Medical
Board Report
Newsletter of the Texas State Board of Medical Examiners
Spring 1999
Volume 20, Number 2CONTENTS:
Frequently Asked Questions
District Review Committees
Formal Complaints
Disciplinary Actions
Texas Medicaid Drug Review
Mammography Info
Controlled Substances Fees
Texas Docs in the News
Renewal Page
Board Rule Changes
CME Information (includes Statement Regarding Advertising for CME)
Letter to HCEs
Physician Assistant Info
Disabled Person License Plates
Practitioner, heal thyself: Coping with stress in clinical practice
By W. Walter Menninger, M.D.Permission for web publication of this article was not granted. To receive a printed copy of the newsletter, write to the board at MC 251, P.O. Box 2018, Austin TX 78768; call (512) 305-7018; or e-mail jill.wiggins@tmb.state.tx.us
Frequently Asked Questions
Q. What information resources are available for foreign medical graduates trying to become licensed in the U.S.?A. Graduates of international medical schools are sometimes frustrated about the process of matching to postgraduate training programs in the U.S. It can be difficult for someone outside the U.S. to determine which agency to contact and understand the roles the Educational Commission for Foreign Medical Graduates, the National Resident Matching Program and the state medical boards play in the match process.
Information for international medical graduates is available from ECFMG and NRMP both through conventional channels and on the Internet. ECFMG distributes its "Information Bulletin" to U.S. embassies and consulates worldwide. This bulletin describes the match process and directs physicians to the NRMP. Information can be obtained by writing NRMP, 2501 M Street NW, Ste. 1, Washington DC 20037-1307.
A wealth of information is available on these organizations' web sites. The ECFMG's web address is http://www.ecfmg.org, and NRMP can be found at http://www.nrmp.org.
District Review Committees
Established by Section 5.03 of the Medical Practice Act and Board Rules, Chapter 191, there are four District Review Committees, each representing a geographic area of Texas. The members may serve the board in several ways, such as providing public information functions and reviewing investigative files. Their duties consist primarily of serving as panel members for informal settlement conferences, at which they hear cases and make recommendations to the Board.The Medical Practice Act requires that each committee be composed of five persons appointed to a six-year term by the governor and that three members must be M.D.s, one must be a D.O. and one must be a public member.
Following are the current DRC members:
DRC 1: A. David Axelrad, M.D., Bellaire; Herman Lott Koester, M.D., La Marque; Thomas A. Reiser, Houston; Kevin R. Smith, M.D., Houston; Frank R. Wellborne, D.O., Houston.
DRC 2: David Baucom, Sulphur Springs; H. Jane Chihal, M.D., Carrollton; Allan N. Shulkin, M.D., Dallas; Buddy Roger Siebenlist, M.D., Jonesville; Rodney M. Wiseman, D.O., Whitehouse.
DRC 3: Victor A. Diaz, M.D., El Paso; Robert C. Henderson, M.D., Amarillo; Thomas Lionel Marvelli, M.D., Fort Worth; Robert Allan Watson, Fort Worth; Irvin E. Zeitler, Jr., D.O., San Angelo.
DRC 4: Julian Gomez III, M.D., McAllen; Manuel G. Guajardo, M.D., Brownsville; Larry Hufford, Ph.D., San Antonio; Leah Raye Mabry, M.D., San Antonio; Ann Nolen, D.O., La Grange.
Formal Complaints
The following formal Complaints were filed with the State Office of Administrative Hearings since the last publication of The Medical Board Report regarding the licensees listed below:Physicians Date filed Alleged statutory violations
Herbert R. Melt, M.D. 2-17-99 3.08(4)(E) and 3.08(18)Mary Francis Slahetka, M.D. 3-17-99 3.08(5)
David William Davis, D.O. 3-26-99 3.08(4)(E) and 3.08(4)(F)
Michael Earl Tyler, M.D. 3-31-99 3.08(4), 3.08(4)(E), 3.08(4)(F) and 3.08(18)
Acupuncturist
Lam Vuu 10-9-98 6.11(a)(4) and 6.11(a)(5)The filing of a formal Complaint merely indicates that allegations are being made against the licensee. Licensees are entitled to a contested case hearing on the allegations above before a determination of violations of the Medical Practice Act is made by the Board. Subsequent to any determinations by the Board, adverse findings to the licensee are subject to appeal procedures.
Texas Medicaid Drug Use Review
By Jennifer Seltzer, Pharm. D.A new class of nonsteroidal anti-inflammatory drugs (NSAIDs) designed to reduce inflamma tion and pain by selectively inhibiting cyclooxygenase 2 has been discovered. It has been accepted that aspirin and NSAIDs exert anti-inflammatory and analgesic effects by inhibiting the activity of cyclooxygenase, which regulates the conversion of arachadonic acid to prostaglandins, the main constituents in the inflammatory process and pain production. Recently, two forms of cyclooxygenase have been identified: cyclooxygenase 1 (COX-1), which is located extensively in tissues throughout the body, including the gastrointestinal (GI) tract and platelets, and is thought to protect the gastric mucosa; and, cyclooxygenase 2 (COX-2), which is found primarily in inflamed tissue, as well as in healthy tissue, especially the brain and kidneys. This finding implies that NSAIDs exert anti-inflammatory effects through inhibition of COX-2 while gastrointestinal ulceration and hemorrhagic complications are due to interference with COX-1. Celecoxib (Celebrex®), the first COX-2 selective NSAID, has recently been approved by the FDA to relieve signs and symptoms of osteoarthritis and rheumatoid arthritis. Celecoxib is available in 100 mg and 200 mg capsules. Dosages of 100 mg twice daily or 200 mg once daily are utilized to manage osteoarthritis while doses of 100 to 200 mg twice daily are prescribed to manage rheumatoid arthritis. Short-term studies have shown that celecoxib produces fewer ulcers than older NSAIDs; however, these data do not prove that long-term treatment with COX-2 inhibitors like celecoxib will be associated with a lower incidence of GI bleeding and serious ulcers. Celecoxib has not been shown to inhibit platelet aggregation. Preliminary studies suggest that celecoxib does not interact with warfarin. Celecoxib is structurally similar to sulfonamides; therefore, patients with sulfa allergies should avoid using this agent. Celecoxib offers the potential to control the arthritis pain and inflammation with the possibility of fewer gastrointestinal adverse effects.
1. Celecoxib for arthritis. Med Lett Drugs Ther 1999;41:11-12.
2. Simon LS, Lanza FL, Lipsky PE, Hubbard RC, Talwalker S, Schwartz BD, et al. Preliminary study of the safety and efficacy of SC-58635, a novel cyclooxygenase 2 inhibitor. Arthritis & Rheumatism 1998;41:1591-1602.
3. Lipsky PE, Isakson PC. Outcome of specific COX-2 inhibition in rheumatoid arthritis. J Rheumatol 1997;24 Suppl 49:9-14.
4. Doctor's Guide to Medical & Other News. Celebrex now available in the U.S. for arthritis treatment. http://www.pslgroup.com/dg/E7042.htm
Rebetron®, a combination of Rebetol® (ribavirin) and Intron® A (interferon alfa-2b, recombinant), has recently been approved for use in patients diagnosed with hepatitis C who have not received prior treatment. Recent studies have shown that combination therapy with Rebetol® and Intron® A produced a significant increase in the number of patients showing a sustained loss of hepatitis C virus compared to patients receiving standard alpha interferon as monotherapy. Rebetron® combination therapy is also indicated for use in chronic hepatitis C patients with compensated liver disease who have relapsed following alpha interferon monotherapy. Recommended dosages for Rebetron® combination therapy include 3MIU of Intron® A administered subcutaneously three times weekly in conjunction with 1000 to 1200 mg of Rebetol® capsules administered orally in a divided daily dose given in the morning and evening. Patients weighing 75 kg or less should receive 1000 mg Rebetol® daily while patients weighing more than 75 kg should receive Rebetol® 1200 mg daily. Duration of therapy for patients previously untreated with interferon is 24 to 48 weeks while the treatment duration for patients who have relapsed following interferon therapy is 24 weeks. A black box warning has been assigned to the Rebetron® package insert instructing patients and their partners to use two forms of contraception during therapy with Rebetron® due to the risk of birth defects or loss of a pregnancy. The ribavirin component of the treatment regimen is targeted as the culprit for increasing risks to the fetus.
1. Doctor's Guide to Medical & Other News. FDA approves Rebetron for previously-untreated hepatitis C patients. http://www.pslgroup.com/dg/D059E.htm
2. Poynard T, Marcellin P, Lee SS, Niederau C, Minuk GS, Ideo G, et al. Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. International Hepatitis Interventional Therapy Group (IHIT). Lancet 1998;352:1426-32.
3. Doctor's Guide to Medical & Other News. New warnings placed on Rebetron Hepatitis therapy. http://www.pslgroup.com/dg/e63f2.htm
Physicians need to be aware that Neoral® (cyclosporine for microemulsion) and Sandimmune® (cyclosporine, USP) are not interchangeable. There have been reports of substitution of the two different formulations of cyclosporine, resulting in potentially serious medical consequences for patients. Neoral® and Sandimmune® are not bioequivalent and therefore not interchangeable. Safe conversion between these formulations often involves dose adjustments and frequent blood level monitoring. Physicians should specify the intended formulation on prescriptions for oral cyclosporine to avoid confusion as to which product is being prescribed. Additional information regarding this issue can be obtained by calling (800) 631-8184.
Revisions in the troglitazone (Rezulin®) package insert have been made to incorporate warnings related to hepatocellular injury. Troglitazone lowers blood glucose by improving target cell response to insulin and is approved to manage type 2 diabetes either alone or in combination with a sulfonylurea or insulin. Isolated cases of idiosyncratic hepatocellular injury have been reported following troglitazone use. These hepatic effects are usually reversible following drug discontinuation, although a small percentage of patients have developed hepatic failure and subsequently died or required liver transplant. Therefore, a black box warning has been added to the troglitazone package insert alerting health care professionals and patients to this significant adverse reaction. Assessment of serum transaminase levels is recommended prior to therapy, monthly for the first six months of therapy, every two months for the remainder of the first year of therapy, periodically thereafter, and at the first symptoms suggestive of hepatic dysfunction.
1. Watkins PB, Whitcomb RB. Hepatic dysfunction associated with troglitazone. N Engl J Med 1998;338:916-7.
2. Gitlin N, Julie NL, Spurr CL, Lim K, Juarbe HM. Two cases of severe clinical and histologic hepatotoxicity associated with troglitazone. Ann Intern Med 1998;129:36-8.
3. Product Information. Troglitazone (Rezulin®). Morris Plains, NJ: Parke-Davis, June 1998.
Oral dolasetron(Anzemet®), granisetron(Kytril®) , and ondansetron(Zofran®) are not indicated for use in controlling generalized nausea and vomiting. Dolasetron, granisetron, and ondansetron, also known as serotonin type 3 (5-HT3) receptor antagonists, are antinausea/antiemetic agents. Oral dolasetron is indicated for use in control of cancer chemotherapy-induced nausea and vomiting, and prevention of postoperative nausea and vomiting. Oral granisetron is utilized in the management of cancer chemotherapy-induced nausea and vomiting. Oral ondansetron is indicated for use in control of cancer chemotherapy-induced nausea and vomiting, prevention of postoperative nausea and vomiting, and radiotherapy-induced nausea and vomiting. The maximum duration for most cancer chemotherapy and radiotherapy regimens is 30 days, although some protocols may last longer. Treatment with serotonin 5-HT3 receptor antagonists should not extend beyond 30 days for most chemotherapy/radiotherapy treatment regimens, unless otherwise specified. Prevention for postoperative nausea and vomiting is confined to the time period immediately prior to surgery. Serotonin 5-HT3 receptor antagonists are not indicated as first-line therapy for chemotherapy-induced or radiotherapy-induced nausea and vomiting; rather, other less expensive antiemetic agents should be utilized first in an attempt to control these types of nausea and vomiting.
. St. Louis, MO: Facts and Comparisons, Inc., 1999.4. Facts and Comparisons Loose-Leaf Drug Information Service
5. Micromedex® Intranet Knowledge Bases. Englewood, CO: Micromedex®, Inc., 1999.
Prepared by Jennifer Seltzer, Pharm. D., Drug Information Service, The University of Texas Health Science Center at San Antonio, and the College of Pharmacy, The University of Texas at Austin, in association with the Texas Medicaid Vendor Drug Program.
The above article is provided for informational use only. Physicians should exercise their clinical judgment as to the appropriateness of treatment options on a case-by-case basis. The article should not be construed as a position statement of the Board. The Board thanks Jennifer Seltzer for contributing the guest article.
Doctors May not Perform Mammography
Many physicians may not be aware that they may not perform mammography. In
accordance with the Health and Safety Code, §401.421 et seq, mammography is a
radiologic procedure which may only be performed by an MRT who meets the
qualifications relating to mammography. Mammography shall not be performed by a
practitioner, an LMRT, an NCT, or any other person.
Controlled Substances Frees Increased
Effective January 1, 1999, new applicants and those renewing their controlled
substances registration with the Texas Department of Public Safety need to be
aware of a fee change from $5 to $25. The increase was authorized by the 75th
Legislature and is the only fee increase in the 25-year history of the
registration program. A registration issued by DPS is required to manufacture,
distribute, analyze, dispense or conduct research with controlled substances in
Texas.
Texas Doctors in the News
Several Texas physicians have been in the news in the past year.
Congratulations to Nobel Prize winner Ferid Murad, M.D., of the University of
Texas Health Science Center in Houston, who was awarded the Nobel in medicine in
1998 for the discovery that nitric oxide is important to human health. Dr. Murad
is a prospective Texas licensed physician. Past Nobel winners among Texas
physicians include Michael Brown, M.D., and Joseph Goldstein, M.D., both of
Southwestern Medical Center in Dallas, who received the 1985 Nobel in medicine
for discoveries related to cholesterol.
In the literary arena, Abraham Verghese, M.D., an infectious disease specialist in El Paso who previously published My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS, published his second book, The Tennis Partner: A Doctor's Story of Friendship and Loss. Deborah Douglas, M.D., a San Antonio pathologist, published Stirring Prose: Cooking with Texas Authors, a collection of recipes and food anecdotes by Texas writers.
Congratulations also go to Dixie Melillo, M.D., whose nonprofit organization, The Rose, provides free mammography and breast cancer diagnostic procedures to uninsured, low-income women. On March 4, Dr. Melillo was inducted into the Texas Women's Hall of Fame, which is administered by the Governor's Commission for Women. Governor George W. Bush presented the award.
Board Takes Renewals Seriously
The Board recently completed the first 1999 renewal cycle. Of the 12,500
forms submitted during the February renewal cycle, approximately 25 percent had
to be returned. The most common reason for return of the form was the failure to
fulfill the CME requirements or the failure to document completion of CME
credits. The requirement most often lacking was the completion of one hour of
CME in medical ethics or professional responsibility. (See box on this page for
more information on the CME requirement for ethics.)
The Board takes license renewal requirements very seriously and urges physicians to pay close attention to the following when renewing their licenses:
• Complete every question on the form, front and back.
• Sign the form; stamped signatures are not acceptable.
• Report all CME hours earned during the 12 months immediately preceding the expiration date of your license. Twenty-four hours per year are required: 12 formal, including one hour in medical ethics or professional responsibility; and 12 informal.
• Mail early to avoid any delay in receiving your updated annual registration permit.
• Although there are no penalty fees imposed until 30 days following the expiration date of your license, remember that practicing without a current permit is the same as practicing without a license.
Rule Changes
The Board has adopted the following proposed rules that were published in the
Texas Register:
Chapter 162, Supervision of Medical School Students, rule review and amendment to section 162.3 relating to registration requirements.
Chapter 163, Section 163.1 of the licensure rules regarding acceptable combinations of examination for licensure; amendment to Section 163.10 regarding distinguished professors temporary license.
Chapter 166, Physician Registration, rule review and amendments to sections 166.2 and 166.4 regarding continuing medical education requirements and expired permits.
Chapter 171, Institutional Permits, repeal of sections 171.1-171.9 and new sections 171.1-171.6 regarding requirements for institutional permits.
Chapter 193, Standing Delegation Orders, amendment to section 193.2 relating to definitions.
Chapter 197, Emergency Medical Service, repeal of sections 197.2-197.5 and new sections 197.2-197.5, that will update rules to current practices. For copies of these rules, write to the Board at MC 901, P.O. Box 2018, Austin TX 78768-2018, or e-mail pat.wood@tmb.state.tx.us. To purchase copies of complete Board rules, call (512) 305-7040.
Clarification on CME Ethics Requirement
As part of their CME requirement, physicians must take one hour of formal CME
in ethics or professional responsibility.
• Ethics CME taken during 1998 up to the 1999 renewal date meet the CME requirements for the 1999 renewal period. Subsequently, the hours will be calculated from expiration date to expiration date. Excess CME hours earned in ethics may be carried over as outlined in Board rules.
• Whether an ethics hour fulfills the requirement is determined by the accredited CME sponsor of the activity.
• Formal courses should be from ACCME-accredited Category 1, AOA-approved Category 1-A, or prescribed credit by the American Academy of Family Physicians.
If you have questions about CME or annual registration, call TMB's Permits Department at (512) 305-7020.
For information on CME courses,
call TMA at (512) 370-130 or www.texmed.org;
TOMA at (512) 708-8662 or www.txosteo.org;
or the Texas Academy of Family Physicians at (512) 329-8666 or www.tafp.org
Statement Regarding Advertising for Continuing Medical Education
In light of recent advertising practices used by some sponsors of continuing medical education activities, the Board has issued the following statement regarding proper advertising in this area:Advertising for continuing medical education activities should in no way imply endorsement by the Texas State Board of Medical Examiners. Advertisers should not use wording that would mislead the public or physician population into believing that the CME activity is sponsored or approved by the Texas State Board of Medical Examiners. The following is wording that is used by the Texas Medical Association and is an example of acceptable advertising, particularly for ethics/professional responsibility courses: "This course has been designated by the Texas Medical Association for one hour of education in medical ethics and/or professional responsibility."
Letter Sent to Health Care Entities about Doctors under Investigation
The following is the text of a letter that the Board's Investigations Department sends to health-care entities regarding doctors who are under investigation:Ms. Mary Smith
Medical Staff Coordinator
Apple Hospital
1111 Main Street
Anytown, Texas 70000Dear Ms. Smith:
This report is in response to your request for investigational information on the below-referenced subject(s). The Medical Practice Act, Section 4.05(c) states that the board shall provide information to a health-care entity concerning whether the licensee is under investigation by the board and the basis of the investigation. The board will also release information concerning a complaint filed against a licensee that was resolved after investigation by a disciplinary order of the board or by an agreed settlement that was a public record at the time of its execution.
Except as authorized by the above statute, the Board's investigative files are confidential The following is a complete list of ALL the information the Board is allowed to disclose to you concerning the referenced subject(s).
It should be noted that the fact that the Board has received allegations against or is conducting an investigation of a subject is in and of itself not a reliable indicator of a possible deficiency. Perhaps as many as 70 percent of the Board's investigations are concluded without any resulting disciplinary action. If any public disciplinary action has been taken by this Board against the below listed subject(s), documentation of this action is attached.
Name Texas Lic. # Type of Allegation File Number
Doe, John M.D. #Z0000 3.08(18) 00-0000Sincerely,
Lloyd McRae, Director
Investigations DepartmentNOTICE: THIS INFORMATION IS CONFIDENTIAL AND IS BEING PROVIDED AS AUTHORIZED BY THE MEDICAL PRACTICE ACT. FURTHER DISSEMINATION IS FORBIDDEN BY LAW. INFORMATION PROVIDED HEREIN IS ONLY FOR THE USE OF THE ABOVE-LISTED ENTITY FOR THE CREDENTIALING AND PEER REVIEW PROCESS.
TxDoT Information on Disabled Person License Plates
In the Spring 1998 issue of The Medical Board Report, we published information provided by the Texas Department of Transportation announcing changes in procedures for obtaining disabled person license plates and/or placards. One of the changes announced was the requirement of a notarized signature of a licensed Texas physician or a written original prescription from the licensed physician who signed the Application Form for Disabled Person License Plates and/or Placards, Form VTR-214. The article said that if the physician provided a written prescription for a disabled patient, it would still be necessary to sign the Form VTR-214.TxDoT has reviewed this policy and determined that if a physician provides a written prescription in lieu of a notarized signature on Form VTR-214, the physician does not need to sign Form VTR-214. The written prescription must include the physician's name, address, professional license number, the disabled person's name, and a statement indicating that the disability is either temporary or permanent.
Texas State Board of Physician Assistant Examiners
Physician Assistants are wholly responsible for and required to submit their registration, physician's request to supervise and address changes. PAs are required to submit notice of practice location and supervising physician before starting to practice. Supervising physician must submit notice of intent to supervise within 30 days of employment of the PA. A PA who is not registered in a timely and proper manner may be subject to disciplinary action by the Board. Documents must be mailed to the Board at MC 232, P.O. Box 2018, Austin TX 78768-2018.Address changes must be in writing and may be submitted by fax to (512) 305-7008. Include full name, license number, old and new addresses.
Physicians
Alderman, John A., D.O., Odessa, TX, Lic. #E3639
An Agreed Order was entered on 10-24-98 wherein the physician voluntarily and permanently surrendered his license in lieu of further investigation or hearing.Barrada, M. Ismail, M.D., Houston, TX, Lic. #G6898
An Order was entered on 4-8-99 suspending the physician's license. Action due to violation of probation.Blume, Horst Gunther, M.D., Sioux City, IA, Lic. #D1551
An Agreed Order was entered on 10-24-98 assessing an administrative penalty in the amount of $7,500. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public.Bowles, Theodore A. Jr., D.O., San Antonio, TX, Lic. #H7392
An Agreed Order was entered on 9-16-98 temporarily suspending Dr. Bowles' medical license. Action due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. An Agreed Order was entered on 1-29-99 suspending his license; however, the suspension was stayed and he was placed on indefinite probation under certain terms and conditions. Action due to intemperate use of alcohol or drugs, and unprofessional conduct.Brown, Barry M., M.D., Houston, TX, Lic. #D6234
An order was entered 12-4-98 suspending the physician's license due to violation of probation.Bryant, Mary M., M.D., Puyallup, WA, Lic. #H6786
A Proposal for Decision was heard concerning Dr. Mary M. Bryant on 12-10-98. The physician's license was revoked. Action due to intemperate use of alcohol or drugs, unprofessional conduct, impairment due to illness or chemical abuse, practice inconsistent with public health and welfare, and disciplinary action by another state. Action will not be final until all appeals have been exhausted.Burgos, Hernan E., M.D., Fort Worth, TX, Lic. #D2649
A Proposal for Decision was heard concerning Dr. Hernan E. Burgos on 1-28-99. The physician's license was revoked. Action due to conviction of felony or crime involving moral turpitude, unprofessional conduct, and practice inconsistent with public health and welfare. Action will not be final until all appeals have been exhausted.Cannon, Carrie S., M.D., Houston, TX, Lic. #H7277
A Temporary Suspension Order was entered on 11-10-98 temporarily suspending Dr. Carrie S. Cannon's license due to evidence and information that her continuation in the practice of medicine would constitute a continuing threat to public welfare. The allegations related to the application for temporary suspension are to be the subject of a disciplinary hearing as soon as can be accomplished under the Administrative Procedure Act and the Medical Practice Act.Cerday, Eddie L., M.D., San Antonio, TX, Lic. #F9289
An Agreed Order was entered 4-10-99 placing Dr. Cerday under certain terms and conditions for five years. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public and violation of Board Rules.Chepko, James D., Houston, TX, Lic. #F0931
An Agreed Order was entered on 4-10-99 restricting the physician's license under certain terms and conditions and assessing an administrative penalty in the amount of $1,000. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public by his violation of probation.Cox, Bruce E., Big Spring, TX, Lic. #E4272
An Agreed Order was entered on 4-10-99 restricting the physician's license for three years under certain terms and conditions. Action due to failure to practice medicine in an acceptable manner.Delgadillo, Francisco, M.D., Houston, TX, Lic. #E0233
An Agreed Order was entered on 10-24-98 placing Dr. Delgadillo under certain terms and conditions for five years. Action due to failure to practice medicine in an acceptable manner consistent with public health and welfare and nontherapeutic prescribing or treatment.Elliott, Paul T., M.D., Richardson, TX, Lic. #D5979
An Agreed Order was entered on 4-10-99 publicly reprimanding the physician. Action due to failure to practice medicine in an acceptable manner.Farley, Patrick, M.D., El Paso, TX, Lic. #G2696
A Temporary Suspension Order was entered on 1-13-99 temporarily suspending Dr. Patrick Farley's license due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. The allegations related to the application for temporary suspension are to be the subject of a disciplinary hearing as soon as can be accomplished under the Administrative Procedure Act and the Medical Practice Act.Fowler, Stephen Rice, M.D., Breckenridge, TX, Lic. #H9514
A temporary suspension order was entered 9-3-98 temporarily suspending Dr. Fowler's license due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. An Agreed Order was entered on 10-24-98 suspending the physician's license until such time as he appears before the Board and provides sufficient evidence and information that indicates he is physically, mentally, and otherwise competent to safely practice medicine. Action due to intemperate use of alcohol or drugs, unprofessional or dishonorable conduct, impairment due to illness or chemical abuse, failure to practice medicine in an acceptable manner consistent with public health and welfare, and disciplinary action by peers.Goswami, Anilkumar P., M.D., Odessa, TX, Lic. #E7095
A Temporary Suspension Order was entered on 12-4-98 temporarily suspending Dr. Anilkumar P. Goswami's license due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. The allegations related to the application for temporary suspension are to be the subject of a disciplinary hearing as soon as can be accomplished under the Administrative Procedure Act and Medical Practice Act.Gunderson, Erik Waters, M.D., Plano, TX, Lic. #J3111
An Agreed Order was entered 4-10-99 assessing an administrative penalty in the amount of $250. Action due to violation of Board Rules and false, misleading or deceptive advertising.Hampton, Raymond M., M.D., Pampa, TX, Lic. #B9647
An Agreed Order was entered on 12-12-98 publicly reprimanding the physician and assessing an administrative penalty in the amount of $2,000. Action due to practice inconsistent with public health and welfare.Johnson, Tone Jr., M.D., Corpus Christi, TX, Lic. #G6946
An Agreed Order was entered on 4-10-99 publicly reprimanding the physician. Action due to unprofessional conduct, violation of laws connected with the practice of medicine, failure to supervise delegatees, abetting the unlicensed practice of medicine, and failure to practice medicine in an acceptable manner.Key, Luther S., M.D., Albany, TX, Lic. #B9658
An Order was entered on 3-24-99 suspending Dr. Key's license. Action due to violation of probation.Knight, Kyler S., M.D., Pasadena, TX, Lic. #J6005
An Agreed Order was entered on 4-10-99 restricting the physician's license under certain terms and conditions for three years. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public.Levenson, Alvin J., M.D., Sugar Land, TX Lic. #E1022
An Order was entered on 1-29-99 suspending the physician's license. Action due to failure to pay child support.Levin, Ira Mark, M.D., Austin, TX, Lic. #J3142
A temporary suspension order was entered 9-3-98 temporarily suspending Dr. Levin's license due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. The allegations related to the application for temporary suspension are to be the subject of a disciplinary hearing as soon as can be accomplished under the Administrative Procedure Act and Medical Practice Act. Effective 10-24-98 an Agreed Order was entered lifting the suspension and placing the physician on probation for 10 years under various terms and conditions. Action due to intemperate use of alcohol or drugs and unprofessional conduct.Lostetter, Alvin Charles, M.D., Laredo, TX, Lic. #D6070
An Agreed Order was entered 10-24-98 suspending the physician's license; however, the suspension was stayed and he was placed on probation for seven years under various terms and conditions. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public, persistent or flagrant overcharging or overtreating, and violation of laws connected with practice of medicine.Martinez, Daniel, M.D., San Antonio, TX, Lic. #E8695
An Order was entered 10-14-98 revoking Dr. Martinez's medical license. Action due to violation of Order dated 8-22-98.Melch, Herbert R., M.D., Fort Worth, TX, Lic. #C5450
An Agreed Order was entered on 4-10-99 restricting the physician's license for five years under certain terms and conditions. Action due to failure to keep drug records, non-therapeutic prescribing or treatment, failure to supervise delegates, and failure to practice medicine in an acceptable manner.McElroy, Delmer G., M.D., New Caney, TX, Lic. #C5792
An Agreed Order was entered on 12-12-98 restricting his license under certain terms and conditions. Action due to unprofessional conduct and prescribing or dispensing to habitual user.McLean, James R. Jr., D.O., Dallas, TX, Lic. #D6496
An Order was entered 4-8-99 suspending the physician's license. Action due to violation of probation.Moran, Paul A., M.D., Coleman, TX, Lic. #D6301
An Agreed Order was entered on 4-10-99 suspending physician's license; however, the suspension was stayed and he was placed on probation for five years under certain terms and conditions. Dr. Moran was also publicly reprimanded. Action due to unprofessional conduct, non-therapeutic prescribing or treatment, administering dangerous drugs in an improper manner, and failure to practice medicine in an acceptable manner.Northam, Ben L., D.O., Dallas, TX, Lic. #D6510
An Order was entered 4-8-99 suspending the physician's license. Action due to violation of probation.Peterson, Jon L., M.D., Houston, TX, Lic. #E8816
An Agreed Order was entered on 4-10-99 publicly reprimanding the physician and assessing an administrative penalty of $100. Action due to violation of Board Rules.Rhodes, Thomas P., M.D., Corpus Christi, TX, Lic. #G0007
A Temporary Suspension Order was entered on 12-4-98 temporarily suspending Dr. Thomas P. Rhodes' license due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. The allegations related to the application for temporary suspension are to be the subject of a disciplinary hearing as soon as can be accomplished under the Administrative Procedure Act and Medical Practice Act.Robin, Sidney T., M.D., Austin, TX, Lic. #E2824
An Agreed Order was entered on 1-29-99 publicly reprimanding the physician and assessing an administrative penalty in the amount of $100. Action due to violation of Board Rules.Rivera, Raul, M.D., El Paso, TX, Lic. #C8420
An Agreed Order was entered on 1-29-99 suspending the physician's license until such time as he appears before the Board and provides sufficient evidence and information to indicate he is physically, mentally, and otherwise competent to safely practice medicine. Action due to intemperate use of alcohol or drugs.Santibanez, Alfredo L., M.D., Houston, TX, Lic. #E8234
An Agreed Order was entered on 12-12-98 suspending his license; however, the suspension was stayed and he was placed on probation for five years under various restrictive terms and conditions. Dr. Santibanez was also publicly reprimanded and assessed an administrative penalty in the amount of $10,000. Action due to unprofessional conduct, violation of laws connected with the practice of medicine, violation of Board Rules, and practice inconsistent with public health and welfare.Seifert, John D., M.D., Garland, TX, Lic. #D4855
An Agreed Order was entered 10-24-98 assessing an administrative penalty in the amount of $5,000. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public.Stenger, Earl M., M.D., San Antonio, TX, Lic. #D7315
An Order was entered on 2-9-99 suspending Dr. Stenger's license. Action due to violation of probation. Effective 4-10-99 an Agreed Order was entered staying the suspension and placing his license under restrictions for ten years under certain terms and conditions.Teague, Robert C., M.D., Phoenix, AZ, Lic. #C5261
An Order was entered 4-8-99 revoking the physician's license and assessing an administrative penalty in the amount of $50,000. Action due to unprofessional conduct, violation of Board Rules, and disciplinary action by another state.Tessmer, Jon F., M.D., Houston, TX, Lic. #G5685
An Order was entered 10-24-98 suspending the physician's license until such time as he appears before the Board and provides sufficient evidence and information that indicates he is physically, mentally, and otherwise competent to safely practice medicine. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public.Thomas, Stephen C., M.D., Lubbock, TX, Lic. #J5036
A Temporary Suspension Order was entered on 11-10-98 temporarily suspending Dr. Stephen C. Thomas' license due to evidence and information that his continuation in the practice of medicine would constitute a continuing threat to public welfare. An Agreed Order was entered 4-10-99 suspending the physician's license until such time as he appears before the Board and provides sufficient evidence and information that indicate he is physically, mentally, and otherwise competent to safely practice medicine. Action due to intemperate use of alcohol or drugs and unprofessional conduct.Thomas, James H. Jr., M.D., Houston, TX, Lic. #G0199
An Agreed Order was entered on 4-10-99 publicly reprimanding the physician and assessing an administrative penalty in the amount of $1,000. Action due to failure to practice medicine in an acceptable manner and disciplinary action by peers as a result of his failure to keep adequate records.Townsend-Parchman, Wallace, M.D., Carrollton, TX, Lic. #F7683
An Agreed Order was entered 4-10-99 suspending the physician's license; however, the suspension was stayed and he was placed on probation for five years under certain terms and conditions. Action due to unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public.Villarreal, Cesar Q., M.D., El Paso, TX, Institutional Permit #27005
An Agreed Order was entered on 1-29-99 publicly reprimanding the physician and assessing an administrative penalty in the amount of $5,000. Action due to unprofessional conduct.Weitzel, Robert, M.D., Salt Lake City, UT, Lic. #H2895
An Agreed Order was entered on 10-24-98 publicly reprimanding the physician and assessing an administrative penalty in the amount of $3,500. Action due to unprofessional or dishonorable conduct likely to deceive or defraud the public and violation of Board Rules.Womack, James C., M.D., Bandera, TX , Lic. #G8516
An Agreed Order was entered on 1-29-99 suspending the physician's license until such time as he appears before the Board and provides sufficient evidence and information to indicate he is physically, mentally, and otherwise competent to safely practice medicine. Action due to intemperate use of alcohol or drugs.Physician Assistants
Hilsmeier, Kimberly, Conroe, TX, Lic. #PA01468
An Agreed Order was entered on 10-30-98 restricting the physician assistant's license under terms and conditions for three years. Action due to unprofessional conduct, professional failure to practice in acceptable manner, nontherapeutic prescribing or treatment, and disciplinary action by peers.Teegarden, Dennis D., Coleman, TX, Lic. #PA00893
An Agreed Order was entered on 10-30-98 restricting the physician assistant's license under terms and conditions. Action due to professional failure to practice in acceptable manner and nontherapeutic prescribing or treatment.Acupuncturists
Chen, Shing-Fu, Austin, TX, Lic. #AC00250
An Order was entered on 1-29-99 canceling the license due to failure to meet automatic licensure requirements. Action will not be final until all appeals are final.Choi, Chi Bok, Dallas, TX, Lic. #AC00090
An Order was entered on 1-29-99 canceling the license due to failure to meet automatic licensure requirements. Action will not be final until all appeals are final.Jin, Yifen Jennifer, Houston, TX, Lic. #AC00241
An Order was entered on 1-29-99 canceling the license due to failure to meet automatic licensure requirements. Action will not be final until all appeals are final.Nguyen, Maihoa Thi, Houston, TX, Lic. #AC00161
An Order was entered on 1-29-99 canceling the license due to failure to meet automatic licensure requirements. Action will not be final until all appeals are final.Otte, Per, Hot Springs Village, AR, Lic. #AC00264
An Order was entered on 1-29-99 canceling the license due to failure to meet automatic licensure requirements. Action will not be final until all appeals are final.Shih, Shu Pin, Houston, TX, Lic. #AC00040
An Order was entered on 1-29-99 canceling the license due to failure to meet automatic licensure requirements. Action will not be final until all appeals are final.For a printed copy of the newsletter or to be put on the mailing list, write to the board at MC 251, P.O. Box 2018, Austin TX 78768; call (512) 305-7018; or e-mail jill.wiggins@tmb.state.tx.us