The Texas Medical Board Tolerates Child Molestors

So says this article in the Dallas Morning News.

After its last meeting, in late August, the board announced decisions on four sex-related cases. Two involved doctors whom judges had already sentenced for crimes against children. Two involved psychiatrists found to have had affairs with adult patients – potentially sexual assault under Texas law, but they've not been charged.

The child abusers were allowed to go on practicing medicine, though not with kids. The other two are working without restrictions.

It's all part of a broader pattern of tolerance for misconduct, a News analysis shows. Others who kept their licenses after the August meeting include two doctors convicted of lucrative federal crimes that put patients in harm's way; a neurosurgeon who operated on the wrong body part four times; a cardiologist found to have performed dozens of invasive procedures with little or no cause; and at least seven physicians linked to a death.

In the article, the Texas Medical Board explains this and other problems in their disciplinary process to the process itself.

The "further improvements" reference points back to 2002, when the newspaper series led to reform pledges – and to actual change. The board got money to expand its investigative and legal operations. It began examining malpractice claims, many involving patient deaths, which had been ignored for years. The number of cases resulting in discipline shot up. More doctors began to lose their licenses.

But while playing catch-up, the board also has faced a surge of new business. It granted almost 50 percent more licenses in the recently ended fiscal year than in 2002. The number of patients complaining to the board was up 35 percent.

Texas is "a favorable location to practice medicine" because of a relatively strong economy and caps on malpractice awards, board officials explained in a legislative funding request last year. The caps, which voters approved in 2003, also "may have resulted in patients who previously filed malpractice suits now turning to the state regulatory agency to resolve concerns about their care."

The TMB essentially says that with Texas having a good economy as well as favorable laws for doctors (see tort reform) that their resources are extended. In fact, I think there's a much simpler reason and that's corruption. The reason that the TMB doesn't punish bad doctors is because the TMB is filled with systemic corruption. Besides the four doctors mentioned in the piece that should have their license revoked, I'll add a few more that I know of. First, there's Dr. Dan Dugi of Cuero, Texas. In this early 2007 report, Dr. Dugi was caught by investigative reporters from Houston's KPRC of testing a drug not approved by the FDA without patients' permission.

Food and Drug Administration has launched an investigation into a mysterious medicine that was tested on patients in several small towns southwest of Houston, Local 2 Investigates reported Thursday.

The federal investigation centers around a complaint filed by a nurse anesthetist who reported that he witnessed the unapproved drug being given to patients without their knowledge or consent.

...

emphasized in an elaborate sales packet that Dugi provided to Local 2 Investigates.
Former CEO Buckner said, "When I asked him what was in this product as the active ingredient, he wouldn't disclose it, (saying) 'It's still patent pending, waiting for FDA approval,' and they couldn't share that information with us."

In the promotional literature provided to Local 2 Investigates, Dugi wrote that he had treated "well over 1000 patients" and he reported "a superior success rate" in over 90 percent of the patients he treated.

The sales pamphlet then contains 18 separate entries marked "Case Summary," spelling out how the drug performed when applied to those patients' wounds. Some of the documents are marked, "Confidential," but Dugi admitted to KPRC Local 2 that they were all his patients. Photographs and graphs illustrate the healing of the various wounds.

When KPRC Local 2 Investigates approached Dugi for answers, he invited the camera crew into a back room at one of his clinics, but he said very little.

"No filming! No filming!" Dugi said.

The main source on this story, Tim Goosby, had given all of this information and more to the TMB starting in 2003. Dr. Dugi continues in his position at Cuero Community Hospital to this day. The FDA has since removed the drug. Dugi is now being investigated by the U.S. Attorney in the area for crimes related to this and other events.

Then, there's the case of Dr. Mark Blotcky. Dr. Blotcky has had complaints to the board by three former patients that I've confirmed. The most recent complaint came within the last year. Complaints range from misdiagnosis, misuse of prescription drugs, as well as all sorts of corruption related charges related to his duties as an expert witness in the Dallas County family court system. Dr. Blotcky continues to be a practicing psychiatrist in Dallas today.

On the other side, the TMB often targets doctors for wrongdoing for marginal issues. For instance, there's the case of Dr. Bill Rea. Dr. Rea was investigated by the TMB following an anonymous complaint from a patient in 2005. Soon enough, it became obvious that the complaint was actually coming from Oxford Medical Insurance. Dr. Rea became a leader in the field of environmental medicine and was able to build his practice without accepting insurance. Dr. Rea employed the help of his roughly 30000 patients and many wrote and communicated to the TMB of his effectiveness. Still, the TMB continued to investigate Dr. Rea for the better part of three years.

I've also featured the cases of Dr. Chris Kuhne and Dr. Shirley Pigott . The TMB threatened to remove Dr. Pigott's license for not providing a set of medical tests in proper time to a patient. Dr. Kuhne had a similar situation with a patient that was changing doctors and asked for their records. When those records didn't arrive on time, the TMB went after Dr. Kuhne, in a case that wound up lasting about four years.

The long time head of the TMB disciplinary committee, Dr. Keith Miller, was removed about two years ago for charges related to corruption in his role on this committee. (It's this committee that decides punishments for the likes of Dr. Kuehne, Dr. Rea and Dr. Blotcky) In fact, TMB corruption was the subject of a Texas legislature hearings and the conclusions from the legislature were scathing.

Greetings! Three months of grueling preparation paid off handsomely as the Texas
Medical Board took one crushing blow after another from the questions of the legislators on the committee and from the testimonies from the physicians and others at the October 23, 2007 House Appropriations Subcommittee on Regulatory Hearing. This hearing was convened to investigate the abuse of power by the Texas Medical Board. It was a marathon session lasting 11-1/2 hours. Without this hearing we would not have been able to expose the corruption at the TMB. We all owe a debt of gratitude to Representative Fred Brown who, by holding this hearing, demonstrated indomitable courage and determination in the face of extreme political pressure to abandon it.

The hearing made it clear that there is an unholy cabal made up of Don Patrick, Executive Director, Mari Robinson, Director of Litigation and Enforcement, and Roberta Kalafut, President of the TMB, who have despoiled the TMB. There can be no reform without removing them from the board.

Both Kalafut and Patrick have either left the board, or in the case of Patrick retired, but Mari Robinson is still the Executive Director of the Texas Medical Board. Finally, at those hearings, Mari Robinson claimed that Dr. Chris Kuehne signed an affidavit admitting to sexual misconduct with a patient. Dr. Kuehne denied this charge to me and stated unequivocally that there is no such affidavit. Robinson, to this day, has never produced this affidavit. Since she was under oath in front of the legislature, if this is a lie, that would constitute perjury.

The article I linked at the start is the first article in a long time really lifting the veil of the TMB to come from the MSM. Still, it merely scratches the surface. It remains to be seen of the Dallas News, and the author of this piece, Brook Egerton, will stop here or follow up. There should be no shortage of stories if they choose the latter.

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.

The Nightmare of Dr. Shirley Pigott (Update)

Talk to most any competent and knowledgeable doctor and they are likely to tell you that one of the flaws of our entire health care system is that doctors negotiate with the insurance companies rather than having the individual negotiate with the insurance company. Think about that as I tell this story that starts with the video I am about to show. This is an arrest that happened September 29th, 2007. This started as a speeding ticket that ended with a violent confrontation.









The driver is Dr. Shirley Pigott. On this night she was headed to Houston Intercontinental Airport on Saturday, September 29, 2007, to attend the annual meeting of the American Academy of Family Physicians in Chicago. She was to meet Doug Curran MD, President of the Texas Academy of Family Physicians, to discuss a grievance. At the time, she was alleging that he retaliated against her by having her investigated for what she described as a trivial complaint by his cohort on the BCBS Advisory, Keith E Miller MD, who was Chairman of the TMB Disciplinary Process Review Committee. She was stopped by two Texas State Police Officers, Alfred Ochoa and Daniel Terronez. The events of that night are unclear so here is her testimony of what happened that night.

07:53 minutes: Officer Terronez goes to his car, gets in, and backs up, with the obvious intent to wedge me in.

08:31 minutes: Ochoa: "Stop! You're going to cause a [sic] accident! What are you doing?!?" I realigned myself at a 45 degree angle from the highway.

09:16 minutes: Officer Terronez walks to the right rear of my car and begins bashing the window in with his heavy flashlight. This is no emergency according to the Texas Penal Code. According to the Texas Penal Code, he is using overwhelming force.

09:18 minutes: Terronez continues his violent attack. I haltingly start off..

09:19 minutes: Ochoa: "Stop! There's
traffic coming!" Terronez continues to bash in my right rear window
violently.09:21 minutes: I pull out onto the highway, moving faster. Terronez
does not even pause, although he is facing oncoming traffic, and should have
seen the rapidly approaching 18-wheeler barreling down upon us - particularly
because Ochoa was screaming about it.

09:30 minutes: Seeing the 18-wheeler, Ochoa
yells a side-splitting exclamation: "THERE'S TRAFFIC COMING!!! YOU'RE GOING TO
GET RUN OVER!!!"

09:45 minutes: Terronez does not even pause. On the contrary,
the video shows him running after my car striking it violently, forcing me to
flee as I told him I would!

09:49 minutes: I stomp on the accelerator and almost collide with the monster truck I had not seen nor heard. If the driver had not swerved left (without slowing) and I had not swerved right, I would have been obliterated by a semi-truck hurtling down the highway at 70 mph. My children would now be orphans. As I quickly accelerate, the truck can be seen on the video flying by. The Doppler sound effect confirms its top speed. When I reach 107 mph, the car smells like it's burning so I go no faster. I continue at 107 mph for 93 seconds until I see a place that may be open for business. I slow down and see that it's not.11:22 minutes: I accelerate back up to 55 mph until
I'm inside the Wharton City Limits and see other law enforcement officers waiting as I had originally requested.

15:12 minutes: I pull over beyond the parked patrol cars and wait for the officers. To my dismay, officer Ochoa and Terronez are the ones who approach me again. I requested for one of the new officers to question me. I wait for the other officers to gather around, then get out.

Just over a year later, she was charged with a first degree felony aggravated assault with a deadly weapon against an officer in the line of duty. The same day she was first charged, her husband, Dr. Dale Pigott, killed himself. She is now facing potentially spending the rest of her life in prison.



As you should have been able to tell, everything I have just said is part of a much longer story. All of this is either the paranoid rantings of Dr. Shirley Pigott, or she has been treated for nearly eight years like no American should, and she's about to face spending the rest of her life in jail.

If you believe Dr. Pigott, here is essentially what happened. For years, she, like most private family physicians, has done battle with her main insurance carrier, Blue Cross/Blue Shield, over proper payment. She eventually formed an alliance with other private family physicians all over the country in order to stand up the insurance company's heavy handed tactics in billing. The group she lead was making headway and as a result, BCBS formed an alliance with several powerful doctors in order to commit sham peer review against Dr. Pigott. Their attempts eventually fizzled out and failed, and then she was targeted with this particular arrest.



To understand the story, here is a list of most of the main characters and their role in it.


Dr. Doug Curran is private family physician in a modest area of Texas. He is also the former head of the Texas Academy of Family Physicians and continues to be one of three members of the super secret BCBS Texas Medical Advisory Committee. The TAFP is the Texas branch of the American Academy of Family Physicians. The AAFP is the most powerful special interest group representing family physicians. Dr. Curran serves on the super secret BCBS Texas Medical Advisory Committee with two other doctors, Dr. Keith Miller and Dr. Fred Merian. Dr. Miller is currently a private family physician in Center, Texas and he was during the events in question the head of the Texas Medical Board Disciplinary Committee. That committee is in charge of judging cases of purported malfeasance by doctors in Texas. Dr. Fred Merian is the third person on the BCBS Texas Medical Advisory Committee and he was during the time in question also the head of the Texas Medical Association. The TMA is the biggest association of doctors in Texas.

Dr. Shirley Pigott is a practicing private family physician for twenty five year private family physician in Victoria, Texas. She was also during the time in question an active member in the TAFP. . Dee Whittlesey was the "physician's advocate" for BCBS during the time in question. ) Dr. Pigott went through the process of medical peer review at the Texas Medical Board. This involved a process called an informal settlement conference. This was the TMB's equivalent of a hearing and this hearing was presided by Dr. Keith Miller. The committee rendered its findings in writing, and the process of appealing these findings went through a state agency called the State Office of Administrative Hearings (SOAH).



Dr. Doug Curran was once both head of Texas Academy of Family Physicians and one of three members of the BCBS Texas Medical Advisory Committee. A few years back, he was featured in this print ad. Within months, this puff piece appeared on the internet. It featured some flattering comments from Dee Whittlesby of Blue Cross Blue Shield. Blue Cross Blue Shield carries the insurance for about one third of all Texans. As such, they have a regional monopoly for health insurance in Texas.

Now, remember what I said at the beginning. Dr. Curran is clearly in a conflict of interest. He's a member of some board on BCBS, he's featured in their advertisements, at the very same time he's head of the most powerful group representing doctors in Texas. In other words, he represents doctors at the same time he is in bed, so to speak, with the very insurance companies that he and the doctors he represents have to negotiate with.




All of this Dr. Pigott discovered during a nearly five year ordeal that was reaching its zenith when Dr. Pigott began driving toward Houston's airport to meet Dr. Curran to confront him again when she was stopped by two state police on September 29th, 2007.


For years Dr. Pigott had always had disputes with BCBS over billing.
Over the course of several meetings with other doctors in the profession, she found out that most private family physicians had similar experiences. Throughout the country members complained that they were being squeezed, intimidated, and targeted by insurance companies. Many members complained that the AAFP wasn't doing enough to represent their interests against insurance companies. After about a year, the group finally decided to stop complaining and do something about it. What eventually grew was a group of doctors that called themselves the "35 group" (because the group initially had 35 members). They formed an alliance of private family physicians that was going to demand action from the AAFP.

The "35 group"* came up with three mandates that they planned on presenting first at the state level and eventually nationally. The three mandates were as follows: 1)the AAFP was going to be more aggressive in representing the interests of family physicians, 2)it was not acceptable for insurance companies to refuse to pay for medically necessary office tests or minor procedures 3)a clearing house would be created for complaints of family physicians to be shared among members of AAFP.

These three mandates would serve as the bedrock for a new commitment for the AAFP to serve the interest of its private family doctor members more aggressively.

Dr. Pigott was put in charge of getting these three mandates through the Texas branch of the AAFP later that year in 2005. The proper procedure in the TAFP would for these three mandates to be debated in the Health Care and Managed Care Services Committee. The committee was enthusiastic about the three mandates and there was near unanimous agreement that this be moved to the full TAFP. Only one doctor argued against the resolutions - Dr. Doug Curran. Dr. Curran was not even a member of this particular committee. He was however the President Elect of the TAFP and decided to sit in on this particular hearing. At this time, Dr. Pigott had only heard of Dr. Curran, and this was her first direct contact with him. Despite Curran's dissension, the mandates passed and eventually they were passed in the national organization (AAFP) later that year.

In March of 2006, Dr. Pigott treated a peculiar patient. (due to the doctor/patient relationship the name obviously can't be revealed) The standard procedure that Dr. Pigott uses in her practice, initially, for a patient who wants her "health risks" evaluated is to take a medical history and order several basic lab tests. Then, when the tests come back, Dr. Pigott would meet with the patient to interpret the tests. It is this second appointment where Dr. Pigott would teach the patient what the tests meant and what the patient can do to improved her health risks. It is now that proper dieting, exercise, and frankly general lifestyle changes can be recommended based on the results of the tests. This particular patient didn't want any part of the second meeting. She sent Dr. Pigott's office a letter requesting that the tests be mailed to her, in violation of Dr. Pigott's policy. A second letter was more confrontational and threatened a complaint to the medical board if the tests weren't sent. According to a board rule, the patient has the right to receipt of those tests within 15 calendar days.

Because the behavior was so unusual, things unfolded before anyone realized. Dr. Pigott's administrative staff received the letters. The tests weren't sent because that is not the procedure. Dr. Pigott wasn't made aware of the letters until just more than 15 days had gone by. The tests were then sent out and no one thought about it again for a while.

In July of 2006, Dr. Pigott again prepared to present that year's mandates on behalf of the group of 35. These were several specific mandates in pursuit of accomplishing the goals of the mandates passed the previous year. Dr. Pigott expected this particular hearing to go fairly smoothly. She had been in contact with the TAFP for months, and each of the mandates had been announced to the organization. Dr. Pigott believed prior to the hearing that this would nothing more than a mere formality.

The hearing went nothing like she expected right from the start. The hearing was scheduled for two hours and it was an hour and forty five minutes before she was even allowed to speak. Each of her proposals was met with resistance. Members claimed that mandates were already being covered by other mandates, or that they had already been addressed. No matter what Dr. Pigott proposed, the committee had a confrontational response to it. Not only were each of the mandates killed but Dr. Pigott felt humiliated by the treatment of the committee. The person that was leading the charge in resisting each of these mandates was of course none other than Dr. Curran. Again, he wasn't even part of the committee, but rather decided to sit in as part of his duties as President.

Within months, several other things happened. First, Dr. Pigott was formally notified in writing of an upcoming informal settlement conference to settle a complaint by the previous patient who claimed that Dr. Pigott didn't return their lab reports in proper time.

Then, Dr. Curran appeared in the advertisement and puff piece I spoke about earlier.

Dr. Pigott found these two things to signal a gross conflict of interest. In fact, it likely violated the Texas Medical Practices Act's position on so called testimonial advertising. Dr. Pigott began reaching out to anyone that would listen. She went up the chain of command at not only the TAFP but the AAFP. She even reached out to Dee Whittelsey herself. She even made several attempts to contact Curran himself. She called Jim White and Doug Henley along with Whittelsey and Curran.

The responses ranged from no comment to simply that none of what she complained about was in fact a conflict of interest. Dr. Pigott was not satisfied. She decided to use listserve. Listserve is the intranet chat room for all members of the AAFP. She complained on listserve that she believed the advertisement, the article, along with Curran's confrontational behavior amounted to a conflict of interest.

Finally, Dr. Curran confronted Dr. Pigott directly by phone. During a twenty minute conversation, Curran vigorously defended his actions and refused to acknowledge any conflict of interest. Then, out of the blue Curran said this,

by the way, do you know I'm on the BCBS Texas Medical Advisor Commitee

By September of 2007, her case came up in the informal settlement conference in front of the disciplinary committee chaired by Dr. Keith Miller. Dr. Pigott expected nothing more than a minor slap on the wrist. After all, not sending out lab reports with 15 days (she says the lab reports got to the patient in about 20 days) is frankly the medical violations equivalent of j walking.Instead, Dr. Miller began questioning Dr. Pigott very heavily. Throughout the hearing Miller tried to get Pigott to admit to wrong doing. He asked questions like

isn't the failure to give lab reports a violation of your oath as a doctor

Dr. Pigott felt like a witness on cross examination. This simple hearing about a technical violation turned into an interrogation.

Of course, within weeks, the incident that started the story occurred.

There was typical around a six month lag time between the informal hearing and the written findings being issued and thus this portion wouldn't pick up until the beginning of March of 2007.

In one week, at the end of February and the beginning of March, three simultaneous though seemingly divorced (on the surface at least) events happened. First, she received a letter from the AAFP saying that her list serve privileges would be suspended. Then, Dr. Pigott attended a special hearing of the TAFP to discuss the concerns that she had raised about Dr. Curran. Since he had promised to cease all the activities that concerned her, Dr. Pigott had decided that it was no longer necessary to bring any mandates against him up for debate. Thus, when called, she merely said she was fine.

The TAFP, lead by Curran himself, then proceeded to charge three mandates against Dr. Pigott: 1)Dr. Pigott acted nastily and inappropriately toward Dr. Curran, 2)the Committee had treated Dr. Pigott appropriately at the 2006 meeting (when all of the mandates she brought to the floor were voted down), and 3)Dr. Pigott must write a letter to everyone she contacted regarding this matter and essentially make a mea culpa.

Then, when she got home from the meeting, she received the written findings from the TMB Disciplinary Committee. (keep in mind again that this is all over a patient not receiving lab results in fifteen but about twenty days) Here are some highlights.

Board to take disciplinary action against Respondent based upon Respondent's unprofessional or dishonorable conduct that is likely to injure the public, in particular, the disruptive behaviors that could reasonably be expected to impact the quality of her patients' care, as described in Board Rule 190.8(2)(Q).(3) [c04-Vio Rule 165 – Med Recds] Section 164.051 (a)...For a period of one year from the date of the Board's entry of this Order, Respondent's practice shall be monitored by a physician

...

The Compliance Division of the Board shall designate the monitor and may change the monitor at any time for any reason. The monitor shall have expertise in a similar specialty area as Respondent. The Compliance Division shall provide a copy of this Order to the monitor, together with other information necessary to assist the monitor

....

The Compliance Division shall select records for at least 30 patients seen by Respondent during each three-month period following the last day of the month of entry of this Order

Thus, to conclude, for being late in getting lab results, Dr. Pigott

wasunprofessional or dishonorable conduct that is likely to injure the public, in particular, the disruptive behaviors that could reasonably be expected to impact the quality of her patients' care

The punishment for this behavior included being monitored by a doctor appointed by the TMB and access to up to 30 patient's records. I believe the term draconian comes to mind when analyzing this punishment.At this point, Dr. Pigott finally realized for sure that something was rotten in Denmark, as Shakespeare might say. Dr. Pigott decided not to accept the findings. In her letter, Dr. Pigott disputed everything the disciplinary committee found and for the first time she used the term, sham peer review.

This incident is an egregious example of what is commonly termed sham peer review. Without conscience, certain members of the Board have defamed my character and have determined to cause me harm.

Sham peer review is a process by which medical peer reviews like the one that Dr. Pigott had just gone through get corrupted. They can be summarized by one simple phrase: judge, jury, and executioner. The corrupting forces usually not only bring the charges, but they are the ones presenting the charges, and also in a position to rule on them. (veterans of my work will remember the case of Dennis Lennox in which he faced his own cousin of sham peer review. The concept of judge, jury and executionor certainly applied to his case as well) In this case, while there is no proof, the patient was likely a plant, and the corrupting forces always planned to bring the case in front of Dr. Keith Miller so that he could issue this draconian charge.

She decided to investigate some of the players. The most important discovery was the discovery in the TMB website that listed in the bio of Dr. Keith Miller was his position in the BCBS Texas Medical Advisory Board. She began making inquiries to members of the TMB, TAFP, AAFP, and BCBS itself. Everyone she spoke to neither confirmed or denied his position on this panel. She shared what she had found with the TMB attorney Katie Johnonius. Johnonius was unmoved, and thus the battle would now move to SOAH, the medical peer review version of appeals courts.

Once she discovered this new information, she took everything she had and hired Austin, Texas lawyer Clark Watts. Watts took what she gave him and approached Scott Freshour, head of litigation at the TMB. (the head of litigation would take over the case from here). Freshour and Watts agreed to a reduced penalty. This penalty removed most of the draconian language but still instituted a heavy fine and other stiff measures (continuing education, lighter monitoring, etc). Pigott refused to take this. Watts approached Freshour again and this time they settled on a $500 fine and 10 hours of continuing education in patient safetyThe Group of 35, family physicians from all over the country formed to try and do three things: 1)the AAFP was going to be more aggressive in representing the interests of family physicians, 2)it was not acceptable for insurance companies to refuse to pay for medically necessary office tests or minor procedures 3)a clearing house would be created for complaints of family physicians to be shared among members of AAFP. It was the job of each member of the group of 35 to go back to their respective state's Association of Family Physicians to gain momentum for each of these three mandates. Dr. Pigott was in charge of building consensus for these three mandates in Texas. One day, while representing the Group of 35 in a committee meeting within the TAFP, Dr. Pigott first ran into Dr. Doug Curran. He was the only holdout in an idea that Dr. Pigott was presenting on behalf of the Group of 35.


At about this time, Dr. Pigott was involved with a peculiar patient. The patient demanded their blood work without making another appointment. Then, the patient filed a complaint when the X rays weren't released within the allotted time which was supposed to be 15 days. The patient got about 45 days after the appointment.


This initial complaint eventually lead to Dr. Pigott appearing in front of the Texas Medical Board Disciplinary Board then headed by Dr. Keith Miller. Dr. Miller also served on the BCBS advisory board at this time with Dr. Dough Curran. On nothing more than the ridiculous trumped up technicalities, the TMB disciplinary committee eventually heard her case early September of 2007. Eventually the committee made these fndings which included suspension of her license. At about the same time, Dr. Miller was removed from his position from the Texas Medical Board Disciplinary Committee. (Dr. Miller resigned August 31st, 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

Much of the evidence against Dr. Miller that eventually lead to his dismissal was introduced by Dr. Shirely Pigott herself. By then, Dr. Pigott had formed something called the Texas Medical Board Watch. This became one of the only watchdog groups over the TMB. Among the corruption discovered by Dr. Pigott is how the TMB looks the other way while Dr. Mark Blotcky systematically corrupts the Dallas County divorce and child custody system. They've also gone after Dr.'s Chris Kuehne and Dr. Bill Rea among a list of doctors that lists in the thousands.

Dr. Pigott, herself, was grilled in her own hearing in front of the TMB Disciplinary Committee. At one point, Dr. Miller proclaimed.

isn't the failure to give lab reports a violation of your oath as a doctor

By February of 2007, the TMB Disciplinary Comittee had delivered their findings. The initial punishment included suspension of her license, monitoring of her practice for a period of a year among several rather draconian punishments. Rather than accepting this punishment, Dr. Pigott countered with her own written response. In the response, Dr. Pigott accused the TMB of orchestrating a sham peer review against her. Dr. Pigott then hired Clark Watts, a lawyer who had once been a surgeon until he had a sham peer review orchestrated against him. She took all of the evidence against the TMB, Dr. Doug Curran and Dr. Keith Miller, and the multiple conflict of interests she discovered. The case was eventually settled with a slap in the wrist that included a few hundred dollar fine.

All of this would have finally had a happy ending for Dr. Pigott. That is until the arrest on September 29th, 2007.

Since her arrest, a new charge was brought against Dr. Pigott to the very same TMB Disciplinary Board. This time, as a result of her arrest and ultimate grand jury indictment, the TMB Disciplinary Committee, on March 24th of this year, suspended her license to practice medicine. The news of this suspension was carried in Dr. Pigott's local newspaper, the Victoria Advocate.

The action last week came after a determination that Pigott's continuation in the practice of medicine presents a continuing threat to the public welfare, according to a Texas Medical Board news release.

The action was based on Pigott's failure to comply with a previous board order, unprofessional and dishonorable conduct, and impaired mental status, according to the release.

This is all very peculiar because this particular story is the only time that Dr. Pigott appears in the Advocate. Even more peculiar is that the story has 69 comments, and counting, attached to it. That's an impressive number for a story in a major newspaper, let alone for some crime announcement in the local newspaper of a little town in Victoria. The comments are impassioned and they go both ways.


So, there is the story as condensed as I can tell it. Dr. Pigott now faces a trial date and is currently unemployed.

UPDATE:

Here the latest twist in the story.

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 III

Introduction: I will be making references that you simply won't be able to follow unless you read part one and part two. Furthermore, I will make references to other cases I have covered. I will provide a link everytime so feel free to link over and get details.

The cruelest of cruel ironies of this story is that the only thing that Tim Goosby could have done to avoid the nightmare that he found himself in is to not have taken the job in the first place. The only other way he could have avoided this nightmare is to have corrupted himself and gotten into bed with the corruptors that he blew the whistle on. Just think about that for a minute and realize that any system structured for such an outcome is one that needs a total and complete overhaul.

The most glaring problem in the system is the obscene amount of power all centered in the hands of the Texas Nursing Board. The entire appeals process beyond the nursing board in Texas is entirely to bring recommendations back to the board itself. If the TNB is corrupt (and it is), then the entire appeals process is irrelevant. In the case of Tim Goosby, a law judge ruled in his favor when he appealed the corrupt verdict. That meant absolutely nothing because the law judge's ruling was non binding. It was only meant as a guide for the TNB which always had the ultimate say. Thus, once the TNB got the motivation to punish Goosby, there was no escaping their wrath.

The second tragic and glaring weakness of the system is the total lack of protection whistle blowers have. Tim Goosby found out about ILLEGAL DRUG TESTING. That isn't merely som clerical error or finding out that someone comes in five minutes late often. Dr. Dan Dugi was testing a drug not yet approved on unsuspecting patients. Tim Goosby faced one of two choices. He either looked the other way and allow this evil to continue, or worse, he blew the whistle and wound up making his own life a living hell. If whistle blowers face absolutely no protection, then what that does is encourage corrupt behavior at hospitals all over the place. The reason that Dr. Dugi so brazenly broke the law is exactly because he knew that he could punish and eliminate anyone that tried to get in his way. The lack of protections for whistleblowers currently not in our legal system encourages the medical field to continue with the kind of corruption we see here.

Lastly, the Texas medical field is corrupt in a manner that should alarm all residents not only in Texas but in the United States. The case of Dr. Shirley Pigott revealed that Blue Cross/Blue Shield has corrupted the entire medical system in order to punish and intimidate doctors it doesn't like. BCBS is the single biggest health insurer in the state of Texas. The cases of Dr. Chris Kuhne and Dr. Bill Rea show that the Texas Medical Board has been completely corrupted and thousands of Texas doctors have faced the wrath of sham peer review as a result. Now, we have the case of Tim Goosby.

This case reveals that the Texas Nursing Board is as corrupt as the other entities, and it punishes some nurse for blowing the whistle, while protecting other nurses that have the right connection.You simply cannot have a system this corrupted with absolutely no consequences beyond "merely" those of the targeted professionals. The medical system in Texas is corrupted at every level. In the case of Dr. Shirley Pigott, BCBS employed the Texas Medical Board, Texas Medical Association, and Texas Association of Family Physicians, to orchestrate its corruption.

What this means is that nearly every single entity that is supposed to make sure that medicine is performed properly in Texas is actually corrupted and creates the opposite effect. Furthermore, the case of Tim Goosby also revealed a governor's office that's either incompetent or corrupt, but ultimately one, that is asleep at the wheel while its entire medical system is totally corrupted.

This affects all aspects of the way in which medicine is performed both in Texas and in the U.S. Everything from health insurance rates, to patient care, to medical professional competence is affected. You simply are not going to solve the "health care crisis" if this situation is not solved first. If the single biggest health care provider is allowed to corrupt the system, and every single government and professional agency is its partner, then there are no fixes unless this is fixed first.

Lastly, aren't doctors and nurses American citizens also? If they are, then I firmly believe that they deserve the same expectation of civil rights as everyone else. How would any of you reading this feel if you tried to do the right thing and as a result had the rest of your life turned into a living hell? Would you feel as though you received the same civil rights that this country was founded on? Why are we all then standing by and allowing all of these doctors to have their civil rights snatched from them by corrupt forces all over their field? To me at least, this is not the least bit acceptable, and it needs to stop immediately. It won't as long the public in general turns a blind eye to it. As the saying goes

evil flourishes when good men stand by and do nothing

Also, please check out other such stories like a doctor in South Carolina that was targeted for reporting on a serial killer nurse, a doctor in Texas targeted by Blue Cross/Blue Shield, the Texas Medical Board's systematic targeting of doctors, and of course the one that started it all the tragic case of obscene corruption at Atlanta's Grady Hospital. Please read them all and demand that action be taken so that the scourge of sham peer review ends.