Physicians cannot be jailed by the attorney general or local law enforcement for violating Executive Order GA-19, according to a more recent executive order Gov. Greg Abbott issued Thursday.
The previous order – EO GA-19 – mandates that physicians comply with a Texas Medical Board (TMB) rule that requires physicians follow minimum safe-practice standards related to COVID-19.
The executive order modifying EO GA-19, which also applies to hospitals that fail to reserve a certain capacity for treating COVID-19 patients, is retroactive to April 2.
The attorney general’s office can still fine a physician up to $1,000 for violating the order. TMB also can bring a disciplinary action against physicians who violate its rule.
TMB on Wednesday updated a frequently asked questions (FAQ) document about its recent emergency rule establishing the minimum safe-practice standards related to COVID-19, which generated a lot of questions from physicians when it was announced May 1.
Under the rule, physicians, their delegates, and patients are required to wear masks when the physician or delegate is less than 6 feet from the patient.
The board originally recognized only a few exceptions: The patient is not required to wear a mask if it needs to be removed during an exam or treatment, including a procedure or surgery, and there appeared to be an exception for children younger than 2.
The updated FAQ permits new exceptions to the mask or face-covering requirement for patients when less than six feet from the physician or physician’s delegate. Now, there is an exception for situations where a patient cannot wear a mask but is in need of medical assistance. There is also an exception for situations when wearing a mask is not feasible as it would impede the medical procedure or act to be performed. The board provides the following examples: care involving infants, head and neck trauma, and examination of the mouth.
A physician must use his or her best judgment when choosing to treat patients who do not wear a mask or who are incapable of doing so.
“If the physician chooses to deliver care and the patient cannot wear a mask, practitioners should document the circumstances surrounding the decision to render care to a patient who is not wearing a mask,” the FAQ says.
Practices can set their own policy on masks and gloves “outside of a patient-physician interaction,” and masks also are not required if physicians and patients are separated by 6 feet or more, the updated FAQ also says.
Please remember that the rule still requires certain medical settings to post a notice “in each public area and treatment room or area of the office, practice, or facility.” This does not apply to a hospital as defined by Chapter 241 of the Texas Health and Safety Code.
“There is no required design of the notice to post, as long as it contains the required information in the rule and is visible to your patients,” the FAQ says. TMB’s updated FAQ “encourages a robust approach” when posting the required notice so that it is the “most visible” to patients.
The board also prepared a sample notice, available here.
The Texas Medical Association has been in contact with TMB since the rule was announced asking that the agency clarify the rule and explain what physicians who cannot fully comply with the minimum standards should do.
TMA has updated its white paper on the rule and will continue to provide updates as the medical board makes new information available.
To help answer questions and address concerns you might have about Texas’ supply of personal protective equipment (PPE), the TMA COVID-19 Task Force has created a frequently asked questions (FAQ) that addresses topics such as conservation strategies; options if N95 masks are unavailable; whether you should use homemade masks; and whether surgical masks, gloves, and gowns should be reused or used for more than one procedure.
You also can find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.