New Texas Medical Board rules update

I regularly represent clients who have become licensed in other states through the Interstate Medical Licensing Compact, which is a way to expedite license for physicians who are already licensed in one state, and who want to become license in other states.

As a general rule, a physician is considered to be practicing medicine in the state where the patient is located at the time of service, not where the physician might be sitting.That’s why a doctor can’t simply be licensed in New York and treat Texas patients through telehealth, unless the physician is also licensed in Texas.

Currently, 42 states have adopted the IMLC, which means that by paying a fee, a physician can become more attractive to companies who deliver telehealth services across state lines.

This also means that physicians become responsible for understanding the nuances of medical board rules in each state in which they practice.

Fortunately, various medical associations, professional malpractice insurance organizations and industry participants will do they work for you, you just need to“ask” Google or your favorite search engine.

The Texas Medical Liability Trust has published an update by Tanya Babitch and Robin Desrocher which contains a 21-minute audio and a transcript of the conversation, which not only describes what changes have been made to existing Texas Medical Board Rules, but also where the old rules have been moved into newly organized sections which are supposed to make things easier for everyone.

For example there are new rules for MedSPas andIV Clinics under Chapter 169.Under the new rules, specifically Chapter 169, Subchapter E, there are clearer rules as to what delegated acts constitute the “Practice of Medicine” in a MedSpa:

22 TAC§169 Other Delegated Act

(a) In accordance with §157.001 of the Act, the board determined the following to be the practice of medicine and such medical acts can be properly delegated and supervised:

(1) nonsurgical medical cosmetic procedures, including but not limited to the injection of medication or substances for cosmetic purposes, the administration of colonic irrigations, and the use of a prescription medical device for cosmetic purposes; and

(2) using a device to administer for human consumption a nonprescription drug, dangerous drug, or controlled substance.

Other rules specify “when” delegation is appropriate and “where” the delegating physician or mid-level must be standing at the time the procedure is performed:

22 TAC 169.26 Other Delegated Acts

(a) The delegating physician must ensure the individual performing these medical acts:

(1) has appropriate training regarding:

(A) techniques for the delegated act including pre-procedural care, post-procedural care, and infectious disease control;

(B) contraindications for the delegated act; and

(C) recognition and acute management of potential complications; and

(2) signs and dates a written protocol.

(b) A physician must either be appropriately trained or be familiar with and able to perform the delegated medical act according to the standard of care

(c) Prior to performance of the delegated act, a physician, or a physician assistant or advanced practice registered nurse acting under the delegation of a physician, must:

(1) establish a practitioner-patient relationship;

(2) complete and maintain an adequate medical record in accordance with Chapter 163 of this title;

(3) disclose the identity and title of the individual who will perform the delegated act; and

(4) ensure at least one person trained in basic life support is present while the patient is onsite.

(d) A physician or physician assistant or advanced practice registered nurse must either:

(1) be onsite during the procedure; or

(2) be immediately available for emergency consultation in the event of an adverse outcome; and

(3) if necessary, the physician must be able to conduct an emergency appointment with the patient.

When in doubt, it is always advisable to hire a healthcare attorney who is experienced in the nuances of your state’s rules.