of the term “board certified” in advertising can lend a distinct air of authority and expertise that is very attractive to prospective patients. However, unregulated use of the term can lead to confusion among the public, as well as a watering-down of the positive impact on a licensed medical professional.

To protect the public, the Texas Medical Board (TMB) has standardized what the term “board certified” means when used in advertising by physicians. Under TMB rules, use of the term in advertising of a physician’s practice is allowed if any of the following apply:

  1. The specialty board and certifying organization is a member of the American Board of Medical Specialties (ABMS), the American Osteopathic Association Bureau of the Osteopathic Specialties (BOS), or is the American Board of Oral or Maxillofacial Surgery;
  2. The physician holds a certification that was granted before September 1, 2010, by a certifying board that was approved by the TMB for advertising before that date; or
  3. The certifying organization has certification requirements that are determined by the TMB to be substantially equivalent to the ABMS or the BOS at the time of application to the TMB.

In the case of option 3 above, physicians (or the certifying boards on behalf of their members) must apply to the TMB and demonstrate all of the following:

  • The organization requires all physicians seeking certification to pass an exam, which may be delegated to a testing authority, that is written, oral, or both, and that tests the physicians’ knowledge and skills in the specialty or subspecialty. The exam must be validated by a psychometric evaluation.
  • The organization has been determined to be tax-exempt by the IRS under Internal Revenue Code section 501(c).
  • The organization has a permanent staff and headquarters.
  • The organization has at least 100 licensed members, fellows, diplomates, or certificate holders, from at least one-third of the states.
  • The organization requires all physicians seeking certification to have successfully completed postgraduate training that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the American Osteopathic Association, and that provides comprehensive training in the specialty or subspecialty, and the organization uses peer review.
  • The organization provides an online member certification lookup for use by the public.
  • The organization can provide a complete explanation of its certification process and membership on request.

The use of similar terms, such as “board eligible,” “board qualified,” or any other word or phrase intended to convey the same meaning as “board certified,” is prohibited. Any such use constitutes misleading or deceptive advertising.

If you have reason to believe that your medical license is in jeopardy, contact the qualified Texas professional license defense attorneys at Oscar San Miguel, Attorney at Law for the expert advice you need to protect your license.

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Austin, Texas Professional License Defense Attorney Oscar San Miguel represents clients who are located in Austin, Houston, Dallas, San Antonio, El Paso, Fort Worth, Arlington, Amarillo, Lubbock, Brownsville, Laredo, Harlingen, McAllen, Round Rock, Longview, Travis County, Harris County, Dallas County, Tarrant County, Bexar County, Fort Bend County, Montgomery County, Cameron County, Nueces County, El Paso County, Potter County, Lubbock County, Grayson County, Collin County and throughout Texas.
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