And just like that the 10 year rule is gone – Texas Medical Board makes a big change!

At its October 2017 meeting the Texas Medical Board (TMB) struck the decades old 10 year rule stating that the rule impeded doctors from coming to Texas.  Just for full disclosure G&M Consulting was opposed to this measure.  What G&M proposed was a change to the rule making those physician who had been active members of hospital staffs exempt from the rule but requiring physicians who had not been under any formal peer review still have to comply with the rule.  Only time will tell if the board’s decision was correct but in the  meantime WELCOME to Texas all of you physicians who have not wished to re-up your boards or take the SPEX exam.  Any questions – give us a call 888-400-1580.

Since the early 90’s physicians coming into Texas had to have been examined by some type of test in the 10 years prior to their application for licensure.  The Texas Medical Board had instituted this measure when the state bean to see a very large increase in applicants flooding in from out of state.  The board wanted to be sure that some how the medical knowledge of these incoming applicants was up to date.  So, applicants had a choice between a national exam such as USMLE, FLEX, COMLEX or NBOME, or board certification or recertification.  To some this rule has been a blockade of sorts to licensure.

During the 2017 Texas legislative session, Senator Buckingham, proposed that physicians not have to maintain board certification – interesting!  As the bill began to move opposition to the bill reared its head by hospitals who as part of their credentialing did not wish to be dictated to by the legislature when it came to who would qualify for their staff memberships.  But what about all the physicians who are not involved in formal peer review? So, the bill changed, but still some decided that the TMB needed to change its rules and so it did.

Again, only time will tell if there is impact at the initial licensure stage.

Help with Hurricane Harvey Victims

Well Hurricane Harvey has been a beast and will continue to wreck havoc on Texas for some time. There are quite a few emergency shelters open and those shelters will be looking for volunteer physicians.  If you have time and can give of your services visit the Texas Medical Board website at  On the home page you will find several categories where physicians and physician extenders can obtain information on emergency permitting. TMB staff are working round the clock to comply with the governor’s order to get physicians and other medical personnel in quickly.  Texas needs you and NOW!

Hurricane Harvey Response – Visiting Physician Temporary Permit

The Texas Medical Board is issuing expedited temporary permits for out-of-state physicians assisting with the Hurricane Harvey emergency response in Texas. The temporary permit is good for 30 days and there is no charge. All physicians applying must be sponsored by a licensed Texas physician, which may include a facility based physician such as a department director where the visiting physician will be practicing. Applications will be reviewed and immediately expedited upon verification and status of the out-of-state physician’s license.

Please fill out the form with sponsoring physician information and include “HARVEY” in the procedure section of the form.

Email completed forms to:



Well they did – but only for two years – Texas Legislative Update!!

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!

Will they or won’t they???

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 and The Dallas Morning News’ article on Gov Ann Richards and the Texas Dental Board  I doubt that the special session will end with the medical board hanging – lots of lessons can be learned from Gov Richards example!

Mari Robinson exits Texas Medical Board

A bit of old news,  Executive Director Mari Robinson left the Texas Medical Board submitting her resignation in September 2016.  In announcing her resignation Ms. Robinson attempted to put rumors to rest, “I want to reassure you that there is nothing negative behind my decision to leave nor is there anything bad coming down the pike,” Robinson said in a statement released Tuesday to staff and board members. “While there maybe be gossip about this, there is absolutely no truth to anything like that. Honestly, I am just ready to try something new and I am excited about this opportunity.”

Initially I was shocked to learn of Mari’s resignation as were many physicians who were lighting up the Garanflo and Meyer phones.  Also, the Texas Medical Board was headed into Sunset hearings before the 2017 Texas Legislative session and the Teladoc lawsuit had still not been resolved – BUT, the more I thought about it the more it made sense.  There is probably not anyone in the state of Texas that knows more about how Telemedicine should look in Texas and heading up UTMB Gavleston’s Telehealth program is a good fit.

Jaime and I wish Mari the best and know that she will work hard to make UTMB’s program the best in the state.

Oh the phones!!!!!!!!!!!!!!! Texas Medical Board – Ugh!

I think today was a record for me in trying to reach the Texas Medical Board and specifically CAR. I began dialing using two phones at 8 a.m. – after about 250+ redials I got through to the message that all lines are busy – this happened around 9:15 a.m. and still now at 9:55 a.m. I continue to be on hold. I have some answers on how to fix this issue – but alas I just connected with staff at 9:58 a.m. – UGH!

Texas Medical Board adopts new rules at its June 2014 meeting.

The Texas Medical Board adopted the following rule changes at its June 2014 meeting.  

§163.4, Procedural Rules for Licensure Applicants
The Amendments to rule 163.4, relating to Procedural Rules for Licensure Applicants, relocates language located in Rule 187.13(a) to 163.4(d), in order to clarify the licensure process and options for applicants prior to appearing before the licensure committee as well as the procedures followed by the board during such process.
§163.5, Licensure Documentation
The Amendment to rule 163.5, related to Licensure Documentation, adds language to 163.5(b)(11) to clarify the mechanism by which an applicant can remedy a single deficient U.S. clerkship.
§166.6, Exemption from Registration Fee for Retired Physician Providing Voluntary Charity Care
The Amendments to rule 166.6, relating to Exemption from Registration Fee for Retired Physician Providing Voluntary Charity Care, adds language in Section 166.6(g)-(j) which sets forth the process for a retired physician, providing voluntary charity care, to return to active status.
§172.5, Visiting Physician Temporary Permit
The Amendments to rule 172.5, relating to Visiting Physician Temporary Permit, amends 172.5(b)(1)(B) to provide that a Visiting Physician Temporary Permit holder participating in KSTAR must be supervised by a physician that has not been the subject of a disciplinary order, unless administrative in nature.
§172.8, Faculty Temporary License
The Amendment to rule 172.8, relating to Faculty Temporary License, is amended to provide that an applicant for a Faculty Temporary license is ineligible if they hold a license elsewhere that has been subject to disciplinary action.

§184.4, Qualifications for Licensure for Surgical Assistants

The Amendments to rule 184.4, relating to Qualifications for Licensure for Surgical Assistants, amends language in 184.4(a)(13)(B) in order to correctly identify substantially equivalent surgical assistant programs.
§184.16, Discipline of Surgical Assistants
The Amendment to rule 184.16, related to Discipline of Surgical Assistants, deletes subsection (c) referencing confidential rehabilitative orders, and amends language under subsection (a) so that the Board may enter agreed orders or remedial plans with a surgical assistant.
§187.13, Informal Board Proceedings Relating to Licensure Eligibility
The Amendment to rule 187.13, related to Informal Board Proceedings Relating to Licensure Eligibility, relocates language located in 187.13(a) to 163.4 (Relating to Procedural Rules for Licensure Applicants) in order to organize and group the procedural rules pertaining to the licensure process for an applicant who has been referred to appear before the licensure committee. The Amendment adds a definition for “disciplinary licensure investigation” to 187.13(b). The Amendment adds language to 187.13(c)(1) and (2) which sets forth effect of an applicant who withdraws an application or fails to appear before the licensure committee after being referred and the procedure followed by the Board. Additional Amendments to 187.13(c)(3) and (4) clarify the outcomes relating to an applicant who is offered licensure
with terms and conditions and those who are determined ineligible by the licensure committee.
§187.24, Pleadings
The Amendment to rule 187.24, related to Pleadings, adds language to 187.24(b) to set forth the procedure for an applicant to request an appeal of the board’s ineligibility determination at SOAH and delineates the board’s and applicant’s duties with respect to order of filings. The Amendment further sets forth the effect of an applicant who withdraws their intent to file an appeal at SOAH or fails to timely file the requisite affirmative pleading and the procedure followed by the Board after such events.
§187.26, Service in SOAH Proceedings
The Amendment to rule 187.26, related to Service in SOAH Proceedings, deletes erroneous language relating to the required notice of default as it pertains to licensure cases at SOAH, due to its inapplicability in licensure cases.
§187.28, Discovery
The Amendment to rule 187.28, related to Discovery, adds language to subsection (a) referencing §164.007(d) of the Medical Practice Act and deletes language under 187.28(b)(1)(C) requiring that an expert report be provided in the designation of a testifying expert witness.
§187.29, Mediated Settlement Conferences
The Amendment to rule 187.29, related to Mediated Settlement Conferences, deletes language under 187.29(a)(1) referencing licensure matters.
§190.8, Violation Guidelines
The Amendment to rule 190.8, related to Violation Guidelines, amends subsection (L)(iii)(II) so that physicians are not required to establish a professional relationship prior to prescribing dangerous drugs for a patient’s close contacts if the physician diagnoses the patient with one or more of the listed infectious diseases. The amendments further add language defining a close contact and requiring that the physician document the treatment in medical record related to the patient connected to the close contact. The amendments delete language allowing a physician to provide such prophylactic treatment only in the case in which the patient has an illness determined by the Centers for Disease Control and Prevention, the World Health Organization, or the Governor’s Office to be pandemic, and limits the exception to the
provision of dangerous drugs.
§190.14, Disciplinary Sanction Guidelines
The Amendment to rule 190.14, related to Disciplinary Sanction Guidelines, amends the range and scope of sanctions for violations of the Medical Practice Act.