Sample Coursework on Physician Practice in Texas

Physician Practice in Texas

Introduction

The registration of physicians in Texas is carried out by the Texas Medical Board post after application by qualified physicians. In order to be registered as a practitioner physician, each applicant must have their credentials reviewed by a board designated by the health facility or organization to which they are applying. For any individual to be considered a physician, the applicant’s credentials have to be checked against a standardized for produced by the Texas Medical Board. This implies that any organization that is mandated to carry out the exercise of credential verification must be approved by the Medical board. In order to be considered certified or accredited, one must hold a practice license as a medical doctor or an osteopathy doctor. The core data that is collected during the verification of applicant credentials include: the applicants name as well as other demographic details such as the age, professional education and training, licenses and the existence of any commissions for the graduates who are foreign nationals (Occupations Code, n.d).

The process of collecting, verifying, storage and management of the physicians’ credential information is carried out under the regulation of the board through the provision of standardized forms. The physician is the only one who can authorize the release of credential information to a health facility. The board however has the authority to revoke certificates of health facilities (especially private medical schools) which misuse the credential information relating to specific physicians. The certification of a physician follows the validation of his/ her credentials. However, certification may be revoked for failure to adhere to the professional code of conduct for medical practice. This means that for any form of misconduct, the health facility to which a physician is attached may be held responsible as well as the physician (Occupations Code, n.d).

Key issues

In case of incompetence or suspected misconduct by a physician, the patient affected or their family may choose to file a suit in a civil court of law. The civil complaint process involves a filing of a lawsuit based on the perceived wrong doings of the physician. The plaintiff, in this case the patient is allowed to make a formal report through his/ her attorney for the summoning of the defendant. The patient or family of the patient who files the complaint must be in a position to demand litigation for damages caused by the physician in question. Complaints against individual physicians and health facilities are reported to the Medical board for review by the relevant authorities at later times (Heimenz et al, 2014). To submit the cases, the plaintiff fills a form for reporting allegations, as well as other details.

The complaint report form together with any relevant attachments has to be submitted to the Texas medical board to ensure that investigations into the allegations are carried out. The responsibility of submitting the complaint forms lies with the plaintiff’s attorney and has to be done based on the confirmation of existing mal practice or negligence. The defendant can then be summoned to register an answer to the complaint prior to hearing. The details provided in the incident report have to be as accurate and possible and must include the name of the defendant, place of practice as well as the date of the incidence. The registration of complaints is only if the mal practice happened within the board’s jurisdiction (TMB, 2015).

The complaints filed by patients and/ or their families are reviewed and investigated by the Texas medical board. Following the reception of a complaint and the confirmation that the incidence was jurisdictional, the board goes about collecting evidence as to whether there was a violation of the Medical Practice Act through practices such as prescription, diagnosis or any other medical error that may have resulted in injury to the patient in question. During this process, which lasts about 45 days after the registration of the complaint, the board attempts to contact both the practicing licensee, who is the defendant in the case and the complainant (TMLT, 2008). Different cases are assigned to different board staffs depending on the nature of the cases. Those involving requests for records are assigned to be reviewed by the board’s attorney while those involving malpractice are reviewed by the physician investigator.

Cases that do not clearly indicate the complaint type are considered not filed. The review of cases is then followed by an opening of investigations into the case. Once investigations are opened, the defendants are contacted to provide any additional information that may be instrumental to the case. After consideration of all evidences, a case may be taken through either of two procedures i.e. referral to the disciplinary review committee for appropriate action or for further evaluation. Alternatively, the licensee may be offered a remedial plan, which is not exactly considered as a disciplinary action but is still a corrective action (TMB, 2015).

In practice, the physician is vulnerable to various forms of mal practice and negligence. Various actions constitute professional misconduct. However, all the actions end up in damage for the patient. Physicians are expected to deliver high standards of care to their patients and any practice that results in less than the expected outcome may be associated with mal practice especially if it causes damage to the patient. When any form of action on the physician’s part does not relate to professional ethics or professional expectations, the physician may be liable to malpractice. Actions that relate to negligence have to be confirmed through an evaluation of the 4Ds of negligence. On the other hand, mal practice is often associated not only with adverse effects to the patients but also with evidence that the physician’s actions were not guided by clear judgment.

In negligence, physicians may commit offences described as malfeasance, misfeasance and nonfeasance. Mal feasance is defined as a situation where the physician or any other medical practitioner does something illegal. For instance, while it is right for the physician to delegate roles to the nurses, a physician who assigns a nurse the role of prescribing medication commits malfeasance. Similarly, when the physician provides medical care without licensing, the practitioner commits malfeasance. Misfeasance is when the physician performs a legal act in a wrongful way such as prescribing medication before examination in a case where examination should be core to developing the prescriptions. Physicians also carry out non feasance when they fail to perform responsibilities that are necessary towards the well-being of a patient. In case of negligence, the physician must be confirmed to have been in a position associated with care over the patient (Fremgen, 2012).

Various risk management measures can be taken by health facilities and individual physicians to prevent instances of negligence and to reduce the risk of liability. First, it is necessary that all records are kept up to date. This is important to avoid the risk of liability among physicians, especially in big health facilities where a single patient may be seen by different physicians at different times. The availability of treatment records can help the physicians to keep tabs on each patient’s treatment and medical history thus avoiding the potential for misdiagnosis or other forms of ill practice (Fremgen, 2012).

Secondly, it is also essential for all medications and needles to be kept safely and under sterilization. Moreover, they should also be well labeled. This can help physicians to avoid issuance of wrong directions to patients without their knowledge, or even from administering wrong medication to patients. Issues of patient abandonment and improper follow up can be addressed by always having a physician on call. The main reason why cases of patient abandonment occur in health facilities in most cases is because those facilities are understaffed. By having doctors on call, health facilities can help avoid these cases. Similarly, improper follow up also occurs due to busy schedules that the physicians posses.

Another way in which risks can be managed is through the employment of risk managers whose role in the health facility is to oversee all forms of practice within the health facility with the aim of reducing the potential for harm to patients and thus avoiding lawsuits. The risk managers are a risk management strategy in the health facilities since they ensure that the feared risks do not take place. In addition to the described risk management strategies, it is critical for health facilities to practice efficient record keeping for incidents that occur during operations. The rationale behind this is that effective record keeping can help the facilities in determining areas of weakness and hence improving those areas prior to the escalation of risks (Fremgen, 2012).

Although risk management measures may be taken by various health care facilities, sometimes failure occurs and suits are filed. Following the filing of a lawsuit against a physician, it is essential for the defendant to provide sufficient proof that contradicts their guilt claims. Once the case has been filed in the court, the defendant is summoned to the initial pre trial hearings. This may result in agreement to settle matters out of court. The implication of this is that other alternate dispute resolutions strategies may be used for sustained business relationships. However, if the pre-trial hearings fail to yield fruit, the defendant’s attorney may be required to file an answer to the court summons. The defendant then has to wait for the trial date to be set. The trial hearings involve the hearing of the case either before a judge or before a jury comprising of between six to twelve members.

Following the hearing during the trial periods, the parties to the case may be satisfied with the final ruling or not. This means that any party that is dissatisfied with the final rulings may file an appeal within a specified number of days. Sometimes it may be necessary for the case to move up to the supreme courts based on the rulings of the appeal court and the decisions of the case parties. It is important for both the plaintiff in the case and the defendant to always tell the truth since an expert’s opinion may be requested (Fremgen, 2012).

References

Fremgen, B. (2012). Medical Law and Ethics 4th Ed. New Jersey: Pearson, Prentice Hall.

Heimenz, M., Leung, S., & Park, S. (2014). Crossing boundaries: a comprehensive survey of medical licensing laws and guidelines regulating the interstate practice of pathology. American Journal of Surgical Pathology, 38(3), 1-5.

Occupations Code. (n.d). Chapter 162: Regulation of practice of medicine. Retrieved from http://www.statutes.legis.state.tx.us/Docs/OC/htm/OC.162.htm

Texas Medical Board TMB (2015). Texas Medical Board. Retrieved from http://www.tmb.state.tx.us/page/place-a-complaint.htm

Texas Medical Liability Trust TMLT (2008). Understanding the Texas Medica Board – a resource for physicians. Texas Medical Liability Trust.