How to eliminate sham peer review at the Texas Medical Board

Mr. Webb is a member of the Texas Medical Board. He practices criminal law in Houston.



Dear Mr. Webb,

I am still alive and well and am committed more than ever to reforming the Texas Medical Board.

The board should move toward a different way to evaluate complaints. This is not something which could be done overnight and should, I believe, start with volunteer physicians. Eventually, every physician in the state (licensed or not, under orders or not) as a condition for licensure, should participate unpaid in free CME toward this end. The board should oversee the process.

The board would make the following provisions:

1. There must be a failsafe way to ensure that every complaint, jurisdictional or not, is logged in and assigned a case number. The case numbers must be sequential and unchangeable; the complaints initially should be separated into one of two categories: jurisdictional or non-jurisdictional

2. Whether or not the board has jurisdiction should be determined by one criterion only: Is the physician licensed? If the physician is licensed, the complaint is jurisdictional and should be filed under "Jurisdictional complaints".

3. Non-jurisdictional complaints should also be assigned sequential and unchangeable case numbers and go to volunteer physician reviewers to determine:

a. their "significance" or "relevance"
b. the answer to the question "could the health of Texans be improved if this complaint were addressed effectively?"
c. what group(s), or state or private entities could be approached to address the complaint properly? a House Committee? another state agency? a federal agency? the FBI?
d. the board would oversee the process by making sure that each non-jurisdictional complaint is appropriately addressed depending on its significance.

4. Jurisdictional complaints should be handled similarly: they should be assigned sequential and unalterable case numbers, logged in, and go to volunteer physician reviewers to determine:

a. their "significance" or "relevance"
b. the answer to the question "could the health of Texans be improved if this complaint were addressed?"
c. what group(s), state or private entities, could be approached to address the complaint most effectively?
d. what process(es) should be used to address the complaint?

I reference Amendments IV, VI, and XIV of the United States Constitution.

Amendment VI of the United States Constitution states:

In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the state and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the assistance of counsel for his defense.

Complaints against a physician's license initiate quasi-criminal proceedings, so there is great potential for abuse. The board, in my opinion, in its duty to fulfill its mission, has a duty to protect physicians from abuse, but has utterly failed to do so.

Amendment XIV states, in part:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within itsjurisdiction the equal protection of the laws.


Amendment IV states:


The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.


Process changes which the board has the power to make include:

1. Every complaint should be accompanied by a probable cause affidavit and the complainant identified.
2. The complainant should propose a solution such as:
a. talking to the physician face to face alone or with a mediator
b. can the complainant identify a process which if corrected could have prevented the problem?
c. can the respondent physician identify a process which if corrected could have prevented the problem?
3. The physician should propose a solution.
4. The board should move in the direction of acting on the complainant's and physician's proposals.
5. Invite physicians and patients to bring their successes to the whole board for recognition
6. Encourage the media to report on significant successes.

I would like to present an overview of this to the board at its next meeting during the time allotted for public testimony.

The Texas Medical Board is under considerable public scrutiny within Texas and nationally. Taking steps like I have described would set a positive precedent nationwide for reform.

I have taken the liberty of posting this letter on my scribd site and on my blog.

Sincerely,

Shirley Pigott MD
Texas Medical Board Watch
Texas Phoenix 007
scribd Shirley Pigott MD
361-894-6464 home
361-652-9474 cell