Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 9 - TEXAS MEDICAL BOARD › Chapter 190 - DISCIPLINARY GUIDELINES › Subchapter B - VIOLATION GUIDELINES › Section 190.8 - Violation Guidelines

Current through Reg. 49, No. 28; July 12, 2024
When substantiated by credible evidence, the following
					 acts, practices, and conduct are considered to be violations of the Act. The
					 following shall not be considered an exhaustive or exclusive listing.
(1) Practice Inconsistent with Public Health
				  and Welfare. Failure to practice in an acceptable professional manner
				  consistent with public health and welfare within the meaning of the Act
				  includes, but is not limited to:
(A) failure
				  to treat a patient according to the generally accepted standard of
				  care;
(B) negligence in performing
				  medical services;
(C) failure to
				  use proper diligence in one's professional practice;
(D) failure to safeguard against potential
				  complications;
(E) improper
				  utilization review;
(F) failure to
				  timely respond in person when on-call or when requested by emergency room or
				  hospital staff;
(G) failure to
				  disclose reasonably foreseeable side effects of a procedure or
				  treatment;
(H) failure to disclose
				  reasonable alternative treatments to a proposed procedure or
				  treatment;
(I) failure to obtain
				  informed consent from the patient or other person authorized by law to consent
				  to treatment on the patient's behalf before performing tests, treatments,
				  procedures, or autopsies as required under Chapter 49 of the Code of Criminal
				  Procedure;
(J) termination of
				  patient care without providing reasonable notice to the patient;
(K) prescription or administration of a drug
				  in a manner that is not in compliance with Chapter 200 of this title (relating
				  to Standards for Physicians Practicing Complementary and Alternative Medicine)
				  or, that is either not approved by the Food and Drug Administration (FDA) for
				  use in human beings or does not meet standards for off-label use, unless an
				  exemption has otherwise been obtained from the FDA;
(L) prescription of any dangerous drug or
				  controlled substance without first establishing a valid practitioner-patient
				  relationship. Establishing a practitioner-patient relationship is not required
				  for:
(i) a physician to prescribe medications
				  for sexually transmitted diseases for partners of the physician's established
				  patient, if the physician determines that the patient may have been infected
				  with a sexually transmitted disease; or
(ii) a physician to prescribe dangerous drugs
				  and/or vaccines for post-exposure prophylaxis of disease for close contacts of
				  a patient if the physician diagnoses the patient with one or more of the
				  following infectious diseases listed in subclauses (I) - (VII) of this clause,
				  or is providing public health medical services pursuant to a memorandum of
				  understanding entered into between the board and the Department of State Health
				  Services. For the purpose of this clause, a "close contact" is defined as a
				  member of the patient's household or any person with significant exposure to
				  the patient for whom post-exposure prophylaxis is recommended by the Centers
				  for Disease Control and Prevention, Texas Department of State Health Services,
				  or local health department or authority ("local health authority or department"
				  as defined under Chapter 81 of the Texas Health and Safety Code). The physician
				  must document the treatment provided to the patient's close contact(s) in the
				  patient's medical record. Such documentation at a minimum must include the
				  close contact's name, drug prescribed, and the date that the prescription was
				  provided.
(I) Influenza;
(II) Invasive Haemophilus influenzae Type
				  B;
(III) Meningococcal
				  disease;
(IV) Pertussis;
(V) Scabies;
(VI) Varicella zoster; or
(VII) a communicable disease determined by
				  the Texas Department of State Health Services to:
(-a-) present an immediate threat of a high
				  risk of death or serious long-term disability to a large number of people;
				  and
(-b-) create a substantial risk
				  of public exposure because of the disease's high level of contagion or the
				  method by which the disease is
				  transmitted.
(M) inappropriate prescription of dangerous
				  drugs or controlled substances to oneself, family members, or others in which
				  there is a close personal relationship that would include the following:
(i) prescribing or administering dangerous
				  drugs or controlled substances without taking an adequate history, performing a
				  proper physical examination, and creating and maintaining adequate records;
				  and
(ii) prescribing controlled
				  substances in the absence of immediate need. "Immediate need" shall be
				  considered no more than 72 hours.
(N) providing on-call back-up by a person who
				  is not licensed to practice medicine in this state or who does not have
				  adequate training and experience.
(O) delegating the performance of nerve
				  conduction studies to a person who is not licensed as a physician or physical
				  therapist without:
(i) first selecting the
				  appropriate nerve conductions to be performed;
(ii) ensuring that the person performing the
				  study is adequately trained;
(iii)
				  being onsite during the performance of the study; and
(iv) being immediately available to provide
				  the person with assistance and direction.