It’s April 25, 2019 and the Texas legislature it just over 30 days away from closing out another session. This is the second session that the Texas Medical Board has come under Sunset review and still HB 1504 and SB 610 have been slowly moving through the process. The two bills are supposedly identical but rumor has it that what comes out in the end might be a surprise to us all. The thought of an expedited license for out of state physicians has been a big highlight of Representative Paddie and Senator Nichols bill, but does it go too far. And I quote “(d) An applicant described by Subsection (b) who has held a full license and been in active practice for at least five years is considered to have satisfied the examination requirements of this chapter regardless of the type of examination the applicant passed or the number of attempts within which the applicant passed the examination or any part of the examination. Wow! Will Texas really consider allowing an applicant to be licensed based on just any examination and on any number of attempts? I don’t know about you but this needs a much closer look. Hold onto your seats folks the times they are a changing!
In the past five years the Licensure Division of the Texas Medical Board has issued 21,615 physician licenses. Now that number is just a small portion of what the Licensure staff accomplished in those same five years. This same group of folks licenses or issues permits to other health related professionals such as Physician Assistants, Acupuncturists, Surgical Assistants, Physicians in Training, Visiting Physicians, Faculty Temporary Licenses, Visiting Professors, Conceded Eminence physicians, Medical Radiologic Technicians, Medical Physicists, Perfusionists, Respiratory Care Practitioners and Non-Profit Health Organizations.
Back in the day, 1985 to 2010 we didn’t have quite this many license or permit types. I cannot even imagine how an analyst keeps it all straight. Physicians are not easy to license, there are no two docs that are the same for sure. And when you add on all of these other license types and the complexity that goes with each group it is a wonder that the Licensure staff stays on track – but they do – and they do it quite well, but it takes time.
When physicians seeking licensure ask me why Texas is so hard to get a license in I just laughed and say it’s not – it just takes time. You cannot ask a staff the size of the licensure department at the Texas Medical Board to possibly rush through all of these license types – they all take time. Each license or permit type comes with its own set of laws and rules and keeping all of that straight is a headache.
So physicians if you would like to see the medical board perhaps return to taking care of their primary mission – the licensing, registration and discipline of physicians you have an opportunity in the upcoming legislative session. If you are interested in helping solve the issues of licensure I urge you to contact the Texas Medical Association and the Texas Osteopathic Association and get them on the case of getting the Texas Medical Board back to their roots.
April 2018 saw a new page for the Texas Medical Board. The board chose a new Executive Director, Mr. Stephen Brint Carlton. According to the board’s bulletin, “Mr. Carlton, of Orange, Texas, has experience as a county judge and prosecutor for Orange County, and prior to that was in private law practice. He holds a Master of Health Administration from the University ofFlorida at Gainesville and his Juris Doctor and Master of Business Administration degrees from St. Mary’s University in San Antonio. Carlton also has a Bachelor of Science degree from the University of Texas at Austin.Carlton holds the rank of Major in the United States AirForce Reserve, and joined the United States Air Force as a first lieutenant, Medical Service Corps officer, after
graduating from the University of Florida. He spent nearly four years on active duty stationed at the 17th
Medical Group, Goodfellow Air Force Base, Texas. He was responsible for disaster management and group
practice management as a health administrator. Mr. Carlton also deployed to the 386th Expeditionary Medical
Group, Ali Al Salem Air Base, Kuwait for six months in2009 and helped coordinate aeromedical evacuation
missions for Operations Iraqi Freedom and Enduring Freedom “Our committee worked diligently on the agency’s executive search this past year and we are very excited with the skills and talent that Mr. Carlton will bring to the agency,” said Dr. Sherif Zaafran, M.D., Board President.“We look forward to working with Mr. Carlton on fulfilling the Board’s core mission of public protection. I alsowant to acknowledge Scott Freshour, who served as acting Executive Director leading the agency during the the interim. We’re very thankful for his continued leadership.” Mr. Freshour resumed his previous role as the agency’s
Welcome to the TMB Mr. Carlton! Garanflo and Meyer wishes you great luck. You have inherited an amazing staff. We hope you can convince the Texas Legislature to provide you will additional staff and resources and perhaps hold off the inclination for the Sunset Committee to add yet more licensing types!
So, the Texas Legislature during their only special session this summer decided to approve the TMB, Texas Medical Board, continuing operation for two years. Yes, only two years! That means that in two years the TMB staff will once again be before the legislature proving their worth – and in the meantime they will be once again spending ridiculous amounts of time gathering more data and explaining to legislators and their staffs why there needs to be a TMB! I of course am not privy to all the whys but this action once again proves to me that the Texas legislature has not clear direction on what it’s priorities need to be. The TMB is probably one of few agencies that not only funds itself but plenty more – the agency via license and registration fees generates millions of dollars and keeps maybe one third. If I was a physician in this state I think I would pull a California and demand that my associations – Texas Medical Association and the Texas Osteopathic Association get deeply behind some legislation to pour more money into the TMB so that additional staff resources could be obtained. And maybe, just maybe before any more small agencies are added to the already overloaded TMB staff TMA and TOMA might, just might oppose such an action and get the TMB back to what they are supposed to be about – the licensing and regulation of physicians!
So during the 2017 regular legislative the Texas Legislature seemed to forget that they needed to vote on the Texas Medical Board staying in existence! So, Gov Abbott called them all back to Austin for a special session – and he told them – approve the med board – but alas here we are with only 7 days left of the special session and still not legislation to keep the medical board going. So, what happens if the legislature allows the TMB to fade away?? Well, many years ago Gov Ann Richards had had it with the Dental Board and away they went – some part to the Attorney General and some part to the Dept of Health – it was a mess and a lesson should have been learned but apparently not. A couple of great articles on the subject matter are the Texas Medical Association’s Doomsday article https://www.texmed.org/Doomsday/ and The Dallas Morning News’ article on Gov Ann Richards and the Texas Dental Board https://www.dallasnews.com/news/texas-legislature/2017/06/03/ann-richards-help-gov-greg-abbott-special-session-pickle. I doubt that the special session will end with the medical board hanging – lots of lessons can be learned from Gov Richards example!