The Texas Medical Board Vs. Doctors...More Corruption in Texas I

This past week, I introduced a case of corruption in health care in Texas. The particular case I discovered is only the opening of a pandora's box of curruption that has its nexus in the Texas Medical Board. In 2002, The Dallas Morning News ran a series of articles that wound up having all sorts of unintended consequences.

In 2002 a series of stories in The Dallas Morning News detailed the board's reluctance to punish doctors who sexually assaulted patients or whose repeated mistakes injured or killed patients. The Legislature responded by strengthening the board's regulatory powers and giving it more money for investigators. The number of disciplinary actions brought against physicians by the board nearly tripled from 2001 to 2007.

The Dallas Morning News series was a well meaninged attempt to point out that the Texas Medical Board was not strenuously pursuing its duty in holding bad and irresponsible doctors responsible. It lead to not only a massive increase in the TMB budget but also a license for aggressive action.

Unfortunately, the unintended consequences were that the TMB wound up being corrupted and sources I have spoken with believe that thousands of doctors may have been the victim of a process known as sham peer review. Up until the summer of last year, the nexus of this corruption was a gentleman named Dr. Keith Miller. Those that have read my previous series know that Miller is a small town doctor, head of the TMB's Disciplinary Committee, and also a member of the super secret Blue Cross/Blue Shield Texas Medical Advisory Board. We will likely never know the extent of his entire body of corruption however here is a summary of why he was forced off the board last year.

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.

Miller's resignation was merely the tip of the ice berg in resignations of corrupt individuals on the TMB. Earlier this year, TMB executive director announced his retirement.

At today’s meeting of the Executive Committee of the Texas Medical Board, Donald Patrick, M.D., J.D., announced that he will retire from his position as Executive Director on August 28, his 70th birthday.

He did so under a cloud of suspicion. Back in October of 2007, the higher ups at the TMB showed up for Senate hearings in which they thought that their yearly budget was going to be discussed. They were blind sided when a plethora of doctors were called to give testimony about conflicts of interest, abuse of power, and incidents of sham peer review.

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.

Because there are likely so many victims, the motivations ranged. Because Miller simultaneously held the dual position as head of the Disciplinary Committee and henchman for BCBS, many times he was simply doing the dirty work of the insurance company, including the incident I wrote about in my first series. It is also rumored that in the aftermath of the 2002 article, the TMB created quotas for prosecutions, and so it is likely some doctors may in fact have been targeted because the TMB simply hadn't convicted enough doctors yet.

The poster child, so to speak, for the victim of the TMB corruption is Dr. Bill Rea. Dr. Rea is a leader in the innovative field of environmental medicine. He was trained at the prestigious Parkland Hospital in Dallas, Texas. Furthermore, he doesn't accept insurance from his patients. This is important because Dr. Rea's patients then take their bills and contact their insurance companies themselves after they have paid Dr. Rea. Unlike most doctors, this gives Dr. Rea a great deal of power against insurance companies that other doctors don't have. Whereas insurance companies can simply kick a doctor out of their network if they become too expensive or too much hassle, kicking out their patients leads directly to their own lower bottom line.

This set up is important because the complaints against came from anonymous sources. Dr. Rea estimated that he has treated over 30,000 patients and has been practicing medicine for decades. Up until these anonymous sources complained, he had the overwhelming respect of his patients. In fact, once word spread of the charges against Dr. Rea, many of his patients wrote letters to the TMB in support of their doctor. So called anonymous sources are standard operating procedures for corrupt medical review boards and their corrupt partners. In fact, here is the hypothesis from Dr. Rea himself.

The complaint against me was almost certainly made by United Health Care/Oxford. All five patients cited in thecomplaint had no knowledge that they or their information was being used in this way. Further, none of the patients are alleging mistreatment or malpractice against me and all five are still under my care. Additionally, these patients have allwritten to the Texas Medical Board and informed them that they are not part ofthis complaint and they are not making any allegations against me of any kind.

Two of the patients have stated that I saved their lives.The Texas Medical Board has dismissed the protests of these patients andcontinues to pursue charges against me. Further, the board refuses to officiallyreveal who made the complaint, what I am alleged to have done, or what evidencewas presented against me. They continually maintain that this information isprotected and does not have to be revealed.

However, we are almost certain that United Health Care/Oxford is behind the complaint. All five patients were from Manhattan (New York City), New Yorkand all had the same insurance company - United Health Care/Oxford. As youknow, our clinic does not take insurance, so all patients file claims directly with their respective insurance companies. We therefore do not have any direct connection with this insurance company. Evidence showing these facts was supplied to the Texas Medical Board, but was apparently disregarded as they have decided to pursue the charges despite the evidence.

The nature of an anonymous source is such that the truth will never be known about who it was that initiated the complaint and what their motivation was. What cannot be argued is that Dr. Rea's patients came to his defense in an overwhelming manner. It cannot be argued that Dr. Rea achieved a terrific professional reputation prior to these charges. Furthermore Dr. Rea presented 18 expert witnesses at his hearing that all said his treatment was entirely within ethical guidelines.

The TMB’s attorney informed Dr. Rea’s attorney that it didn’t matter what was said or what evidence was presented, Dr. Rea’s license would be revoked. Despite the fact that 18 physicians evaluated and approved of Dr. Rea’s treatment, one hired board expert denigrated it. At the end of the sham review hearing, Dr. Miller recommended that Dr. Rea’s license be revoked.

Dr. Rea continues to fight these charges at a great personal and financial cost to him. (for a complete wrap up of the unbelievable corruption in the case of Dr. Bill Rea take a look at this link)

While Dr. Rea's case has received a great deal of media attention, there are likely thousands of more doctors that have been wronged by the TMB who's story has not received the attention they deserve.

Furthermore, if you take a look at the links, you will find none that are linked to any major media source. While the Dallas Morning News was all too eager to point out when the TMB was not performing their job strenuously enough, they, along with their media partners, were totally asleep at the wheel when the results of their story lead to such an overreach.

In fact, this story has largely been driven Dr. Steven Hotze, the American Academy of Physicians and Surgeons, Texas Medical Board Watch. All of these folks have done yoeman's work in exposing this corruption, they have in effect done the job that the media was supposed to do. Much of this corruption goes back to 2003 and even before, and yet much of it has only come to light within the last year. Furthermore, while many bad apples, like Miller, have been dealt with, the public at large is mostly unaware at the obscene level of corruption he and his cohorts have committed. This can and must be laid directly at the feet of the media in Texas who's job it is to make sure this sort of corruption is exposed.

The fact that the Dallas Morning News was all too willing to bring to light a lack of action on the part of the TMB, but totally uninterested in the corruption that the story started is not only shameful but downright dangerous.

In part 2, I will put my direct focus on another case of sham peer review at the TMB that has received absolutely no media attention.

Please follow this link for part two of this story.