Medical professional standing with arms crossed. In the background, negotiations for agreed order with the TMB are occurring.

Negotiate an Agreed Order with the TMB

Texas physicians facing the TMB (Texas Medical Board) enforcement process have options beyond severe sanctions. The solution is to offer to negotiate the terms of an agreed order with the TMB, which saves reputations.

During this challenging process, it is vital to have an experienced TMB attorney by your side. At Gardner Employment Law, we have helped physicians and other professionals obtain favorable results in a collaborative negotiation process.

The TMB Enforcement Process

With thousands of formal complaints submitted to the TMB annually, in today’s world it is more important than ever for physicians to be keenly aware of their duties to their patients. The number of complaints filed is steadily rising every year.  If the TMB undertakes an investigation into a complaint filed against you, here is a succinct summary of the process before the issue reaches a formal hearing:

  1. Complaint: A complaint is filed against a physician by a patient, a patient’s family member, another medical professional, or anyone who believes the physician has violated the Texas Medical Practice Act. The TMB will send a letter notifying the physician of the complaint. For more information on how to respond to a complaint letter, read more on A Physician’s Response to the TMB’s Complaint Letter.
  2. Investigation: The TMB launches an investigation into the allegations. This includes gathering relevant medical records, conducting interviews, and collecting patient evidence. After the investigation, the complaint could be dismissed or it could move on to the next stages of the process.
  3. Informal Resolution: This phase involves an Informal Settlement Conference before a panel consisting of a board of representatives. The purpose is to review information and determine the physician violated the Medical Practice Act as claimed. If no violation is found, the case may be dismissed. If a violation is found, the TMB attorney handling the case frequently offers the physician an agreed order outlining terms and sanctions to end the matter without a formal hearing.  It is this point where you attempt to negotiate the wording of the agreed order with the TMB attorney.

While not exactly ideal, an agreed order can be far more lenient on physicians than the outcome reached by an Administrative Law Judge at a formal hearing. With an expert on your side, you could be able to negotiate a favorable agreed order to put an end the process.

Understanding an Agreed Order by the TMB

An agreed order is an efficient alternative to a formal disciplinary hearing where the matter will be decided by an Administrative Law Judge. The purpose of an agreed order is to facilitate the prompt resolution of claimed violations.  Agreed Orders are issued when the TMB has discovered evidence of non-compliance or misconduct. The order specifies the terms and conditions agreed upon by the parties which the physician must then follow. This collaborative approach allows both parties to reach a mutual understanding and decide on appropriate corrective actions.

An Agreed Order typically includes these fundamental components:

  • It recounts the findings resulting from the TMB’s investigation. This ensures that both parties are on the same page regarding the facts of the case, on what actually happened.  The wording matters in describing to the public what the physician did or did not do.
  • It documents the disciplinary action to be taken. Specific sanctions or penalties, such as reprimands, probation, fines, or educational requirements, are specified.  On its website the Texas Medical Board outlines the most common disciplinary actions and provides details on the enforcement process.
  • It identifies the non-compliance issues and establishes a plan for rectification or improvement to ensure future compliance with medical practice laws and regulations.  In short, the Agreed Order establishes a procedure ensuring that the physician will never engage in the claimed behavior again.

The final Agreed Order must be formally approved by the TMB before it becomes legally binding. The TMB reviews the proposed terms and conditions to ensure they align with its regulatory objectives and will protect the interests of the public. Once approved, the Agreed Order carries the same weight and enforceability as a disciplinary decision would have had the case been litigated at a formal hearing. By utilizing Agreed oOrders, the TMB streamlines the enforcement process, promotes cooperation between the involved parties, and expedites the resolution of potential violations, ultimately contributing to the maintenance of high standards in medical practice.

Common Misconceptions about Negotiating Agreed Orders

One of the common mistakes that healthcare professionals and doctors make about negotiating Agreed Orders is considering it an admission of guilt. Negotiation does not imply fault. Instead, it is a tool that enables the parties to arrive at a mutually acceptable outcome through a cooperative effort. Healthcare entities and physicians can use the Agreed Order process to provide their perspectives on the issues and to ensure that the final order is appropriate, balanced, and equitable.

Entering an Agreed Order does not automatically lead to negative repercussions on a physician’s reputation or career prospects. While Agreed Orders are a matter of public record, they can be structured to minimize the impact on the physician’s professional record or reputation.  Remember:  As we have cautioned, “Make no mistake, the TMB is a prosecutorial organization.”  Leave the wording of an Agreed Order to the TMB’s attorney at your peril.  Experienced negotiators can help physicians navigate these concerns and optimize their positions.

Successful Strategies for Negotiating an Agreed Order at the TMB

Negotiations for an Agreed Order at the TMB can be somewhat contentious at times and requires a lawyer who is skilled in negotiation and has experience in dealing with the TMB attorneys and staff. Here are four strategies that can guide you in the negotiating process:

Early Engagement: Initiate the negotiation process as soon as you receive a notice from the TMB.  Start by mentioning terms and reasons why amicably ending the process will benefit both parties.  This offers more time to develop customized negotiation strategies, increasing the chances of obtaining favorable results.

Open Communication: Prompt responses to the TMB’s inquiries, clearly and accurately discussing the issues will enhance trust, establish a cooperative atmosphere, and facilitate the negotiation process.  Open discussions often lead to a well-calibrated Agreed Order.

Expert Guidance:  As we have already mentioned, engaging skilled and experienced negotiators early in the process can provide valuable insights, navigate complex legal requirements, and advocate for your best interests.

Creative Solutions: Creative solutions that make good sense to the TMB attorney can present alternative resolutions beyond typical disciplinary actions.   Persuading the TMB attorney that making corrective actions, taking additional training, or agreeing to be monitored can result in beneficial negotiations.  Show that these programs will address the identified non-compliance or misconduct issues to prevent any recurrence.

All of these strategies can minimize the impact on your professional and public record.

Consult with an Expert TMB Attorney

Consulting with an experienced expert TMB attorney is the best action you can take to obtain an Agreed Order. At Gardner Employment Law, we possess the knowledge and expertise to offer personalized advice, develop effective negotiation strategies, and advocate for your best interests if you are facing a TMB disciplinary action.

Call us today if you need guidance to negotiate a favorable TMB Agreed Order.

Scroll to Top