Content Highlights
Likely you never expect to face a complaint before the TMB. Yet investigations can begin suddenly – often after a single incident or allegation – and can place your medical license and professional reputation at risk.
At Gardner Employment Law, we advise physicians facing Texas Medical Board investigations involving alleged violations of the Texas Medical Practice Act. Understanding the most common violations could help you respond appropriately and protect your career.
Why Is It Important for Physicians to Know about Medical Practice Act Violations?
It is important for you to know about the specific violations listed in the controlling law soyou can be proactive to avoid, even inadvertently, violating the statute. Violating the Texas Medical Practice puts your license at risk.
The Act (Texas Medical Practice Act) gives the TMB (Texas Medical Board) broad authority to investigate and discipline physicians, often in ways that surprise even experienced practitioners. Violations are not limited to criminal conduct or obvious misconduct. Many cases arise from documentation gaps, prescribing decisions, boundary issues, or clinical judgment calls made under real-world pressures.
Importantly, the TMB is not required to prove that you committed malpractice or that you harmed a patient to impose discipline.
The standard is whether the physician complied with the requirements of the Act and established “standards of care.” Conduct that you might think is defensible—or even reasonable in hindsight—can still trigger enforcement action against you.
If you understand how the law defines the violations, then you can
- Recognize risk areas in everyday practice.
- Respond appropriately to complaints or investigations.
- Avoid statements or actions that unintentionally worsen your position.
Common Violations That Lead to Discipline by the TMB
We list below some of the violations that we frequently see in daily medical practice:
-
Illegal Dispensing of Controlled Substances
Controlled substance cases escalate quickly. These cases often involve:
- Prescribing without medical necessity
- Inadequate patient evaluation or documentation
- Failure to monitor use or diversion
These matters may also draw DEA scrutiny and can lead to swift license restrictions. This category carries some of the harshest penalties.
2. Alcohol or Drug Abuse
Practicing while impaired violates the Act even without patient harm. Cases commonly involve:
- On-the-job impairment
- Positive drug or alcohol tests
- Failure to comply with monitoring or treatment
Our firm handled a case for a really bright young physician who put herself under enormous stress. She was an absolute perfectionist. This led to taking a few pills to calm her nerves. Her boyfriend was a heavy drinker, so he tried to help by getting her intoxicated during off hours. As you can predict, things went from bad to worse. A stellar career in the making was derailed. Fortunately, this client learned her lesson — the hard way.
3. Sexual Misconduct or Inappropriate Touching
The Act strictly prohibits sexual or inappropriate conduct involving patients, employees, or trainees. Even consensual relationships can trigger discipline due to power imbalances. These cases are treated seriously and often result in severe sanctions.
We have handled these cases, also. Invariably, physicians who get involved with their patients begin with compassion and feeling of concern for their patients lives. This is especially true in the long-term conditions such as cancer.
The answer is clear: maintain your boundaries. If you ever feel any feeling that is even remotely personal towards a patient, consider transferring the patient to a colleague’s care.
4. Overbilling and Financial Fraud
Physicians may face discipline for:
- Billing for services not rendered
- Upcoding or inflated time reporting
- Unbundling codes, which is similar to upcoding
- Financial misrepresentation
- Double-billing that is disguised
Patient harm is not required for discipline in these cases. If you make a mistake, that can enough to get you in trouble.
5. Inadequate Recordkeeping
While you may think this is merely a clerical topic, believe me – inadequate recordkeeping can lead to a malpractice action. Also, the converse is true. Our firm has been successful in helping physicians have meritless complaints dismissed by using the medical records.
When the TMB investigator can review the medical records and tell right away that you satisfied the required standard of care, the complaint is never filed. That is the best outcome of all.
The Bottom Line
TMB investigations can lead to not only disruptions of your work and personal life, but if the investigation turns up a true violation of the Act, your livelihood is at stake. You need to understand the risks, maintain strong documentation, and respond carefully to protect your licenses and reputation.
We are glad to help you identify and solve any potential problems before they become true investigations.