Topic: Action needed- Texas Medical Board up for review under Sunset Commision
me
Frequent Contributor (1K+ posts)
Member # 45475
posted
Hello All,
For Texans and those that got bit in Texas:
There still is time to post your comments regarding the Texas Medical Board's review up before the Sunset Commission. And we need people to also show up on December 9 at the Sunset Commission's public hearing on the TMB.
***IMPORTANT--If you fill out the form on the link, the info will be public. It is confidential if you entered your info prior to a certain date, but now it's not.
Public Input Form for Agencies Under Review | Texas Sunset Commission -- and choose Texas Medical Board from the list -
You can share your story, which for many patients goes something like this -- “I got Lyme, it took forever for me to get diagnosed in TX because docs don’t understand it, I had to go out of state because the TMB has a history of discouraging effective treatment in TX, (or disciplining Lyme doctors, etc), and y’all should do something.....”
........like require the TMB to put a notice about free Lyme Continuing Medical Education on the www.txlda.com website and in their bulletin/newsletter that goes out to all doctors in Texas.
We need the TMB to show they are supportive of Lyme Continuing Medical Education so that doctors here are not afraid to test, diagnose and treat,
It will make a big difference if a lot of us take action. Together, we can do it!
[ 11-23-2016, 02:39 AM: Message edited by: me ]
-------------------- Just sharing my experiences, opinions, and what I've read and learned. Not medical advice. Posts: 1431 | From USA | Registered: Mar 2015
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TX Lyme Mom
Frequent Contributor (1K+ posts)
Member # 3162
posted
I just got back home from the Sunset Commission hearing regarding our Texas Medical Board (TMB) late yesterday evening. There were 9 of us who presented oral and written testimony, which we will be allowed to revise (with a drop-dead deadline of Wed., 12/14/16, by 5:00 CT).
Here is a link to the re-play of the live broadcast -- except that this link appears not to be functioning properly right now, as I'm writing this -- not sure why not. It was working OK last night, so maybe it will work again later.
If not, then I'll come back to this topic to post another message later (but probably not before the first business day on Monday), depending upon whether the link has changed by then or not.
Here's the tape from Friday - our first panel starts at hour 2, minute 51:
The other panel of Lyme advocates from the DFW area begins at hour 7, minute 20.
Six of us spoke during the morning session, all seated together, during the first panel, because we arrived early and signed in early. The second group from the DFW area arrived later and were not called upon until the afternoon session.
We all met together in the cafeteria after the morning break and shared notes. This had the advantage that the second panel of witnesses were able to revise their testimonies in order to include suggestions that we didn't have time to cover during our morning panel, since each witness is limited to just 3 minutes.
One of our leading ILADS LLMDs testified about his experience of having been prosecuted by the TMB approx. ten years ago and how he had to close his medical practice -- although he has since reopened his practice and began treating Lyme patients again back in 2012.
This occurred after we had succeeded in passing protective legislation for our Lyme specialists, based on a clause in our 140 year old Texas Constitution (Art. 16, Sect. 32) which protects different schools of medical thought from discrimination by our state medical board -- and which our TMB had been stubbornly ignoring, in spite of our continued reminders about it when we had testified (futilely) about this discrepancy before the TMB in past years.
....to be continued in my subsequent message, to follow next after this -- 'cause I'm saving the very best part until last, and I want it to stand alone in order to showcase it. So, stay tuned....
Posts: 4563 | From TX | Registered: Sep 2002
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TX Lyme Mom
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Member # 3162
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....Drum roll, please....
The best part occurred during the meeting when we were all seated together in the audience. Our TxLDA legislative liaison leader had been working quietly behind the scenes with his contacts who are staff members in the all-powerful Texas Medical Association (TMA), who have been closely aligned with the IDSA in the past.
Somehow he had succeeded in illuminating the TMA folks, and he received an e-mail from them which he shared with the rest of us while we were all seated together in the audience, awaiting our turn to testify. It really bolstered our spirits and stoked us up, shortly before we were called upon to present our oral testimony to the Sunset Commission.
The TMA has agreed to post a link to the ILADS continuing medical education (CME) courses which were authored by Dr. Elizabeth Maloney, MD and which are accredited by the Family Medicine doctors' group.
This is a major coup for Texas, and I only hope that other states can succeed in accomplishing something similar!
Posts: 4563 | From TX | Registered: Sep 2002
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TX Lyme Mom
Frequent Contributor (1K+ posts)
Member # 3162
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The link works OK, but you might need to use a different browser other than Internet Explorer. Another strategy for getting onto the website would be to copy and paste the link into your browser and then you'll be able to access the website that way.
Be sure to watch Rep.Zedler's "rant" -- he's Lyme friendly -- which starts at 1:43:00 and continues for about 20 min., including Q&A from his peers on the Sunset panel. Awesome!
(It wasn't really a "rant" but he was talking very fast and loud in order to cover all of his talking points during his time limit, so it had the impact of sounding like a rant. He was very passionate.)
Rep. Zedler's testimony preceded ours, so that opened up the opportunity for us to go further than what we had originally planned to say.
Because we are allowed 3 business days to revise our written testimony, we are now loaded for bear. My revised testimony includes a lot of Rep. Zedler's ideas in order to re-emphasize what he said. Thanks, Rep. Zedler!
I could go on and on and on, but nobody seems to be reading this topic, so I'll stop now.
Posts: 4563 | From TX | Registered: Sep 2002
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TX Lyme Mom
Frequent Contributor (1K+ posts)
Member # 3162
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I'm now ready to released my final (revised) written testimony which was submitted to our Texas Sunset Commission yesterday. I'll break it into two parts because it is too long for one post.
Hello. My name is Elizabeth Naugle from College Station. I am Co-Moderator of our TxLyme internet discussion forum with over 500 members. Additionally, there are at least two, maybe three, Lyme FaceBook groups in our state, for a combined membership of probably a couple of thousand members. Most of our members are late-stage, chronic Lyme patients, whose numbers are never represented in the Texas Department of Health (TDH) statistics for Lyme disease, because TDH is assigned to report only just early-stage cases of Lyme disease.
In spite of passing protective legislation for our Lyme specialists back in 2011, nothing has changed in the last five years since then. Lyme patients are still having an extremely difficult time finding Lyme-literate doctors capable of diagnosing and willing to treat them. Why? It’s primarily because of the perception that they will be prosecuted/persecuted (take your choice) by the Texas Medical Board (TMB) if they accept chronic, late-stage Lyme patients into their practices. Something needs to be done to reassure doctors that it is OK and safe for them to treat Lyme disease, without fear of unfair prosecution by TMB.
This situation is inexcusable, especially when we consider that our 150-yo Texas Constitution (Art. 16, Sec. 31) guarantees that the state medical board cannot discriminate against different “schools of medical thought”. (Upheld in case law by Halsted, et al in 1944) That Constitutional clause was the very basis of our protective legislation for Lyme specialists when HB 1360 was passed back in 2011.
Nevertheless, our Lyme doctors look around them and see that other doctors who specialize in Complementary Alternative Medicine (CAM) are still being unjustly persecuted by our TMB. This persecution of CAM doctors occurs frequently, in spite of Chapter 200 of the Medical Practice Act (MPA) which was originally designed to protect CAM doctors in Texas – all to no avail though because of extraneous legalese written into Sec. 190.8 of the MPA, which subverted the original intent of that law.
It seems to me that the majority of members of our TMB hold a paternalistic attitude towards Texas citizens, as if we need protection from “medical charlatans” because we are not smart enough to discern for ourselves what is best for us concerning our own health care needs. This overly protective attitude is ridiculous because patients today have access to the internet, including authoritative websites such as PubMed and Medscape, to do our own research on medical topics. We do not need Big Brother looking after us by discouraging doctors from practicing medicine in innovative ways. Texas patients should be assured of exercising their right to “informed consent” without worrying that their favorite CAM doctors will be run out of business, or out of Texas, by an overly zealous medical board.
My Recommendations:
(to be continued in the next message, below....)
Posts: 4563 | From TX | Registered: Sep 2002
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TX Lyme Mom
Frequent Contributor (1K+ posts)
Member # 3162
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My Recommendations:
My first recommendation to the Sunset Commission therefore is for you to ask the Governor that when vacancies arise on the TMB that he appoint new TMB members who are knowledgeable about and supportive of late-stage, chronic Lyme disease and also about complementary/alternative medicine, in order to create a better balance of medical viewpoints among the TMB itself. Likewise, whenever Expert Panels are called upon to review complaints against CAM doctors or Lyme-friendly doctors, then these experts should be selected from among those same schools of medical thought, instead of being restricted only to practitioners of mainstream allopathic medicine who are unacquainted with the tenants of CAM.
(It is important to be aware that lawyers with our TMB frequently refer to “Standard of Care” which is outdated medical terminology. The correct new term for this basic concept is “Practice Guidelines” according to the Institute of Medicine and to the National Clearing House for Guidelines (NCG). “Standard of care” implies something very legalistic and rigid; whereas, Practice Guidelines implies broader flexibility because guidelines change frequently, as new medical research emerges. That’s why the NCG requires that Practice Guidelines be up-dated frequently, on a regular schedule, to insure they are sufficiently current to qualify as valid for being posted there.)
Furthermore, please review Chapter 200, Sect. 190.8 of the MPA and fix it so that it is unambiguous that CAM physicians are welcome to practice freely here in Texas, according to the tenants of their various CAM associations’ practice guidelines, without fear of unjust persecution by an over-reaching TMB.
I concur whole-heartedly with what Rep. Bill Zedler said in his testimony. I would like to see us go back to the earlier composition of the TMB when an MD was the Chief Medical Director of the TMB, who supervises the legal team which must answer to the Medical Director in the chain of command. “Why?” you ask. That’s because MDs have all taken the Hippocratic Oath about “First, do no harm.” It’s an entirely different mindset altogether! TMB lawyers, on the other hand, should lend their legal expertise by insuring “fair due process” to physicians whenever they must defend themselves during informal settlement conference (ISC) hearings.
I also want to reiterate Rep. Zedler’s astute comment about the importance of getting rid of the current “confidential” (effectively, “anonymous”) complaint process – with rare exceptions of course, such as when hospital nurse whistleblowers fear reprisal for filing a legitimate complaint against a bad doctor or when a patient is embarrassed by an unwanted sexual advance by a physician.
The reason for this important revision is that surrogates of the insurance industry, who do not want to pay for treating complex chronic health conditions, can too easily take advantage of the confidentiality clause by filing frivolous complaints against CAM doctors, which then allow the TMB to go on “fishing expeditions” by seizing patient records -- without those patients’ knowledge or express consent -- to use their records against their own doctors whom they trust and depend upon.
Similarly, doctors who desire an open public ISC hearing should be allowed to request it, as is done in other states across the country. Instead, what we have now is secret “kangaroo court” proceedings, behind closed doors, without any expectation whatsoever of fair due process for our physicians. This has a very intimidating and chilling effect on the readiness of all doctors to dare to treat chronically ill patients, including Lyme patients, for fear that insurance companies will turn them in for practicing outside some antiquated “standard of care.”
The Texas Legislature has already gone a long way with tort reform in 2003, but now the pendulum has swung too far in the wrong direction, by empowering the TMB with too much authority over doctors, but without assuring doctors of their right to fair due process in defense of their medical licenses and without assuring patients of their right to “informed consent” in their choice of complementary/alternative medical care by harassing their favorite CAM doctors and running CAM doctors out of our state.
I have one other suggestion about the role of the TMB in upholding their mission statement regarding physician education, but I plan to work directly with the TMB on that concern. Besides, others in our TxLyme (aka: TxLDA) group will be addressing that issue. (Also, it simply won’t fit on this page.)
All of these proposed changes will go a long way toward making Texas one of the very best states in the entire country for receiving first class medical care. Thank you.
Elizabeth N., Co-Moderator, TxLyme
Posts: 4563 | From TX | Registered: Sep 2002
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
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Totally amazing! GREAT WORK! GREAT points. Love it all. Working on a project to compliment it.
Thank you TX. We need 100 more like you in our circle of friends. For sure!
posted
You sure did a wonderful job on your submission! Thank you so much.
-------------------- Posts: 704 | From Huntsville, Texas | Registered: Oct 2000
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Catgirl
Frequent Contributor (5K+ posts)
Member # 31149
posted
Right on!
-------------------- --Keep an open mind about everything. Also, remember to visit ACTIVISM (we can change things together). Posts: 5418 | From earth | Registered: Mar 2011
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