Texas Professional License Defense Lawyer Blog

Since the Texas State Legislature's previous legislative session, the Texas Dental Board has begun ramping up enforcement against general dentists and subspecialists such as oral surgeons and endodontists, and other medical professionals licensed under its auspices. Of particular concern is the Dental Board's increased enforcement of their rules regarding DWIs and other alcohol-related offenses. Like other medical licensing boards, the Dental Board typically does not regard alcohol-related offenses and public intoxication as the basis for disciplinary action absent special circumstances or evidence of an ongoing impairment or addiction. However, upon receiving notice that a dentist or oral surgeon has been arrested for or convicted of a second such offense, the Board will begin actively pursuing sanctions against the individual in question, often including restrictive multi-year monitoring orders. This is true regardless of the amount of time that has passed between offenses.

One step that the Texas State Board of Dental Examiners (SBDE) will often take in the case of a dentist or oral surgeon / subspecialist with multiple alcohol-or-drug related offenses is to recommend consultation with the Professional Recovery Network, or PRN. I strongly recommend not doing so without first consulting with an attorney. This is because, as I have written previously in this forum, there are significant limitations in the confidentiality protections provided to medical professionals who consult with the PRN. Not only that, but professionals seeking aid from the PRN are often not told of these limitations up front, with the result that statements that the professional believed were confidential often end up being reported to the Dental Board. This means that, by turning to the PRN for assistance, a professional may end up inadvertently handing the Dental Board statements or evidence that may be used against him or her in an eventual disciplinary proceeding. As such, it is essential for licensed dental professionals to consult with an attorney / law firm familiar with administrative law and the practices of the Texas State Board of Dental Examiners and PRN to determine the best course(s) of action.

This increase in enforcement by the SBDE has a number of ramifications for professionals licensed by the Board. First, the Board has begun aggressively pursuing harsher sanctions than in previous years, even for comparatively minor offenses. For instance, as I noted in a previous entry, in one case, the Board sought to impose a multi-year reprimand based on a comparatively minor misdemeanor for which the dentist in question was placed on deferred adjudication. Secondly, should the professional in question agree to any discipline, they will potentially be required to report it to their provider networks, malpractice insurers, other credentialing bodies or states where they hold licenses, and the Department of Public Safety and DEA.

This makes it all the more important that a professional under investigation by the Texas Dental Board consult with an experienced administrative law and state board lawyer to best protect their interests and their practice.

Recently the Austin American Statesman interviewed me in detail regarding my representation of numerous dentists before the Texas State Board of Dental Examiners (TSBDE) for whom I had been the attorney of record. During the interview I also spoke to the reporter about several cases that were still in the investigative stage and as such she would not have known anything about the case or that I was the attorney representing the dentist in front of the TSBDE as the investigation(s) are confidential pursuant to the texas_detal_practice_act_254.pdf Most were disciplinary cases involving general dentists or oral surgeons who had been accused of violations of the Dental Practice Act involving the abuse of their DEA / DPS controlled substances prescribing authority, fraud, the intemperate use of drugs and alcohol or their arrest / plea of guilty to a criminal offense. The article focused on the status of the dentist's license to practice medicine as regulated by the Texas Dental Board.

During this interview I clearly told the reporter several things that were either overlooked or ignored which led to a sensational and inaccurate version of many of the events covered. The article was then syndicated by a number of newspapers and readers throughout Texas (see below) which yielded in what I believe to be a widespread misunderstanding of the disciplinary authority vested in the TSBDE as well as their use of that authority with respect to disciplinary / license investigations.

The article implied that the Dental Board was slow to act and/or failed to impose disciplinary sanctions commensurate with the dentist's transgressions. The article cited to a case which is still in the throes of a disciplinary investigation and as such is privileged pursuant to statute. I made this overly clear to the reporter, yet she continued to trash the dentist and the Board for what she called an apparent failure to act responsibly. Since that time the TSBDE has taken appropriate action in that case and the DPS has also initiated measures consistent with its statutes and rules. The unfortunate fact is that I told the reported that appropriate discipline was imminent, yet this reality was ignored for a hyped article which seemed to be geared towards angering readers rather than unveiling the truth.

The reporter then began to compare the Texas Medical Board's disciplinary authority and their aggressive use of that authority against licensed physicians to the TSBDE's recent history of issuing suspend probate orders to dentist's who have received treatment for drug or alcohol use, substance misuse or chemical dependency. I made it clear to her that the Texas Medical Board (TMB) had a vehicle by which they could issue private, non-public, confidential rehabilitation orders that were exempt from the Freedom of Information Act, but such an option was not available to the Dental Board. Thus the idea of comparing statistics was unfair and that the TMB public disciplinary orders related to substance abuse were likely to be harsh due to the physician not being granted a private rehab order.

Fortunately, the former Executive Director of the Texas Medical Board, Donald Patrick (a physician and an attorney) explained that the Dental Board was largely underfunded and would benefit from the receipt of extra monies from the legislature to beef of the number of its attorneys / lawyers and administrative legal staff. Dr. Patrick went on to say that until the TMB was able to hire more seasoned attorneys that the agency was at an unfair advantage and was often overworked or out-maneuvered.

Finally, I informed the journalist that both the TMB and the TSBDE recognized substance abuse / chemical dependency as a treatable disease and as such attempted to allow for rehabilitation as opposed to the discipline of the physician or dentist's license to practice medicine. I also made clear that the legislature clearly authorized peer assistance programs pursuant to the Health & Safety Code Chapter 467, but unfortunately no mention was made of this fact either. For those who believe that we should not bother to rehabilitate our trained medical professionals, it is important to note that the notion of long-term treatment, rehabilitation and the return to work theory was first utilized by the United States Navy with respect to its alcohol dependent pilots in whom our country had invested tremendous resources. Research showed that our pilots, with rigorous treatment and monitoring, performed at heightened levels once their disease process was arrested and recovery could begin. Arguably this is true for Texas' physicians and dentists as well.

Lubbock On Line

El Paso Times

Corpus Christi TV