The Texas Medical Board (TMB) licenses and regulates physicians and other medical professionals. Part of those duties involve receiving and investigating complaints about these medical professionals. The TMB also brings formal disciplinary action against those professionals if there is sufficient evidence to believe they have violated the rules or laws that govern their professions.
Obtaining experienced legal counsel to represent your interests in disciplinary proceedings before the TMB can be a substantial step in reaching a positive outcome in your case. Therefore, if you are facing disciplinary investigations, complaints, or formal proceedings before the Board, you should consult a medical license defense attorney for help.
Understanding the Corporate Practice of Medicine
22 Tex. Admin. Code §177.17 outlines the legal doctrine of the corporate practice of medicine, which generally prohibits corporations, entities, or non-physician individuals from practicing medicine. Furthermore, no individuals or entities can advertise or indicate in any way that they are licensed to practice medicine in Texas if they are not licensed to do so.
The purpose of this doctrine is to preserve the doctor-patient relationships and prevent the abuse that can result from corporations controlled by non-physicians that employ licensed physicians to practice medicine. As a result of laws concerning the corporate practice of medicine, any policies concerning medical decision-making must include physician participation, input, and approval.
Even while employed by such an entity, a physician is solely responsible for making medical decisions for their patient, including meeting the required standard of care. A physician must be free to use their medical judgment without any interference from their employer.
However, §177.17 specifically identifies entities that are entitled to employ a physician and retain all or part of the professional income generated by that physician for medical services provided, so long as the requirements of the physician employment enabling statute are satisfied. In other words, these entities are exempt from the rules barring the corporate practice of medicine. These entities include:
- A hospital that primarily provides medical care to children younger than 18 years of age as provided under §311.061 of the Health and Safety Code, and that:
- Is owned or operated by a nonprofit fraternal organization; or
- Has a governing body the majority of members of which belong to a nonprofit fraternal organization;
- A hospital, including health care facilities owned or operated by the hospital, that is:
- Designated as a critical access hospital under the authority of and in compliance with 42 U.S.C. §1395i-4;
- A sole community hospital, as that term is defined by 42 U.S.C. §1395ww(d)(5)(D)(iii); or
- Located in a county with a population of 50,000 or less;
- Commissioners court of a county with a population of 3.3 million or more for the purpose of providing health care services to inmates in the custody of the sheriff;
- U.S. Government and Military Forces;
- Private nonprofit medical school (Texas Occupations Cnonprofiter 162);
- School districts (Texas Education Code, §33.208 and §38.016);
- State institutions:
- Academic institution as defined under §172.8 of this title (relating to Faculty Temporary Permits);
- State hospitals as defined under Chapter 552 of the Texas Health and Safety Code; and
- Prisons;
- Rural health clinics operated in accordance with 42 CFR 491.8 of the Rural Health Services Clinic Act; and
- Various city and county hospitals listed by name in this section.
Prohibited Practices Involving the Corporate Practice of Medicine
The ban on the corporate practice of medicine implicates various prohibited practices that could lead to disciplinary action. First, on a basic level, a person may only practice medicine in Texas if they hold a license issued by TMB. A person is ineligible for a medical license unless they meet specific requirements, which only an individual – not an entity – could meet. Therefore, an entity attempting to practice medicine is prohibited by the most elemental provisions of the Texas Medical Practice Act.
Furthermore, Tex. Occ. Code §157.001 allows a physician to delegate the performance of a medical act to a properly trained person under their supervision in certain circumstances. However, the person to whom the delegation is made may not represent to the public that they are licensed to practice medicine.
Likewise, under Tex. Occ. Code §164.052(a)(13), a physician commits a prohibited practice if they “impersonate[s] a physician or permit[s] another to use the person’s license or certificate to practice medicine in this state.” Next, under Tex. Occ. Code §164.052(a)(17), physicians may not “directly or indirectly aids or abets the practice of medicine by a person, partnership, association, or corporation that is not licensed to practice medicine by the board.”
Finally, Tex. Occ. Code §165.156 prohibits misrepresentation of entitlement to practice medicine. This code section states:
A person, partnership, trust, association, or corporation commits an offense if the person, partnership, trust, association, or corporation, through the use of any letters, words, or terms affixed on stationery or on advertisements, or in any other manner, indicates that the person, partnership, trust, association, or corporation is entitled to practice medicine if the person, partnership, trust, association, or corporation is not licensed to do so.
TMB Complaints Concerning the Corporate Practice of Medicine
The TMB receives complaints about the corporate practice of medicine just as it receives complaints about any other alleged violation of the Texas Medical Practice Act or other relevant laws or rules. When receiving such a complaint, the TMB will process, review, and investigate it like any other complaint.
We Can Advocate for Your Interests in TMB Disciplinary Proceedings
The medical license defense lawyers of Bertolino LLP can help guide you through the disciplinary complaint process. Regardless of the allegations you face, we are here to represent your interests and work to minimize the negative effects of a complaint on your medical professional license and career. We can help resolve the case against you and maintain your licensure or certification. Call us today at (512) 980-3751 to reach the offices of Bertolino LLP or contact us online.
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