Some Perspective on Rick Perry

Most heard the news yesterday that Senator Kay Bailey Hutchison announced that she would run for Governor. I am not a resident of Texas and I certainly don't know that much about the inner dynamics of the state. I do know that a corrupt politician is one that we cannot stand for and I believe that Governor Perry is corrupt. I want to lay that case out and leave no doubt that in fact Governor Perry is corrupt.

I have done several stories involving corruption in the Texas Medical Board and the Texas Nursing Board. The first story involved a nurse named Tim Goosby. In this story, Mr. Goosby discovered that a powerful doctor, Dr. Dan Dugi, at his hospital Cuero Community Hospital was using poor patients as human guinea pigs to test drugs for a company that Dugi was a principle of. Goosby blew the whistle on this corruption to his superiors. Rather than taking care of the corruption orchestrated by Dugi, the principles retaliated against Goosby. They eventually brought the Texas Nursing Board into the fray. The Texas Nursing Board attempted to remove Goosby's license because he didn't report a DUI years earlier. Eventually, they did. He was even run out of the state and now lives in Wisconsin. In the middle of this process, he reached out to the Governor, Rick Perry. He told Perry of the systemic corruption in the Texas Nursing Board. Perry's response (in letter that is in the link I provide) was that he would have the Texas Nursing Board investigate the matter. In other words, according to Perry, the same place that was the subject of corruption would investigate itself for the corruption that it was creating.

In October of 2007, the corruption of the Texas Medical Board became so overwhelming that principles of that organization were brought in front of the Texas legislature. At that hearing, members of the Texas Medical Board were castigated for the systemic corruption at that organization. Routinely, doctors would be targeted, threatened, and punished for minor offenses. At the same time, doctors that were a menace to the system weren't investigated. At this hearing, Mari Robinson, executive director of the TMB, lied under oath when she accused a doctor of signing an affidavit admitting to sexual misconduct. To this day, she has been unable to produces said affidavit. To this day, she is still the executive director of the TMB. This is a position that Perry could remove her from at any time.

The corruption at the Texas Medical Board only begins there. For years, the Texas Medical Board Disciplinary Committee was run by Dr. Keith Miller. Dr. Miller was finally forced off the board in December of 2007.

Notorious Texas Medical Board (TMB) henchman, Dr. Keith Miller, abruptly resigned his position on the TMB on Friday, September 7, 2007.

Miller’s resignation was due to the intense scrutiny of his abusive and tyrannical actions against physicians while on the TMB. It was also due to his relationship with Bridget Hughes, his Nurse Practitioner. Bridget Hughes, who was found to be a narcotics addict by the Texas Board of Nurse Examiners while employed by Miller, continues to work as Miller’s nurse practitioner at his office in Center, Texas. Hughes had her prescription writing ability suspended when she was disciplined by the Texas Board of Nurse Examiners (TBNE) on April 16, 2007 for stealing (50) triplicate prescriptions from her previous supervising physician employer and forging his name to obtain narcotics for her own use.

Inside sources have informed us that Ms. Hughes will be charged shortly with narcotic violations by the Drug Enforcement Agency (DEA) in Federal District Court in East Texas. Why has Dr. Miller continued to employ Bridget Hughes as his nurse practitioner? Why has Miller continued to protect her? What goods does Hughes have on Miller? Do not be surprised if Hughes points the finger at Miller if the Justice Department offers her a shortened sentence for coming clean about her relationship with him.

Dr. Miller used his position of power in the TMB to attack hundreds of doctors with bogus and nonsensical charges. I highlghted two such stories. At the same time Dr. Miller headed the TMB Disciplinary committee, he also worked for Blue Cross Blue Shield's advisory board. As I pointed out, Dr. Miller used these dual positions to do the bidding of the insurance company and thus corrupt the entire medical system. All of this happened on the watch of Governor Perry and he never once tried to reform the TMB or its disciplinary board. In fact, despite lying under oath, Mari Robinson continues to run the TMB today.

Dr. Miller is also a doctor. He had a nurse that worked for him for several years, Bridget Hughes. Hughes admitted to forging at least 50 prescriptions of level II drugs. Those are drugs like oxycondone, morphine, and cocaine. The only drugs stronger than level II are drugs like heroin, PCP, and LSD. Level II drugs are the most potent that can be prescribed. Even though Hughes admitted this, and it was in a report done by the Texas Nursing Board, her punishment for this breach was that she "voluntarily surrendered her license" to prescribe drugs for a year. Keep in mind, Tim Goosby's license was removed because he didn't list a prior DUI. Again, the TNB is part of the executive branch of the Texas government. Perry chooses its members.

Finally, there is the case of Dr. Mark Blotcky. While the TMB was busy going after hundreds of doctors on flimsy charges. They have totally ignored the systemic corruption that Dr. Blotcky has perpetrated on the Texas medical system. For at least six years, the TMB has received multiple complaints about this doctor. None of those investigations resulted in any disciplinary actions. The last time a complaint was presented to the TMB was earlier this year. In that case, Mari Robinson ran interference to make sure that the complaint received as little attention as possible.

Now, some will say that it's unfair to view the corruption at the TMB and the TNB as a reflection of Governor Perry. I think that such a view minimizes the corruption. Clearly, Governor Perry doesn't care. He received first hand knowledge of the corruption by Tim Goosby and he ignored it. The TMB was castigated by the Texas legislature and he did nothing about it. Its main principle, Mari Robinson, lied under oath at hearings in front of the legislature and she continues in her position. Corruption is not a partisan issue and we cannot stand for it. Those that protect or look the other way on corruption allow that corruption to spread like a cancer. The corruption at both the TMB and the TNB have corrupted the entire medical system and that affects the health and safety of all Texans. That Governor Perry ignored all that corruption speaks for itself, and hopefully that puts some perspective on the race.

Why Is the Texas Medical Board Protecting Dr. Mark Blotcky

Introduction:

Since July, I have chronicled the corrupt practices of Dr. Mark Blotcky, a psychiatrist and expert witness in Dallas. Three witnesses came forward, Dr. Susan Diamond, Katherine Tranum, and Darcy Boatman. Furthermore, several more people left comments in response like this one from Dr. Fred Maese.

I have had a similar experience with Dr Blotcky when he was hired by my ex-wife's attorneys in 5-2007 to testify at Judge David Hantschen's court in Dallas that she had "Battered Woman's Syndrome" during our divorce case involving the custody of our 3 children. He pulled this diagnosis out of a hat even though none of the 4 accepted diagnostic criteria were not met. His supportive evidence came from very brief interviews of the elder children (ages 10 and 11)and her, and reports of the psychologist and psychiatrist that her attorneys had encouraged her to see, without ever corroborating the veracity of such information. The younger child has a learning difference and he can be made to say whatever an adult tells him to say. Daniel, the older one told him he loved me and wanted to spend more time with me. Dr Blotcky would get angry with him or ignore him if he said anything kind about me. The children were very upset that they were being taken to see this guy. He came across in court as an arrogant buffoon and I do not believe the Judge took him seriously. However, earlier in the case he also participated in a hearing against me at Judge
Nicholson's Court(the associate Judge, for the purpose of gaining a protective order against me, which was granted, causing untold pain for both the kids and myself as well as grossly elevating all fees (my case lasted 1.5 years and cost us approximately 2.5 million in legal fees).

The court appointed psychologist in our custody case was Dr Ray McClung, another "Blotcky"! He is an elderly gentleman whose ethics, negligence, incompetence, bias and greed I would be happy to expose. His prejudicial findings and recommendations were so far out there that he also came across as out of tune with the reality of the situation. Another paid "expert", charging whatever he wanted without the Judge making him accountable. In the end he also contributed to increasing the duration of the case and unnecessary pain to the kids and myself. His incestuous relationship with her attorneys (McCurley Law Firm) is hideous.I can tell you so much about what I call "The Sherry Lane Racket". We ended up with shared custody and I have extended standard possession on weekends 2,4 and 5 of each month as well as every Tuesday night for dinner. I love my children , I am a Cardiologist and like Dr Diamond, a huge target for this broken system!

I am considering filing a complaint with the Texas State Board of Psychologists and perhaps a lawsuit. Would this board react differently than the TSBME? What would you recommend? Has this Dr McClung been under the radar before? Thanks for any input, Dr Fred Maese MD FACC.

In the case of Dr. Diamond, Dr. Blotcky "diagnosed" her as having Munchausen by Proxy. This was a rather bizarre diagnosis since he did without ever examining her. No matter because once he rendered this diagnosis as an expert witness in court she didn't stand a chance and lost custody of all her children. In the case of Katherine Tranum, Dr. Blotcky put her son a cocktail of drugs that caused him to gain about 30 pounds over a ten week period when he was nine. In the case of Darcy Boatman, Mr. Boatman, who weighs approximately 270 lbs, was accused of child abuse against his then teen-age son. While this charge was leveled within the family court system, neither Dr. Blotcky nor his partner on this particular case, Dr. Benjamin Albritton, saw fit to report him to DCFS or the police and the D.A. in the area. For all of this, Dr. Blotcky routinely charges anywhere between $200-$400 per hour for his services.

Furthermore, Dr. Blotcky also gives seminars to attorneys in techniques for defending child molestors. In the early 1990's, Dr. Blotcky was employed at the Timberlawn Psychiatric Hospital. While there he dated and married another colleague, Dr. Lisa Crumpton, a child psychologist, who he began dating while she still doing her residency at Timberlawn. As such, he began dating her while he was her professor. On December 8, 1992, Dr. Crumpton committed suicide from a massive dose of Valium and anti-depressants.

...

Now then, upon publishing these three pieces, Texas Medical Board Watch took up the case of Dr. Mark Blotcky. The organization, headed by Dr. Shirley Pigott (herself featured in this story) filed a formal complaint against Dr. Blotcky with the Texas Medical Board.

The Texas Medical Board has gone through its own upheaval over the last year or so. The head of its disciplinary committee, Dr. Keith Miller, stepped down in September of 2007. (His corrupt exploits are featured here) In private practice, Dr. Miller employs Bridget Hughes, who herself has admitted to forging 50 schedule 2 prescriptions.

Since Dr. Miller left the TMB, the board appears to take its marching orders from Mari Robinson, the interim Executive Director of the Texas Medical Board. Robinson is an attorney by trade and in her thirties.

So far, the email correspondence that I have been privy to have Robinson as the front person in the "investigation" of Dr. Blotcky. The case assigned case # 09-0368 has been assigned to Joan Donley. Donley has been unavailable for comment. Robinson did brief Dr. Pigott on the status of the investigation a couple of days ago.

A thorough review of this matter has now been completed. An investigation was not filed because the initial review provided for in Sec. 154.058 does not indicate that the actions referenced in your complaint fall below the acceptable standard of care.

In other words, the TMB will take no further action against Dr. Blotcky as a result of these stories. Of course, it is difficult to believe that a "thorough review" occurred since none of the victims that I featured were ever contacted by anyone at the TMB. If you are familiar with any of the pieces I wrote, this should come as no surprise. That's because complaints were filed in each of the three cases already at the time each was victimized. In each of these cases, their complaints were similarly dismissed? As such, the only question remaining is why is the Texas Medical Board protecting Dr. Mark Blotcky.

Bridget Hughes: The Addicted Nurse

According to this order from the Texas Nursing Board (link download attachment) this is a damning indictment of Bridget Hughes, a nurse practioner in Texas. Between July of 2004 and September of 2005, Hughes was employed at the office of Dr. Craig McMullen in Center, Texas. Dr. McMullen confirmed to me that everything in this order is in his judgment exactly 100% accurate.

According to this order, beginning in July of 2004 through September of 2005 (when McMullen finally removed Hughes and reported her to the TNB) Hughes began forging at least 50 triplicate prescriptions of Level II drugs. According to the DEA, here is how Schedule II drugs are described.

A) The drug or other substance has a high potential for abuse.

(B) The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions.

(C) Abuse of the drug or other substances may lead to severe psychological or physical dependence.

Some examples of Schedule II drugs are morphine, cocaine, oxycodone (Percodan®), methylphenidate (Ritalin®), and dextroamphetamine (Dexedrine®). In fact, Schedule II drugs are the most potent and addictive drugs that can be prescribed. The only thing more potent is Schedule I which includes such drugs as heroin, marijuana, LSD, PCP, and crack cocaine.

While her motives for this mass forgery was never revealed in the report, the sheer quantity of the drugs leads to all sorts of speculations including chronic personal use and/or selling.

Furthermore, according to this order, on December 11, 2006, Hughes admitted that shea an addiction to Hydrocodone and she had that addiction since December of 2003.

While what Hughes was found to have done was indeed shocking, what is really shocking is the punishment (or lack thereof) that the TNB handed down. Keep in mind that everything I just listed was stipulated as fact by the TNB and Hughes herself. For forging 50 Schedule prescriptions and maintaining a near three year addiction to Hydrocodone Hughes "Voluntarily surrendered her license to prescribe medicine" for one year. Hughes voluntarily surrendered her license to prescribe medicine for one year as part of a sort of probation that could have meant the end of her license to practice nursing entirely with further violations.

This rather light punishment is shocking and peculiar. It is even more peculiar in light of the draconian punishment the TNB handed down to Tim Goosby. Goosby had not reported an earlier DUI to the TNB when he first came to work in the state of Texas. For this violation, Goosby had his nursing license removed for one year, and he could only apply, though was not guaranteed, to have it reinstated. Hughes forged at least 50 prescriptions for the most addictive drugs that can be prescribed and admitted to a near three year drug addiction. For this, she "voluntarily surrendered her license to prescribe drugs". Keep in mind that during this year, she still maintained gainful employment as a nurse.

How did all of this come about? Another piece of this puzzle is the doctor that employed Hughes when the TNB rendered its findings, Dr. Keith Miller. Dr. Miller was also then a doctor in Center, Texas, however he was also concurrently head of the Texas Medical Board's Disciplinary Committee. ( I have written multiple pieces about Dr. Miller's involvement in corruption within the Texas medical community) While there is no direct evidence that Dr. Miller played any role in Hughes rather light sentence, there are several things we can conclude. First, Dr. Miller hired Bridget Hughes despite knowing full well that her previous employer, Dr. McMullen, had caught her forging at least fifty prescriptions for extremely addictive drugs. She admitted to continuing to being addicted to Hydrocodone even while she was employed by Miller himself. Yet, despite all of this, she continued to be in his employment and in fact continues in his employment today.

Finally, the story took another bizarre turn in April of 2008, less than a month before her one year "voluntary surrender of her license to prescribe drugs" expired. A source tells me that an undercover agent was sent into see Bridget Hughes posing as a patient. This undercover agent witnessed Hughes not only prescribe drugs to them but Hughes called the prescription into the local CVS herself. All of this was in direct violation of Hughes order.

Hughes was reported to the TNB but she faced no further punishment. In fact, she is now allowed to prescribe drugs and faces no more sanctions from the TNB. In fact, not only has she faced no more sanctions from the TNB, no other investigative agency in Shelby County or the state of Texas has ever brought charges against her. After all, forging prescriptions is illegal and just compare how she was treated by law enforcement to say Rush Limbaugh. Furthermore, to understand how truly corrupt her case was handled by the TNB just compare her situation again to Tim Goosby. Given that she worked at the time for Dr. Keith Miller, then head of the Texas Medical Board Disciplinary Committee, this presents strong evidence that the corruption in medicine in Texas is widespread and systemic.

Responding to Mr. Merian: BCBS Vs. Private Family Physicians the Follow Up

Introduction: A couple of months ago, I wrote this piece. The piece focused on the story of Dr. Shirley Pigott. Dr. Pigott is a private family physician in Victoria, Texas and has been for more than two decades. She has also been active within the Texas Academy of Family Physicians. In 2002, she had a billing dispute with her biggest insurance provider BCBS of Texas. Blue Cross Blue Shield of Texas is not only the biggest insurer of the patients of Dr. Pigott, but they insure about one third of the folks in Texas altogether. In other words, it is difficult to be a physician in Texas unless you are a part of their network.



At roughly the same time that this billing dispute began, Dr. Pigott and her colleagues also began complaining to each other about how difficult the insurance companies were making it on them. Keep in mind that private family physicians have no salary. Everything they make comes from whatever they charge their patients. Since one third of patients in Texas can be expected to be covered by BCBS, BCBS is in a position to make things very difficult for family physicians if they so choose.



In about 2004, Dr. Pigott formed a group called the group of 35, of family physicians around the country, that decided that enough was enough. They decided that it was time for the American Academy of Family Physicians to fight harder for private family physicians. Initially, this group took three demands, or mandates as they are called, to the state levels of the AAFP. Dr. Pigott was given the responsibility of presenting these mandates to the Texas Academy of Family Physicians. The mandates essentially simply asked the TAFP to recognize the struggles that family physicians go through and fight harder for them.



Dr. Pigott presented the mandates to the proper committee within the TAFP. It was completely well received except for one doctor. That doctor's name is Dr. Doug Curran. Dr. Curran was then the President Elect of the TAFP. He wasn't even on the committee and was merely visiting the committee that day. Despite his objections, the three mandates passed the committee, the full TAFP, and eventually the AAFP.



At about this same time, Dr. Pigott received a complaint from the Texas Medical Board Disciplinary Committee. At the time, this committee was headed by Dr. Keith Miller. (as you can see if you go to most previous link Dr. Miller has been the subject of controversy and eventually resigned from the committee) In fact, this particular link minced no words in describing Dr. Keith Miller.

Notorious Texas Medical Board (TMB) henchman, Dr. Keith Miller, abruptly resigned his position on the TMB on Friday, September 7, 2007. Miller’s resignation was due to the intense scrutiny of his abusive and tyrannical actions against physicians while on the TMB.

(This will become important because my accuser will also go on to defend Dr. Miller)



The dispute involved a patient that demanded their medical records. Dr. Pigott customarily reviewed the medical records at a follow up appointment. This patient didn't make a follow up appointment and rather demanded the records be sent to their home. Since this broke protocol, Dr. Pigott didn't mail out the records for significantly longer than the law required which is 15 days. While this is a technical violation of the rules of medicine, it is a very mild one and should be the subject of a very mild punishment, if any at all.



Instead, because these records weren't mailed out on time, Dr. Pigott began a nearly four year battle against the TMB disciplinary committee. At one point, the board threatened all sorts of draconian punishments: one year probation during which she would be monitored by another physician, provide the board with random patient records upon request, a $500 fine and force Dr. Pigott to pay for the doctor that would monitor her, and this is among a whole host of punishments numerated 1-10 with several subsets for most. Again, these draconian punishments were in response to Dr. Pigott sending out medical records in an untimely manner. Furthermore, Dr. Keith Miller was later the subject of investigation of much corruption, including another story by me, and his nurse practioner Bridget Hughes was found by the Texas Nursing Board (must then click link download attachment) to have doctored 50 prescriptions of drugs like methadone. Furthermore, it was Dr. Craig McMullen, the doctor that employed Hughes prior to Miller, that discovered this. In other words, Dr. Miller hired Hughes despite knowing full well that she had committed a serious breach medical ethics.



Now, while her proceedings against the TMB disciplinary committee were going on, Dr. Pigott was continuing in a leadership role within the group of 35. She continued presenting mandates and continued fighting on behalf of private family physicians. At one such meeting, she came up against Dr. Doug Curran again. He was now the President of the TAFP and he visiting the committee she was presenting to, again, even though he wasn't a member of the committee. Once again, he confronted and objected to everything Dr. Pigott presented only this time most of the committee objected with him. Dr. Pigott told me that not only were her mandates rejected but she felt humiliated to the point of tears.



At around this time, Dr. Pigott discovered that Dr. Curran was the subject a full spread photo advertisement for Blue Cross Blue Shield, and then within weeks, she discovered this puff piece about Dr. Curran in which members of BCBS are quoted in glowing praise of him. Dr. Pigott began complaining to members of the TAFP as well as other medical authorities that she believed that Dr. Curran had a conflict of interest between his representation of doctors and his close alliance with BCBS.



Her complaints became so noisy that Dr. Curran confronted her and in the middle of their conversation Dr. Pigott says that he told her this...

Do you know that I am a member of the Blue Cross Blue Shield Texas Medical Advisory Board with Dr. Keith Miller, and Dr. Fred Merian.

Now, Dr. Keith Miller I have already touched on but Dr. Fred Merian is also the former President of the Texas Medical Association. Throughout my original piece, I refer to the BCBS Texas Medical Advisory Board as super secret. Of course, this is a bit provocative. It isn't hidden like secret parts of the CIA, however, you will find scant little information about it on the internet. You will certainly not be able to confirm on the internet who serves on this board. Most importantly, why are three doctors also working for the insurance company. This is of course an inherent conflict of interest.



Ultimately, Dr. Pigott discovered enough about what happened and then hired a legendary attorney and she wound up being given a slap on the wrist.



Several months later though, Dr. Merian's son found my article and found plenty to object to. Here is his first comment.

You have a lot of nerve maligning my father like that. I am Dr. Merian's son. My father is the most ethical and caring doctor there is. And your labeling him as some corporate shill is downright libeleous. And since when is it wrong to go after doctors who are overcharging their patients?Do you even attempt to contact the three Doctors whom you labeled with this article? I know all three, and they have impeccable reputations with both their patients and their fellow Doctors.All of these Doctors earned their positions, is being from a small town mean you are not qualified to make policy in this state? Do you have to be from Houston or Austin in order to be qualified to hold a position of leadership?

Now, on one hand, I can understand and admire Mr. Merian's instinct to furiously defend his father's reputation. On the other hand, I found it rather peculiar that Mr. Merian was the one up in arms. After all, his dad was mentioned in passing and only because Dr. Curran identified him as one of three on this BCBS Medical Advisory Board. Furthermore, at this point, there is a mountain of evidence that Dr. Keith Miller is NOT a doctor of "impeccable reputation". I, myself, have presented several cases of corruption he was involved with. The Texas Medical Board's Disciplinary Committee was the suject of an investigation by the Texas legislature.



Furthermore, the reputation of the three is beside the point, the story that is the subject of the original piece speaks for itself. You either believe it and draw appropriate conclusions or you don't. That said, Mr. Merian wrote this response in which he attempted to take me to task for my reporting. Let's take things one by one. Here is how he concludes.

My father practiced medicine in Yoakum, Texas (pop 6000) before moving to Victoria, Texas (pop 45,000). Your implication here, of course is that individuals from small towns are inherently unqualified to serve in high profile positions, and therefore can only reach those positions through corruption and collusion. Again, you make this statement with no proof to back it up. In order for your allegation (that my father was put in the Presidency of the TMA by BCBS) to be true, you need to be able to back it up. My father (and Dr. Curran) were elected to their positions by the membership of their organizations. You are accusing thousands of Doctors of selling out to BCBS, all the while offering no proof at all. But challenging me to refute it. This is a logical fallacy known as "Shifting the burden of Proof" The burden is on you to prove your allegations, otherwise they are invalid and not credible.

This statement is absurd on its face. The original story is split into three parts because it is so long. Even the introduction to this piece is probably too long and yet that is the only way I can present all of the relevant information of the story. Furthermore, this is not the only piece I have done about corruption within the Texas Medical Board. You either believe the story or you don't. I believe I have given plenty of supporting evidence to make my reporting solid. The audience can judge.



That said, if you believe this story, and furthermore, if you believe my other stories about the corruption at the TMB, it absolutely leads to troubling conclusions? I never said that doctors from small towns can't be in positions of power. I said that given the evidence I presented, we should all ask how these three got where they got. I find it very troubling that three doctors are in positions of power within the medical community all the while they are also working for the biggest insurance company in a position for which you can find scant information about.



We don't allow lawyers to represent both the plaintiff and the defendant. A lobbyist that concurrently represented a pro family group while they represented Planned Parenthood would be the subject of serious questions. Mortgage brokers can't also work for banks. By the same token, there is a serious conflict of interest if a doctor represents other doctors while they are also representing the interests of the insurance companies. That's exactly what is happening when Dr. Merian is President of the Texas Medical Association while working for the BCBS Medical Advisory Board.



Mr. Merian claims his dad is a pillar of the community and has dedicated his life to doing good. I don't doubt that however so are tens of thousands of doctors in Texas, and yet, it is his dad that concurrently was President of the TMA and part served on a board for the biggest insurance company in Texas. Given what happened to Dr. Pigott, and the role BCBS Texas Medical Advisory Board played, this should be troubling to everyone.



Then, Mr. Merian says this about the BCBS Medical Advisory Board.

A simple Google Search of the BCBSTX.com site pulled up quite a bit of information on it. Including this description:

The Texas Medical Advisory Committee and the Texas PeerReview
Committee serve in an advisory capacity to the Medical Director and HMO Blue Texas regarding health care delivery issues that affect members and participating network Physicians and other Professional Providers. The Committees participate in the development, implementation, and evaluation of required peer review activities

.


That's not quite a bit of information. In fact, this is a snippet as part of a web page related to something totally different within BCBS of Texas. This medical advisory board doesn't have its own web page. BCBS doesn't disclose who is on it and how they got there. They don't publish the minutes of the meetings. All that BCBS does is define what it is as part of a totally different web page. Again, given the role that BCBS Medical Advisory Board played within this story I find this lack of disclosure very troubling.



Then, Mr. Merian says this.

Now, it is obvious this board is not "super secret" so we will move on to
some of your other allegations against my father.You also alleged:

Three doctors, Dr. Doug Curran, Dr. Keith Miller, and Dr. Fred Merian, were simultaneously in significant positions of power in the Texas medical community. Dr. Curran was the head of the Texas Academy of Family Physicians. Dr. Miller was head of the Texas Medical Board's Disciplinary Committee. Dr. Merian was head of the Texas Medical Association. At the same time, these three were also members of the super secret BCBS Texas Medical Advisory Board. In other words, they were playing both sides of the fence. They represented the interests of doctors, and at the same time represented the interests of BCBS against doctors.Dr. Curran was not sworn in as President of the TAFP until 2006, and he served 1 year (not several years as you claimed), Dr. Miller was not appointed to the Board of Medical Examiners until 2003. And my father took his office as President of the TMA in 2002, and he also only served one year. So, you are wrong in alleging that these three men held their offices simultaneously. Also, the President of the TMA while being the visible face of Doctors in Texas, holds NO power outside the TMA. The TMA is not involved in the certification, regulation or discipline of Doctors in Texas. It is also not involved in negotiating with insurance companies for doctors, nor in
the distribution of benefits. Therefore, there is no conflict of interest. Besides, that is a determination for the TMA Board of Directors, the ethics committee and house of Delegates. Both of which were aware of my fathers position, neither of which objected.

This may technically be true, however all of this folks were in positions of power within each of organization long before they became head of each of their organizations. Again, it is just absurd to say that being President of the Texas Medical Association, which he himself says is the face of Doctors, doesn't represent doctors. Furthermore, the fact that no one objected to Dr. Merian simultaneously serving on the BCBS Medical Advisory Board should be troubling not some validation. Furthermore, while the TMA may not have been involved in discipline and certification, the TMB Disciplinary Board was, and Dr. Keith Miller was head of that for several years, while he was part of this group.

Then, Mr. Merian said this.

Physicians advisory boards advocate FOR doctors. You asked how I knew such
boards existed? Simple internet search. (and, I have worked in or around the insurance industry for over 10 years, there are all kinds of advisory boards) Here is the information for the board at Aetna Insurance. The kicker? 19 state Medical
Associations asked for such a board to be created. If such boards were so Anti-doctor, why would 700,000 Doctors demand such a board be created? They wouldn't.

This so called internet search is a google search of the words "physicians advisory board insurance". Of course, some combination of those words will come up a lot. That's how a google search works. Furthermore, if BCBS uses it in a nefarious manner it is reasonable to believe other corrupt insurance companies might want to create one as well. What's more, one paragraph after Mr. Merian painstakingly tried to convince the audience that the TMA doesn't represent doctors, he proclaims that 19 Medical Associations asked for such a board to be created. Who exactly were they representing when they asked for this?

I would also be in favor of such a medical advisory board. Only, if this board actually represented doctors, they wouldn't be a part of the insurance company. A board that looks to try to hash out the differences between doctors and insurance companies in a manner that is beneficial to both wouldn't be a part of the insurance company. Such a board would have representatives of doctors and representatives of the insurance companies working independently of either. Furthermore, their actions would be out in the open. They would have a web site. They would publish their minutes. They would publish their conclusions. This particular board does none of those things. It is very easy to take a well meaning concept and corrupt it. I never said that medical advisory boards are necessarily a bad idea. I said this one is corrupt and I proved it by several stories all split into three parts.

Furthermore, as it applies here, the board was used as a tool of intimidation. If you believe Dr. Pigott, then clearly Dr. Curran wanted her to believe that being a part of this board meant that he could damage her.

Which brings me back to the beginning. In his defense of his father, Mr. Merian never challenged any of the contents of the story. Dr. Pigott did become a leader within the community of private family physicians. She did work painstakingly to make the TAFP and the AAFP work more on behalf of private family physicians. While she was doing this, she was simultaneously brought in front of the TMB disciplinary committee because she didn't send out medical records in a timely manner. They did attempt to punish her in a draconian manner, and it was only after she identified this group within the BCBS that the TMB backed down. Those are the facts. I have backed up each of those facts.

My favorite latin phrase is Res Ipsa Loquitor, the facts speak for themselves. I believe the facts of this story speak for themselves.

Human Guinea Pigs, Sham Peer Review, and the Governor II

Introduction: Please take a look at part one of this series prior to reading this part.


The video linked here includes testimony from Tim Goosby, a nurse anesthetist, in front of Congress just a couple weeks back. Mr. Goosby is an independent registered nurse anesthetist.

Goosby's story starts in in mid 2003 when he was approached by the CEO of Cuero Community Hospital, Jim Buckner, to become the new nurse anesthetist. Cuero Community Hospital is the lone public hospital in Cuero, Texas. Cuero is a small town of only a few thousand folks, mostly Hispanics, poor, and many times illegal. The job offer came with one caveat. The hospital's other nurse anesthetist, Mark Crawford, had recently been caught stealing drugs as well as overbilling Medicare. While these were serious violations of ethics and standards, Crawford wasn't going to fired. Rather, after undergoing psychological evaluations, a temporary leave, along with other punishment, Crawford would return to the hospital and they would share duties.





Within a few month's of Crawford's return to the hospital, Goosby was approached by multiple nurses with new claims that Crawford hadn't changed his behavior. In fact, now the nurses claimed that Crawford was even doctoring prescriptions that Goosby had signed. Goosby immediately approached Crawford with the accusations.





Crawford immediately denied everything. Goosby demanded that he see all of Crawford's patient records. To this, Crawford replied

you will never see the patient records

Finally, after enough grilling, Crawford admitted to everything he was accused of. Goosby immediately went to the CEO, Jim Buckner, with what he had found. Buckner decided to arrange a meeting of all the hospital medical staff so that Goosby could present his evidence to them.





At the staff meeting, a small group of doctors, headed by Dr. Daniel Dugi and Dr. Tim Spradlin, continued to ask the same question of Goosby. Did he tell anyone outside of the hospital what he discovered about Crawford? Of course, he hadn't yet. The next day after a mysterious meeting with Dugi and Spradlin, Mark Crawford left the hospital as well as the town of Cuero never to be heard from in those parts again. (Of course, he later resurfaces in other parts of Texas as the link clearly shows).





As Goosby later found out, Dr. Dugi along with Dr. Spradlin, lead a pseudo mafioso group of doctors that became the de facto rogue administration, and the real administration was too weak to do anything to stop them. The next few months were a living professional hell for Tim Goosby courtesy of Dr. Dugi and his group of medical mafioso. They spread rumors attacking his character. They tried to turn the rest of the staff against him. All of these things were much easier to do given that Goosby was the "new guy" while Dugi, Spradlin, et al had each been at Cuero for many years. Furthermore, Goosby was now doing the work of two nurse anesthetists he was being worked to death. Cuero, like most hospitals, needs the staff's approval before any new medical staff member is hired on. Of course, Dugi made sure than no new nurse anesthetist was hired on.





Within months, Goosby found out why he was being targeted so viciously. Several nurses again approached Goosby. They claimed that Dr. Dugi was making them perform illegal drug tests on patients. Dr. Dugi was associated with a company called Activ Group, Inc. and the two entities had formed a partnership to bring the drug Providex to market. Only, according to the nurse, they weren't going through normal FDA channels to test the drug, but rather they were using the patients at Cuero as human guinea pigs.





Goosby immediately took what he learned to the hospital CEO, Jim Buckner, as well as the head of nursing at Cuero, Judy Krupala. His concerns were rejected by everyone he approached.





Meanwhile, in mid 2004, he was sent in to perform a fairly standard anesthesic procedure. A patient, who also happened to be a fellow nurse at the hospital (obviously due to doctor patient privilege the name can't be revealed), was undergoing a biopsy on his chest. Goosby was sent in to administer the anesthesia. The standard procedure in such a case for the nurse anesthetist to do two things prior to administering the anesthesia: 1) explain the consent form and have the patient sign it and 2) explain the assessment form and have the patient sign it. Goosby insists that both of these things were done just as they were done in thousands of procedures he performed prior.





Within months, this same nurse/patient accused Goosby of not providing these two forms to them. Goosby insisted to the CEO that of course he did, and he even provided the signed consent forms. The CEO backed up Goosby, however at the behest of Dugi the matter was still referred to the Texas Board of Nursing. This started an ordeal for Goosby that continues today.





What Goosby found in the TNB was an organization no less corrupt than the hospital that referred him. Unfortunately for Goosby, he had a DUI charge from a few years earlier that he failed to report to the Texas Nursing Board when he first went to work in the state. While this is a legitimate charge the normal penalty for such a failure is $250. Instead, this charge was used as the basis of what eventually lead to Goosby having to surrender his license in Texas for a year.





After receiving formal written charges, Goosby faced the board in an oral hearing known as an Informal Settlement Conference. Despite presenting the board with copies of the two forms in question and having the patient recant their story under examination, the board still ruled against Goosby. Instead, the TNB used his failure to report the DUI as the subject of an order to remove his license. Of course, such a draconian punishment goes against their own guidelines. (as I said earlier, such an infraction normally results in a $250 fine)





Goosby appealed the decision to a law judge. (this is standard procedure) In front of the law judge, Goosby's attorney referenced a prior decision, Turner Vs. Texas Board of Nursing, in which another nurse was similarly punished outside the guidelines of the case. The law judge sided with Goosby, however there is a serious problem in the manner in which the TNB operates...as Goosby would soon find out. While the law judge can make their ruling, the TNB doesn't have to accept that ruling. Ultimately, what they say is final, and the judge's ruling is only meant to be used as a guide. Of course, in the case of a corrupt board, like the TNB, such a rule puts far too much power in the hands of the corruptors.





Thus, despite having the ruling of the law judge on his side, Goosby was stuck. He could continue to appeal his punishment to the same law judge but the same corrupt nursing board would continue to reject that ruling and insist on their own. In the meantime, the long legal battle had drained nearly all of his financial resources. In fact, at one point, Goosby was approached by the TNB attorney, Liz Higginbotham, and told that they were determined to remove his license, and that he could either surrender it while he still had money or when he was broke. Goosby agreed under the condition that there be no mention that he administered anesthesia without consent or advisement, the two significant charges. Thus, in 2005, Tim Goosby lost his license to practice nursing in Texas for failing to report a prior DUI to the board.





Finally, after nearly two years of fighting the TNB, Goosby agreed to surrender his nursing license in the state of Texas for a period of one year. Of course, this opened up its own pandora's box. Once his license was removed in Texas, other states began to ask questions as well. Suddenly, his license was being threatened in a number of states including: Illinois, Colorado, and his home state of Wisconsin. Defending himself in all of these other states put further financial hardship on Goosby.





Nearly broke, Goosby was given a carrot by the state of Wisconsin. If he got his license restored in Texas, he would be allowed to work in Wisconsin. Of course, he needed to go back to the same corrupt TNB to do it. Through his attorney, he reached out to the TNB. The TNB agreed to restore his license under one condition. Goosby had to face the board and he couldn't speak.





At the hearing, the board once again accused him of administering anesthesia without consent or advisement, two things they promised to remove from his record, and then took it a step further. They now accused Goosby of being a drug addict. In his re instatement order, Goosby was accused of a laundry list of misdeeds including drug use. He was given 90 days to sign the order.





Upon the advice of colleagues, he was told under no circumstances to sign the order. Signing it would be a death sentence to his career. As soon as that order was posted on the TNB site, his license would be threatened by every other state. Instead he was told to reach out to the media. That is what he did.





As such, he became the main source for this investigative series by KPRC of Houston investigative reporter Stephen Dean's expose of illegal drug testing at Cuero Community Hospital. While Dean was painstaking in his coverage of Dr. Dugi's illegal drug testing, the corruption perpetrated at the TNB to Goosby became nothing more than an afterthought in the story.

That nurse, Timothy Goosby, is now licensed to practice in Minnesota. He said he surrendered his Texas nursing license and was forced out of his job at Cuero Community Hospital in retaliation for reporting the drug testing.

He surrendered his license for failing to disclose two drunk driving arrests when he applied for his Texas license. He told Local 2 Investigates the infraction was only discovered when the people involved in the drug testing started filing several accusations against him in response to his being a "snitch."

While Goosby refused to sign the order, the TNB put it up on their site regardless. In an ironic twist of fate, this lead to small bit of redemption for Goosby. The charges were so serious now that many other states did thorough investigations. As such, what they found was what you are reading...that the TNB orchestrated on Tim Goosby a sham peer review. In fact, the state of Illinois used the term "railroaded" in describing the case. The state of Wisconsin allowed Goosby to work in the state though his prior license revokation makes him a significant insurance liability.





Meanwhile, Jim Buckner waited until 2008 to finally speak on the record about some of the things that happened at Cuero Community Hospital. That just happened to be the statute of limitations on many of the crimes he witnessed. In the Dean expose, Buckner said that he left the hospital as a result of what he saw there regarding the drug testing. (It just apparently took him nearly five years to see it) He was replaced as CEO by a gentleman named Darly Stefka. Stefka was the head pharmacist at Cuero when the illegal drug testing was going on.

The pharmacist in charge when the drug was first added to the "formulary," or list of medicines being dispensed to patients by the hospital, has now been elevated to CEO of Cuero Community Hospital.


Darryl Stefka, Cuero Community Hospital's current CEO declined to answer questions on camera, but he insisted the drug's use was "very legitimate." When asked whether it was tested on patients without their knowledge, he answered, "I'm sure they knew."

Mark Crawford popped up on the radar of the TNB in 2007, Crawford was caught at a hospital in El Paso doing many of the same things that he did at Cuero. He was let off with a warning and a fine. There is one case that you won't find on the TNB site. Bridget Hughes was caught stealing 50 triplicate prescriptions, forging signatures, and using them for her own use. For this, her license to write prescriptions was removed for one year, but she was still allowed to keep her license to be a nurse. Hughes was the head nurse for Dr. Keith Miller, former head of the Texas Medical Board Disciplinary Committee. The disposition of her case has "mysteriously" been removed from the TNB site. (though as soon as I figure out how to transfer my copy from PDF, it will be placed back up on the internet)



Finally, Goosby took his pleas all the way to the governor's office of Rick Perry. Goosby pleaded with the governor's office to have the TNB investigated. According to a letter dated May 7, 2008, Dede Keith, (click download original attachment) in the communications office, told Goosby that the governor's office would share Goosby's concerns with Katherine Thomas, head of the Texas Board of Nursing. In other words, the Texas Governor's office thought it would be appropriate if the exact same corrupt TNB investigated itself.

Here is part three and the conclusion of the piece.