Perhaps hearing the complaints about the remote locations for its initial town hall meetings, the Texas Medical Board has finally agreed to hold one in Texas’s largest city, Houston, and hold others in additional central locations.

Despite the out-of-the way location, the meeting in Midland/Odessa attracted some 45 physicians. The board officials there reportedly dodged a question about doctors not coming because they feared retaliation.

In Fort Worth, about 65 persons attended. In response to a question from a recently retired family physician, Mari Robinson, director of enforcement for the Board, indicated that she felt, in her own mind, that the process was fair to physicians. The doctor responded that Texas physicians don’t think so (Fort Worth Star-Telegram 7/3/08).

A physician who attended the Fort Worth meeting said the atmosphere was charged, but the TMB maintained control. The minutes that the TMB secretary was writing, which were projected on a screen but apparently not available for review, bore no resemblance to the proceedings, the physician reported. While doctors were asking about unfair, inquisitorial hearings by the TMB, the secretary was writing: “Over concerns of patients being led to the bathroom undressed.”

Board members could not explain why there had been an explosion of complaints, 1,700 more in 2007 than in 2006. According to documents obtained by AAPS, the next largest source of complaints, after patients and their friends and relatives, is the TMB itself. Newspaper reports are one source of TMB-generated complaints.

A physician complained that the Board’s “experts” are less qualified than targeted physicians. The secretary typed: “Doctors want to have the nonmedical person of the board be trained and become an expert opinion.”

To a question about competitors of a targeted physician recusing themselves, the Board responded that this did not occur; competitors would know more about the case. The secretary typed: “The competition is welcomed by doctors as expert witness.”

This physician attendee concluded that “TMB never got the message.” Physicians are fearful of Board injustice, evidently with good cause.

The additional meetings are scheduled for:

July 15/16 Houston. The Town Hall will be in Room MSB 1.006 (first floor lecture hall) at the University of Texas Medical School, 6431 Fannin St.

July 29/30 Lubbock. The Town Hall will be at Texas Tech University Health Sciences Center, 3601 4th Street (4th St and Indiana Ave), Room ACB100.

Aug 5/6 Tyler. Biomedical Research Auditorium, UTHSC, 11937 U.S. Highway 271.

Aug 12/13 Dallas. T Boone Pickens Biomedial Building Auditorium, Room NG3.112 on the third floor, UT Southwestern Medical Center, 6001 Forest Park Rd.

Aug 19/20 El Paso. Auditorium B, second floor, Administration Building, Texas Tech University Health Sciences Center, 4800 Alberta Ave.

Aug 25/26 San Antonio. The Town Hall will be in Lecture Room MED 309L, School of Medicine, Joe R. and Teresa Lozano Long Campus, UTHSC, 7703 Floyd Curl Drive.

Sept 3/4 Galveston. University of Texas Medical Branch, TBA.

Sept 9/10 Amarillo. Texas Tech University Health Science Center, TBA.

Town Halls are at 7 p.m. the first date. Time and location of seminars may vary. Check www.tmb.state.tx.us under “News,” or call (512) 305-7030.

It would be desirable for as many physicians as possible to attend for mutual support, and take notes. You may wish to make a lawful tape recording. We are interested in your report on the meeting: how many attended, who was there from the TMB, any press coverage, questions or answers of note.

Here are some of the questions that have been suggested:

Which board members resigned and why?

Why do you think the board is perceived as being hostile, abusive, and disrespectful to physicians, and what might be done to change this?

How are board members chosen? What effort is made to avoid conflicts of interest? What is considered to be a conflict of interest? Serving as expert witness for plaintiff in malpractice cases? Working for insurance companies that may wish to remove doctors who submit “too many” claims?

Are board members who are competitors of a targeted physician asked to recuse themselves from investigating, presenting, or voting on a case?

Why should defense against a complaint by a patient who paid $15 for an office visit cost $100,000, even when there is no evidence of harm to the patient?

Why should the process be so complex, so opaque, and so threatening that physicians feel they must hire high-priced counsel at the outset? Why is there not a preliminary process to settle most cases quickly and efficiently, without compromising the doctors’ rights?

Is there any penalty for complainants who lie to the board? If not, why not? Is there some process to determine the plausibility and veracity of complaints before the doctor has to spend time and money defending himself against malicious or frivolous complaints?

What are the qualifications of investigators? How much authority do they have?

If the Board delays processing an application does the physician end up having to pay another fee and start all over again after a certain time has elapsed?

If a complaint is eventually dismissed, can the Board reopen it at any time, or keep using it against a physician? Are dismissed complaints expunged from the record made available to the public?

Has a sitting Board member ever been disciplined?

If an administrative law judge or a court rules that the Board ruled inappropriately, does the Board have to change its disposition of a case? Has it ever undone a sanction based on the findings of a court or a judge on appeal?