The Role of Peer Reviews in Texas Medical Board Complaints

When a physician in Texas faces a complaint with the Texas Medical Board (TMB), the process that follows can be complex and intimidating. One important but often misunderstood component of this process is the peer review, a mechanism used by hospitals, medical groups, and occasionally by the TMB itself to assess a physician’s clinical performance. Understanding how peer reviews function and how they can impact a Texas Medical Board complaint is critical for any physician navigating disciplinary proceedings.

What Is a Peer Review?

In Texas, a peer review is the evaluation of a physician's professional performance by other medical professionals. These reviews are intended to ensure high standards of care and protect patient safety. Peer reviews often occur within hospitals, medical groups, or health plans and are usually triggered by concerns about competence, behavior, or compliance with standards of care.

Under Texas Occupations Code Chapter 160, hospitals and certain other entities are required to report specific peer review actions to the TMB. These reports can lead to or influence a TMB investigation.

How Peer Review Interacts with TMB Complaints:

Peer reviews can influence a TMB complaint in several key ways:

1. Triggering a TMB Investigation

If a hospital’s peer review committee takes adverse action against a physician—such as restricting, suspending, or revoking privileges—that action may be reportable to the TMB. Once reported, it can trigger a formal investigation or be added to an ongoing one.

2. Providing Evidence to the TMB

While peer reviews are confidential under Texas law, certain findings or conclusions may be disclosed to the Board if they relate to violations of the Medical Practice Act. This evidence can shape the TMB’s evaluation of the physician's conduct and may lead to disciplinary action.

3. Impacting Settlement or Resolution

If a peer review has already found a physician’s care to be substandard, the TMB may be less inclined to dismiss a complaint or offer a favorable settlement. Conversely, a peer review that exonerates the physician or finds no substantial issues may support a defense strategy during the complaint process.

Legal Protections and Pitfalls:

Texas law offers some confidentiality and immunity protections for those who participate in good-faith peer review activities. However, these protections do not extend to shielding physicians from TMB disciplinary actions if the review uncovers serious issues.

Physicians should also be aware that peer review reports made in bad faith or for retaliatory reasons can themselves be the subject of legal challenge. A physician who believes a peer review process was unfair or improperly motivated should consult legal counsel familiar with Texas healthcare law.

Key Takeaways for Physicians on Peer Reviews in Texas Medical Board Complaints:

• Know your rights: Understand the peer review process at your hospital or facility, including what actions may be reported to the TMB.

• Respond proactively: If you’re the subject of a peer review, take it seriously and seek representation early—especially if a TMB complaint is possible or already underway.

• Use peer review findings strategically: Whether favorable or unfavorable, the outcome of a peer review can play a significant role in how your TMB case is evaluated and resolved.

Feel free to reach out to us if you have questions or want more information.

Physicians facing a TMB complaint should not go about the process alone. Legal counsel experienced in both TMB defense and healthcare compliance can help manage the risks associated with peer reviews and protect your license and reputation.

Weitz Morgan is a leading law firm in Texas in providing comprehensive advice and guidance to physicians on board complaints. With a deep understanding of the unique challenges and complexities faced by this process and profession, our team of experienced attorneys is dedicated to helping doctors navigate this legal landscape successfully.