When substantiated by credible evidence, the following acts,
practices, and conduct are considered to be violations of the Act.
The following shall not be considered an exhaustive or exclusive listing.
(1) Practice Inconsistent with Public Health and Welfare.
Failure to practice in an acceptable professional manner consistent
with public health and welfare within the meaning of the Act includes,
but is not limited to:
(A) failure to treat a patient according to the generally
accepted standard of care;
(B) negligence in performing medical services;
(C) failure to use proper diligence in one's professional
practice;
(D) failure to safeguard against potential complications;
(E) improper utilization review;
(F) failure to timely respond in person when on-call
or when requested by emergency room or hospital staff;
(G) failure to disclose reasonably foreseeable side
effects of a procedure or treatment;
(H) failure to disclose reasonable alternative treatments
to a proposed procedure or treatment;
(I) failure to obtain informed consent from the patient
or other person authorized by law to consent to treatment on the patient's
behalf before performing tests, treatments, procedures, or autopsies
as required under Chapter 49 of the Code of Criminal Procedure;
(J) termination of patient care without providing reasonable
notice to the patient;
(K) prescription or administration of a drug in a manner
that is not in compliance with Chapter 200 of this title (relating
to Standards for Physicians Practicing Complementary and Alternative
Medicine) or, that is either not approved by the Food and Drug Administration
(FDA) for use in human beings or does not meet standards for off-label
use, unless an exemption has otherwise been obtained from the FDA;
(L) prescription of any dangerous drug or controlled
substance without first establishing a proper professional relationship
with the patient.
(i) A proper relationship, at a minimum requires:
(I) establishing that the person requesting the medication
is in fact who the person claims to be;
(II) establishing a diagnosis through the use of acceptable
medical practices such as patient history, mental status examination,
physical examination, and appropriate diagnostic and laboratory testing.
An online or telephonic evaluation by questionnaire is inadequate;
(III) discussing with the patient the diagnosis and
the evidence for it, the risks and benefits of various treatment options;
and
(IV) ensuring the availability of the licensee or coverage
of the patient for appropriate follow-up care.
(ii) A proper professional relationship is also considered
to exist between a patient certified as having a terminal illness
and who is enrolled in a hospice program, or another similar formal
program which meets the requirements of subclauses (I) through (IV)
of this clause, and the physician supporting the program. To have
a terminal condition for the purposes of this rule, the patient must
be certified as having a terminal illness under the requirements of
40 TAC §97.403 (relating to Standards Specific to Agencies Licensed
to Provide Hospice Service) and 42 CFR 418.22.
(iii) Notwithstanding the provisions of this subparagraph,
establishing a professional relationship is not required for:
(I) a physician to prescribe medications for sexually
transmitted diseases for partners of the physician's established patient,
if the physician determines that the patient may have been infected
with a sexually transmitted disease; or
(II) a physician to prescribe medications to a patient's
family members if 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.
(M) inappropriate prescription of dangerous drugs or
controlled substances to oneself, family members, or others in which
there is a close personal relationship that would include the following:
(i) prescribing or administering dangerous drugs or
controlled substances without taking an adequate history, performing
a proper physical examination, and creating and maintaining adequate
records; and
(ii) prescribing controlled substances in the absence
of immediate need. "Immediate need" shall be considered no more than
72 hours.
(N) providing on-call back-up by a person who is not
licensed to practice medicine in this state or who does not have adequate
training and experience.
(O) delegating the performance of nerve conduction
studies to a person who is not licensed as a physician or physical
therapist without:
(i) first selecting the appropriate nerve conductions
to be performed;
(ii) ensuring that the person performing the study
is adequately trained;
(iii) being onsite during the performance of the study;
and
(iv) being immediately available to provide the person
with assistance and direction.
(2) Unprofessional and Dishonorable Conduct. Unprofessional
and dishonorable conduct that is likely to deceive, defraud, or injure
the public within the meaning of the Act includes, but is not limited
to:
(A) violating a board order;
(B) failing to comply with a board subpoena or request
for information or action;
(C) providing false information to the board;
(D) failing to cooperate with board staff;
(E) engaging in sexual contact with a patient;
(F) engaging in sexually inappropriate behavior or
comments directed towards a patient;
(G) becoming financially or personally involved with
a patient in an inappropriate manner;
(H) referring a patient to a facility, laboratory,
or pharmacy without disclosing the existence of the licensee's ownership
interest in the entity to the patient;
(I) using false, misleading, or deceptive advertising;
(J) providing medically unnecessary services to a patient
or submitting a billing statement to a patient or a third party payer
that the licensee knew or should have known was improper. "Improper"
means the billing statement is false, fraudulent, misrepresents services
provided, or otherwise does not meet professional standards;
(K) behaving in an abusive or assaultive manner towards
a patient or the patient's family or representatives that interferes
with patient care or could be reasonably expected to adversely impact
the quality of care rendered to a patient;
(L) failing to timely respond to communications from
a patient;
(M) failing to complete the required amounts of CME;
(N) failing to maintain the confidentiality of a patient;
(O) failing to report suspected abuse of a patient
by a third party, when the report of that abuse is required by law;
(P) behaving in a disruptive manner toward licensees,
hospital personnel, other medical personnel, patients, family members
or others that interferes with patient care or could be reasonably
expected to adversely impact the quality of care rendered to a patient;
(Q) entering into any agreement whereby a licensee,
peer review committee, hospital, medical staff, or medical society
is restricted in providing information to the board; and
(R) commission of the following violations of federal
and state laws whether or not there is a complaint, indictment, or
conviction:
(i) any felony;
(ii) any offense in which assault or battery, or the
attempt of either is an essential element;
(iii) any criminal violation of the Medical Practice
Act or other statutes regulating or pertaining to the practice of
medicine;
(iv) any criminal violation of statutes regulating
other professions in the healing arts that the licensee is licensed
in;
(v) any misdemeanor involving moral turpitude as defined
by paragraph (6) of this section;
(vi) bribery or corrupt influence;
(vii) burglary;
(viii) child molestation;
(ix) kidnapping or false imprisonment;
(x) obstruction of governmental operations;
(xi) public indecency; and
Cont'd... |