Concerns over retaliation by the Texas Medical Board (TMB) are prompting a state lawmaker to call for greater oversight, following a September 15 ruling by a state Administrative Law Judge exonerating a central Texas physician of wrongdoing.
Recent studies show hospital errors are the third leading cause of death in the U.S., with an estimated 250,000 to 400,000 deaths per year, and up to ten times the annual incidents of non-fatal harm.
Dr. Robert Van Boven, a central-Texas physician, was previously employed by Lakeway Regional Medical Center. After reporting healthcare and safety violations at the hospital, Dr. Van Boven found himself the target of false and disparaging misconduct claims submitted to the Texas Medical Board by a remote manager/investor for Lakeway Regional. TMB then self-initiated complaint proceedings based on the allegations lodged at Van Boven.
Ironically, those with the most training and expertise to detect health and safety deficiencies are physicians themselves, and yet they are the least likely to report these adverse events for fear of losing their careers.
At an October 20 meeting, the TMB declined to enter a final order concerning Van Boven after learning of his exoneration. The board previously placed restrictions on him, effectively preventing him from practicing medicine in 2016. His reports of patient harm and deaths from adverse hospital events were later independently substantiated by external authorities, including the Texas Department of State Health Services, on each of six investigations.
In response to the board’s initial failure to reinstate him, Van Boven filed suit against the TMB, alleging retaliation, lack of due process, and a “civil conspiracy.” At a brief but tense December 8 meeting, TMB accepted the September 15 ruling, but Van Boven chose to move forward with his suit.
The event raises serious questions over the need for legal safeguards to protect physicians as patient advocates and for further oversight of integrity and accountability in the Texas Medical Board.
At a December press conference, physician and State Rep. Bill Zedler (R-Arlington) castigated the TMB for its lack of oversight and other derelictions of duty, including unlawful retaliation. Zedler’s office tells Texas Scorecard that accused doctors are typically flying blind during TMB’s informal settlement hearings, and that the presence of Zedler and State Rep. Stephanie Klick (R-Fort Worth) at the hearings in support of the accused has made a difference, weakening the board’s will to strong-arm the accused during its process.
Zedler also notes that the litigation of Teladoc, a telehealth company, underscores the absence of active supervision of the board and serves as a cautionary tale for increased accountability. Physicians and medical boards both have a legal and ethical duty under The Medical Practice Act and Board Rules to ensure patients receive the highest standards of care, and that patients and the public are protected from harm and injustice.
However, the lack of independent oversight leaves faithful administration of the process open to error and improprieties. The rules are only useful if properly applied.
Currently, TMB is responsible for monitoring and providing statistics on complaints against itself on an annual basis. Zedler contends that data included in the 2015 report by the Sunset Advisory Commission is suspect for fraudulent reporting, demonstrating the need for an independent authority to impartially consider and investigate complaints.
With sunlight said to be the best of disinfectants the coming 2019 legislative session will offer opportunities for lawmakers to bring greater transparency to a largely opaque Texas Medical Board that appears to sorely need it.
Zedler’s most recently earned an “A” and recognition as a Taxpayer Champion in the 2017 Fiscal Responsibility Index. He has also worked with an advocacy group known as Texas Right To Know, calling out a range of abuses by TMB.
