Tag Archives: disciplinary action

Texas medical license defense lawyerWhile any physician can find themselves in the middle of a Texas Medical Board (TMB) investigation, the outcomes of cases vary greatly. Analysts and advocates have long argued that some of the rulings are biased, and based on factors that are not related to the patient or public safety. Now a new study has determined that a history of disciplinary action can increase your chances of severe consequences – including and up to the revocation of your medical license. At first glance, this might not seem problematic, but in taking a closer look, it becomes clear that basing the severity of a consequence on a physician’s disciplinary action history can include a bias. Learn more, including what you can do to protect your medical license during a TMB investigation, and how an experienced attorney can assist.

A History of Disciplinary Action and the Risk of Revocation

Published in the Journal of the American Osteopathic Association, the new study examined data from the Texas Medical Board on investigations and the disciplinary actions taken against physicians in 1998. Details on each physician’s race, gender, degree, years in practice, primary specialty, the method of licensure, and information on the disciplinary action taken were all included in the dataset. Several factors were found to increase the overall risk of severe disciplinary action, including the practice of the physician (anesthesiologists and general practitioners had the highest risk of experiencing severe disciplinary action), but only disciplinary history was positively associated with an increased risk of license revocation.

How Physicians Gain a History with the TMB

Most people assume that physicians only gain a history with the TMB when they consistently commit infractions or endanger their patients. Yet, nothing could be further from the truth.

Responsible physicians – including individuals who have made an honest mistake – can also gain a history with the TMB. As an example, a physician who once struggled with an alcohol addiction may have been reported to the TMB for their DUI charges – none of which occurred while they were treating patients or on call. Even if the physician seeks treatment and turns things around, they could be at an increased risk for severe action from the TMB in future investigations.

The same can apply to practices that are considered to be at an increased risk for investigations from the TMB. Pain management doctors, family physicians, and general practitioners are all in that group – and though they may not have done anything seriously wrong, their history of repeated investigations can work against them in future cases. That is why experienced legal counsel is so highly recommended for every TMB investigation.

Contact Our Texas Medical License Defense Lawyer

With nearly 30 years of experience in the medical-legal arena, Oscar San Miguel, Attorney at Law, can skillfully assist you with any TMB investigation, regardless of how bleak the circumstances may look. Dedicated and experienced, our Texas medical license defense lawyer will aggressively pursue the most favorable outcome possible in your case. Call 512-228-7946 to schedule a free consultation today.


Texas medical license defense lawyerEvery physician is held to the same standards, rules, and expectations. However, a recent study revealed that some physicians may be at higher risk for disciplinary action from the Texas Medical Board (TMB). Furthermore, some practitioners may be at a higher risk for license revocation once disciplinary action has commenced. Think you are safe? You might be surprised.

Disciplinary Actions on the Rise

Like others before it, this recent study was prompted by the steady rise of physician disciplinary action. This one was slightly different, however. Most have sought to understand why disciplinary action has increased. Researchers from this study wanted to understand why certain actions were taken against physicians, and if certain physicians were more at risk for adverse effects than others. They also sought to determine if certain doctors were more likely to experience an investigation, with or without subsequent disciplinary action.

Most Common Violations

Medical state boards indicate that medical negligence, substance abuse, and inappropriate prescription practices are the leading violations. The study carefully examined these violations to determine if some acts were more likely to result in severe penalty (i.e. license suspension or revocation) than others. Interestingly enough, the study authors did not find any correlation between these offenses and an increased risk of license suspension or revocation. They did, however, find that those doctors who were investigated for “other” violations (especially criminal charges prior to, during, or after disciplinary action was taken) had a significantly higher risk for serious and adverse licensing or disciplinary action.

Specialty and the Risk of License Suspension

General practitioners, psychiatrists, and obstetrician-gynecologists were at higher risk for disciplinary action overall. However, not all of these practitioners were considered to be at an increased risk for license suspension or revocation. In fact, only general practitioners, psychiatrists, and anesthesiologists were said to have a higher risk of license revocation once the disciplinary process had started.

More Patients Equals Increased Risk

While, in theory, it would make sense that your time in practice would actually decrease your risk of license suspension or revocation, the study found the opposite to be true. The researchers assumed this was due, at least in part, to an increase in the number of patients treated (more patient exposure translates into higher risk). However, there is no proof to validate this theory.

Risk Increased by a History of Disciplinary Action

Of all the analyzed predictors that increased the risk of suspension, a history of disciplinary action was the least surprising. Those who have had multiple complaints with the Board – even those that were considered to be unfounded – seemed to raise red flags during future complaints that increased their risk of adverse disciplinary action. A history of action against also seemed to suggest that former disciplinary actions were not severe enough. So take heed: if you are facing an investigation (even on an unfounded allegation) or disciplinary action, ensure you are effectively represented by a skilled professional license defense attorney.

Oscar San Miguel, Attorney at Law, has more than 25 years of experience in the medical-legal arena. Committed to protecting your license, and your livelihood, he will fight to achieve the most favorable outcome possible for your situation. No matter what you are up against, our Texas professional license defense attorney has the skills and resources needed to effectively represent your case. Call 512-228-7946 and schedule your free initial consultation today.



Texas professional license defense attorney, disciplinary action, Texas Board of PharmacyResponsible for the licensing status of pharmacists and pharmacies, the Texas Board of Pharmacy has the power to take disciplinary action against licensees for violations of the Texas Pharmacy Act and the Texas Drug Laws. These actions can include (but are not limited to) license revocation, temporary suspension, or denial or renewal. If you are facing possible disciplinary action from the Board, understand the process, and the rights that are afforded to you, by law.

Understanding the Disciplinary Process

Once a complaint has been filed against a licensed pharmacy or pharmacist, the Board will investigate the matter to determine whether or not a violation has occurred. In cases where there is not enough evidence to support or confirm a violation, the licensee will generally receive a written warning, and the complaint will be closed by the Board. If, however, the investigator determines that there is enough evidence to support a violation, an informal settlement conference will be scheduled.

During the informal settlement conference, the licensee is given a chance to show compliance with the law by submitting any and all evidence to a panel of their peers. The panel then reviews the information and will propose a settlement for the case, which may include dismissal of the matter, formal warning, public reprimand, or the imposition of a sanction (license suspension, revocation, denial, etc.).

If the licensee agrees with the proposed settlement, an Agreed Board Order (ABO) will be presented to the Board Members during their next meeting. At that time, the Board will then determine whether or not to enter the order, as agreed. If they, or the licensee reject the settlement, the matter will then be referred for a public hearing with an Administrative Law Judge. After reviewing all the evidence, the Judge makes a recommendation for disciplinary action to the Board. Board Members will then make a final determination regarding the matter.

Understanding Your Legal Rights

Your right to a fair hearing, and due process right, are protected by law. Therefore, Therefore, it is highly encouraged that you also exercise your right to legal representation. However, do not wait until matters get out of hand. Instead, contact an experienced Texas professional license defense attorney as soon as you receive notification of a complaint. Call 512-228-7946 and schedule your free initial consultation with Oscar San Miguel, Attorney at Law, today.


pain management prescribingControlled substances prescribing is an area filled with potential pitfalls that, if not avoided, can lead to serious disciplinary action for physicians licensed by the Texas Medical Board. Each month the press releases published by the TMB detail disciplinary actions involving nontherapeutic and inappropriate prescribing as well as actions involving the proper operation of pain management clinics.

Instances of inappropriate and nontherapeutic prescribing that have resulted in disciplinary actions in the recent past include the following:

  • Prescribing controlled substances to relatives and other persons with whom the physician has a close personal relationship;
  • Prescribing without adequate documentation of a clinical diagnosis;
  • Prescribing for periods of time exceeding the current needs of the patient;
  • Prescribing without conducting a physical examination;
  • Prescribing without making a proper medical record;
  • Failure to look for and respond to aberrant drug use; and
  • Self-prescribing.

These matters have resulted in sanctions including various combinations of the following:

  • Restriction from prescribing certain drugs;
  • Losing the authority to treat patients for chronic pain;
  • Completion of a physician prescribing course;
  • Completion of a specified number of hours of CME in risk management and ethics;
  • Payment of administrative penalties;
  • Passing the Medical Jurisprudence Exam within a specified time period;
  • Following all recommendations of the Texas Physician Health Program; and
  • Not obtaining DEA or DPS Controlled Substances Registrations without TMB approval.

Repeat offenses and failure to comply with the terms of any disciplinary action are met with even stiffer penalties.

Pain management and the prescription of pain medications must be undertaken in compliance with DEA requirements, Texas law, TMB rules, and ethical standards. Physicians must take the utmost care adhere to procedures that include appropriate documentation and delegation policies, as well as procedures to detect indications of patient misuse or addiction.

Physicians should be aware of the potential consequences of noncompliance with pain management rules and requirements. Even physicians with the best of intentions can run afoul of the law. If you find yourself facing charges of inappropriate or nontherapeutic prescribing, having an experienced Texas professional license defense attorney at your side can significantly increase the likelihood of a positive outcome. Contact Oscar San Miguel, Attorney at Law, at the first sign of a problem.

National Practitioners Data Bank Most doctors have heard of the National Practitioners Data Bank (NPDB) and know that the Texas Medical Board must report disciplinary actions to it. But beyond that, there is more that physicians should know.

The NPDB is an electronic information clearinghouse that was created by Congress to provide public information about health care providers. It includes information on actions related to physicians’ state licenses, clinical practices, and membership in professional organizations, as well as state and federal actions related to participation in health care programs, criminal convictions, medical malpractice settlements and judgments, and other regulatory judgments.

Information reported to the NPDB is confidential, and cannot be disclosed to the public. However, the information is available to the following individuals and organizations:

  • Hospitals and other organizations with formal peer review;
  • Professional societies;
  • State and federal licensing boards;
  • Federal health care agencies;
  • Health insurers;
  • State and federal law enforcement;
  • Plaintiffs’ attorneys;
  • Statistical researchers; and
  • Practitioners themselves.

Physicians should be aware that their practice can be affected by a report to the NPDB. Many times the incident will also be reported in the media, alerting the public to an adverse issue with the physician. Retaining experienced legal counsel can be critical when dealing with the Texas Medical Board in disciplinary matters. The terms of any agreement or other resolution of a complaint can be specifically crafted to mitigate the negative impact on the physician when it is reported to the NPDB.

Physicians should also be aware that they should confirm the accuracy of the information reported to the NPDB. Physicians can perform a self-query to see the information that is on file with the NPDB. In addition, a copy of any report made to the NPDB is provided to the practitioner, who should review each report very carefully to check for accuracy. It is possible to contest the accuracy of the report, but this must be done within 60 days from the date the report is mailed to the physician.

If you are facing disciplinary proceedings by the Texas Medical Board, a negative outcome will be required to be reported to the NPDB. You need an experienced Texas professional license defense attorney at your side for the best outcome. Contact Oscar San Miguel, Attorney at Law, for a consultation as soon as possible.


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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