"Still Practicing: Tracking Problem Doctors in Texas"
INVESTIGATIVE CATEGORY
KXAN-TV
02/13/2022
A year-long KXAN investigation told over multiple parts found an oversight system meant to protect Texas patients instead often prioritizes the protection of physicians, including some the state has already deemed a“threat to public safety.” Through deep, original reporting, our team found the Texas Medical Board“ bending over backwards,” according to one expert, to allow problematic physicians to keep practicing – including a half-dozen credibly accused of sexual misconduct with patients – in one case a minor – and another who peddled a million opioid prescriptions for cash.
When a patient is harmed, in most cases, the only recourse is a civil lawsuit. However, our investigation also found that even when the courts determine a doctor is liable for malpractice – including cases where somebody needlessly died due to medical error – patients and the public are often still left in the dark.
Our ongoing coverage resulted in multiple lawmakers proposing legislation to reform the TMB. And as a direct result of our reporting, the board approved a major rule change and funding request for patient safety and transparency.
INVESTIGATIVE METHOD
Our team traveled across Texas to talk with victims and discovered the Texas Medical Board is breaking state law by keeping out-of-state disciplinary records and medical malpractice judgments secret. To find the latter, KXAN analyzed medical malpractice lawsuits filed in Texas over the last decade. We learned 97% of malpractice lawsuits can be shielded from the public when they are settled out of court. The other 3% of cases, when decided by a jury, must be disclosed to the public. Despite that requirement, KXAN found a handful of doctors found liable by a jury for medical malpractice with no record of any judgment on the state’s website, despite Texas law requiring that information be disclosed to the public. That includes at least three cases that resulted in patients dying:
A doctor who failed to diagnose and treat the buildup of fluid in a patient’s brain.
A doctor found to have improperly inserted a breathing tube, which became dislodged, and caused the patient to lose oxygen for more than 30 minutes.
A medical provider who failed to intubate a patient, did not protect his airway and delayed CPR when he began choking on his own blood.
To find out-of-state disciplinary records kept secret, we pulled thousands of physician disciplinary records from more than a dozen states, dating back to 2017. We then crossed-referenced those records with the TMB’s public physician portal one name at a time. We used birthdates, medical schools and graduation records to confirm names. Our investigation identified at least 49 doctors with disciplinary
records in other states– including medical licenses suspended, revoked, or surrendered–still practicing, or able to, in Texas. Some of these physicians were found to be repeat offenders with actions in multiple states.
Among the doctors we found still practicing with “clean” records in Texas, despite that being untrue:
A Colorado neurosurgeon disciplined for performing surgery on the wrong spinal disc
A Wisconsin orthopedic surgeon whose license was suspended indefinitely for operating on a patient while intoxicated
A Florida doctor reprimanded for prescribing “excessive quantities” of oxycodone leading to a patient’s death
We found little incentive for the TMB to follow the law by making these records public because the law has no teeth and little oversight. The result: Texas patients are, at best, ill-informed when it comes to making healthcare decisions about their doctors and, at worst, treated by potentially dangerous doctors.
Some physicians were disciplined following criminal charges including driving drunk, domestic violence, possession of controlled substances and operating a firearm while intoxicated. In total, our team found disciplinary actions taken against a physician’s license in Texas spread out over 30 different states – with no record on the TMB website, suggesting doctors are coming to Texas to leave their pasts behind.
Taking a solutions-oriented approach, we identified a state medical board, North Carolina, that puts all disciplinary records online, indefinitely, in an easily searchable database. We showed that approach to Texas lawmakers; one is now crafting legislation to push the TMB to operate in a similar, more transparent manner.
Our team also explored the intersection of politics and patient safety. Using campaign finance records, we discovered Texas Gov. Greg Abbott tapped top-dollar donors to sit on the medical board – many of whom come from telecom, business, and energy sectors with no obvious patient advocacy or medical experience. Seven board members, collectively, donated nearly $400,000 to the governor’s election campaigns dating back to 2014. One board member, the CEO of one of the largest textile companies in the country, gave the governor nearly $200,000.
We also explored potential conflicts of interest by identifying a board member – who is also a doctor – placed on a remedial plan for failing to keep “adequate medical records for multiple patients.” The board, in deciding discipline for its fellow member, determined this was a “non-disciplinary” action. While remedial plans constitute grounds for dismissal from the board by the governor, Abbott has not taken that step against this member, who donated nearly $40,000 to his campaign.
IMPACT & INNOVATION
As a direct result of our reporting, two state lawmakers are proposing legislative changes to make the TMB more transparent and to specifically address the problems we exposed. At least another three have expressed interest into what we uncovered. During his campaign, the Democratic candidate for Texas governor – Beto O’Rourke – reacted to our coverage, calling for new restrictions for campaign donors on state boards. In response to what we uncovered, the TMB passed a rule change that now requires physicians to self-report any criminal convictions, out-of-state disciplinary actions, and medical malpractice claims within 30 days. Previously, it was every two years. The TMB also said our reporting was “a factor” when it requested $2.5 million from the state legislature to fund more staff to manage a new physician monitoring section for the agency. For $2.50 per doctor annually, the money would also pay for continuous background checks with the National Practitioner Data Bank instead of relying on doctors to self-report. If approved and signed by the governor, the TMB could begin receiving funding on Sept. 1, 2023. The board also says it’s now more proactively updating its online profiles of physicians after KXAN found some out-of-state discipline records kept secret.
Five years after Texas neurosurgeon Dr. Christopher Duntsch – dubbed “Dr. Death” in the media – was sentenced to life in prison for botched surgeries leading to patient deaths and disfigurement, we found Texas patients are no safer today. In response to our “Still Practicing” series, journalist Laura Beil – who created the “Dr. Death” podcast listened to by 60 million people and turned into a Peacock miniseries -- invited KXAN investigative journalist Matt Grant to present his findings at the Association of Health Care Journalists’ national conference in Austin (photos in next section).
Going beyond Texas, our team created an interactive map examining every state medical board in the U.S., so our readers could see how Texas compares to other states. Using sources, including past and present TMB employees, whistleblowers, police records, hundreds of pages of court records, medical board databases, tens of thousands of pages of disciplinary records, doctors, lawyers and other experts, we were able to piece together a portrait of systemic failure that one lawmaker plans to use as “Exhibit A” for evidence in support of new legislation to better protect patients.
We also created a special “Still Practicing” landing page online to allow viewers to easily access the 13 reports we produced since launching this investigation, which has been highlighted by policymakers and patient advocacy groups like Texas.
Link to Content Online
Still Practicing Project Landing Page
Continuing Coverage
Part 1: Gone to Texas
Part 2: Records Still Secret
Part 3: One Doctor, Two States
Part 4: Push for Change
Part 5: Deemed a ‘Threat’
Part 6: Patients & Politics
Part 7: Senator’s Solutions
Part 8: New Rule Change
Part 9: Secret Malpractice Suits
Part 10: National Reform Unlikely
Recognition, Reaction, and Impact
Texas Medical Board Rule Change Following KXAN Investigation
“Attorney at Law” Magazine Article: “KXAN… has blown the lid off some dirty little secrets.”
“Association of Healthcare Journalists” Article Highlights KXAN Investigation
TMB President Responds to KXAN’s Investigation in Extended Interview
Texas Watch TikTok “recommends some important reporting”
Martin Walker Attorneys At Law reaction to project
Center For Justice & Democracy at New York Law School reaction to project
Texas Medical Board Rule Change following KXAN investigation
Rep. Julie Johnson Files First Patient Safety Bill to add public members to Texas Medical Disclosure Panel
Submitted by Josh Hinkle.