Safeguarding the public through professional accountability.

These words will soon begin to appear on Medical Board publications, its booth display for trade shows, and it is already on our home page. We arrived at this slogan through the combined efforts of several Medical Board staff members who brainstormed ideas to get what we do into a very few words.

But words are just abstract marks on the page if they don't have any value behind them. Does this amount to a slick new advertising campaign? How can we as a regulatory agency give these words real heft?

Let's break the slogan down:

"Safeguarding the public..." How do we safeguard the public, the citizens of Texas? When we receive a complaint from a member of that public, what happens? First, we make sure we have all the facts by contacting the complainant and the physician (or other health professional) and giving each a chance to elaborate on the facts in the initial complaint. Then we make sure we have every piece of information we need to document the complaint and determine if it is valid. Our investigators, both in the field and in Austin, are experts at evaluating this information. Then we use expert physician panels to further determine whether there is a violation. Once that process is complete, we turn the case over to our able attorneys, who pursue litigation and assist the board in taking appropriate disciplinary action when warranted.

All this takes time, and some might argue that the public isn't being protected in the meantime. But if we learn of a physician whose practice is so dangerous as to present a threat to the public, we quickly convene a temporary suspension hearing and immediately stop the physician from harming patients.

In a nutshell, that's how we safeguard the public.

"...through professional accountability." Accountability has become such a watchword in recent years as to be nearly a cliche, but there is a reason. All of our institutions have been called to account in recent years, from religious institutions to schools to politicians to regulators, and the medical profession, which once enjoyed virtually unquestioned respect, has not been immune from that scrutiny.

Long gone are the days when the kindly family doctor arrived at the front door with his black bag (and it was nearly always "his"). Because of managed care and job migration, people often change doctors every few years, making a close loyal relationship much rarer.

Managed care has also put additional stresses on physicians, making the other side of this two-way relationship more difficult as they wrestle with ever-heavier workloads and necessary paperwork.

For many years, the Texas Medical Board had a reputation as a "good ol' boy" network of physicians protecting their own. The era of accountability hit this board right between the eyes in the form of a series by the Dallas Morning News in 2002, which got my attention, the attention of the board members, and the attention of the Legislature. We basically got an ultimatum that made us accountable, or else.

The board rose to the challenge, and the agency followed suit. We made the licensure process more efficient while still making sure that only qualified physicians are allowed to practice medicine in Texas. We took more disciplinary actions while making that process more efficient, and also eliminating a backlog of moribund cases.

How does this make the profession accountable? Ask the physician who is under an order for substance problems when he's calling in every morning to find out if his color has come up and it's his day for drug-testing. Ask the physician who has been sent for additional training or who has to go away to take a course on respecting boundaries. Ask the patients who have been harmed or who have lost loved ones to an incompetent physician who has been removed from practice. Or the patient who receives an apology from the physician who has behaved inappropriately.

We're not perfect, and there is still a long way to go to achieve accountability in certain areas of the medical profession. So I consider our slogan a process, a goal, rather than an achievement. But we are moving in the right direction, thanks to the hard work and dedication of our staff and the board.

March, 2006