The Texas Medical Board ISC - Avoiding Formal Discipline

The Texas Medical Board (TMB) resolves 90 percent of disciplinary cases in informal proceedings, including an Informal Settlement Conference/Show Compliance proceeding, or "ISC". Complaints against physicians that are not resolved in the investigations stage by dismissal, referral to the Physician Health Program or through a remedial plan, may be referred to the TMB Litigation Section for further action. Once a case is assigned to a Staff Attorney at the TMB Litigation Section, it can be scheduled for an Information Settlement Conference/Show Compliance proceeding, or ISC, to attempt resolution.

Although these proceedings are termed "informal," it would be a mistake to participate without a Texas license defense attorney. A well-prepared and experienced lawyer can effectively present evidence and legal arguments that can be crucial to outcome of the ISC.

An ISC is a hearing before a Medical Board panel consisting of two representatives of the Board, which is required to consist of one physician member and one public member unless that requirement is waived. A licensee physician may present evidence and arguments that he or she has not violated the Medical Practice Act. It is referred to as an informal hearing because formal rules of evidence and procedure do not apply, but the proceeding is as important as a trial. As a result of the ISC proceedings, the Board may dismiss the case, offer an agreed order (settlement) specifying certain sanctions, or offer a non-disciplinary remedial plan to take corrective action addressing the issue that led to the complaint.

Once a physician is notified by the Texas Medical Board that they are under investigation, it is critical to retain legal counsel. At this early stage, the Board may may seek information from the licensee in addition to medical records. The guiding hand of an attorney can make a big difference in whether a case is ultimately dismissed, informally resolved (ideally without any discipline), or ultimately proceeds to formal resolution at the State Office of Administrative Hearings (SOAH). A physician has 28 days to respond to this initial letter informing them of the complaint. Beyond medical records, the Board typically will request a narrative, evidence to support the narrative, and may want responses to a medical practice questionnaire.

If a Texas physician receives an Informal Settlement Conference, her or she should hire a license defense attorney right away if an attorney isn't already on board. The ISC is rarely postponed, and a rebuttal needs to be submitted 15 days prior to the ISC. A lawyer experienced in Texas administrative law can make sure that key deadlines are met, correct paperwork is filed, and that the case is professionally and effectively handled.

In a case cannot be resolved at the ISC stage and moves on to formal disciplinary proceedings, the complaint and proceedings become a public record. Therefore, if for no other reason that to prevent damage to one's reputation, privileges and certifications, every opportunity must be taken to resolve the case favorably by the ISC, if not sooner. If you have received notification that you have an Informal Settlement Conference matter, immediately contact Ray & Weinstein, PC for a consultation with a Texas license defense attorney.