Governor Vetoes Bill Gutting Medical Board
By Amy Lynn Sorrel

The full force of the Texas Medical Association’s advocacy came to bear in Gov. Greg Abbott’s June 22 veto of Senate Bill 268, which would have eviscerated an important Texas Medical Board (TMB) function in halting the unlicensed practice of medicine by health professionals licensed by another agency in Texas – and which the governor himself said “would inadvertently raise hurdles to protecting public health and safety” in his veto proclamation.  

TMA repeatedly delivered that message in what started as a strong campaign against the bill by its Council on Legislation and legal and lobbying teams throughout the regular session – and ended with an exclamation point from the association’s grassroots army of more than 2,000 physicians who wrote or called the governor’s office urging the veto after the session closed June 2.  

The victory for the practice of medicine and patient safety embodies the relentlessness of TMA’s advocacy from start to finish, particularly on a top legislative priority this session, says President Jayesh “Jay” Shah, MD.   

“This is a powerful reminder that when we stand together, we can protect patient care and preserve physician autonomy,” he underscored.   

“We’re grateful that Governor Abbott vetoed SB 268 – a bill that would have undermined the Texas Medical Board’s ability to protect patients. This is a clear win for patient safety and a recognition that health care must be led by physicians. The veto of SB 268 reinforces our commitment to ensuring that every Texan receives care that meets the highest medical standards. TMA will continue to stand firm for physician-led, team-based care.”  

As it headed to the governor’s desk, SB 268 implemented beneficial measures for promptly sharing complaints among health care licensing agencies, but in so doing, undermined those benefits by limiting the ability of TMB to protect patient safety with an important tool: using cease-and-desist orders to act swiftly when a health practitioner licensed by another Texas agency engages in the unauthorized practice of medicine.   

With the help of a friendly amendment from Rep. Tom Oliverson, MD (R-Cypress), TMA worked successfully to tamp down SB 268’s harmful effects and restore TMB’s enforcement authority. That progress was stripped, however, when Senate and House conferees met to work out the differences on the bill, which returned the provisions at issue in SB 268 to their original – and dangerous – form.    

TMA’s advocacy infantry stepped in.    

“Only TMB is equipped to oversee the practice of medicine in Texas. Texas needs a strong medical board to ensure patient safety,” Dr. Shah wrote in a series of action alerts urging membership to contact their elected officials on the dangers of the bill to an unsuspecting public.    

Based on real-world examples from physicians spanning the state, those dangers include “people playing physician, advertising themselves as medical professionals, and even performing dangerous procedures without any medical training. If the TMB does not have any authority to identify and make these individuals stop, who will?” a concerned Houston physician wrote to the governor.  

A Boerne physician similarly cautioned in their letter: “Texans deserve quality in the care they receive. This cannot be provided by untrained personnel. ... Lowering the bar to allow imposters to do what only doctors can and should do, is doing wrong to the people of Texas.”  

Among thousands of other physicians who joined the write-in campaign, a Dallas physician who oversees advanced practice practitioner credentialing warned, “Without TMB's ability to stop professionals from practicing dangerously and with disregard to the public, bad actors will go unchecked and create public harm.”  

Vetoing SB 268 “contributes to keeping medical care in Texas at [a] high standard well known all over the world,” a Port Neches physician emphasized.  

Established law

TMB has long possessed the authority to issue cease and desist orders – as have other licensing agencies like the nursing, physician assistant, and pharmacy boards.   

Limiting that enforcement authority, however, opened the door for other licensing agencies to divert scope-of-practice expansion complaints with little accountability for follow-up, and inhibited TMB from properly performing its role as the agency charged with regulating the practice of medicine, TMA asserted in testimony throughout the regular session and in a later meeting with the governor’s office.   

Medicine’s message triumphed.   

In his proclamation, Governor Abbott acknowledged SB 268 “aims to ensure a health care complaint is handled by the right regulatory board.”   

He added, however, “it would also prohibit the original board from taking any disciplinary action for portions of a complaint within its jurisdiction. The Medical Board, for example, should not be prohibited from issuing a cease-and-desist order for unlicensed medical practice simply because the specific practice at issue is also regulated by another board. I look forward to working with the author in the future to craft a solution that accounts for regulatory overlap and ensures no gaps in enforcement.”  

Want to learn about medicine's other wins during the 89th legislative session and earn CME? Join TMA for a 90-minute webinar on Monday, June 30 at 6 pm CT to hear from TMA’s lobby team and association leadership. You will receive a Zoom link via email upon registration.