www.tmb.state.tx.us Follow TMB on Facebook October 2020 Message From the TMB President: COVID - 19 Agency Update During the most recent Board We encourage licensees to share information and re- meeting in August, we provided an sources with your colleagues, continue seeking help and update on the Board’s ongoing assistance from your local medical societies and profes- efforts during the COVID-19 pandem- sional workplace groups, and please continue checking in ic. Since the onset of the pandemic, with co-workers and supporting one another. Board staff have issued over 2,800 temporary emergency licenses and The Board will continue to do everything it can to ensure the health and safety of Texans, including our licensees. Zaafran reactivated 60 licenses for recently retired health care professionals. Though the situation in Texas is markedly improved from TMB staff has managed to process these licenses in a where we were several months ago, we should all con- matter of just a few days. tinue to be diligent in following the recommended public health guidelines. It’s worth noting that all of this work is being accom- plished in addition to the already steady workload of This will not only help your family, friends and neighbors processing thousands of regular licensure applicants to in staying healthy and safe, but also help our fellow ensure our state continues to have a strong health care frontline health care professionals as they continue their workforce ready to help care for our fellow Texans dur- hard work caring for our most critical patients. ing this critical time. Thank you and everyone please be safe and well! The Board previously issued several waivers to give some relief to licensees these past months, including a relaxation of continuing education requirements and extended renewal deadlines. At the August Board Dr. Sherif Zaafran, M.D., FASA meeting, the Board approved an extension of its emer- Texas Medical Board President gency rules for prescribing through telemedicine. Board members also discussed doing what we can to help our colleagues experiencing issues of increased stress and burnout. I NSIDE THIS I SSUE : The Board has previously shared health and wellness ARTICLES 2-9 resources, and in this issue of the TMB Bulletin, we’ve included an article from the Texas Physician Health Pro- BOARD RULES 10-11 gram that we hope our licensees will also find helpful. (See Article on Page 2). FORMAL COMPLAINTS 11 CONTINUING EDUCATION 12 DISCIPLINARY ACTIONS 13-32 LICENSES ISSUED 33-50 1 Practitioner Wellness & Stress Management Opportunities We’ve all had increased stress over the last six months, ing on SUD issues, this meeting will address broader is- and current data suggest that physicians and other med- sues of physician wellness and stress management. This ical practitioners may not be the best when it comes to pilot program in Kerr-Bandera Counties seeks to use the recognizing their own need self-care. After all, they are same tools of fellowship and mutual support to address the people that others come to when they need help. more wide-ranging issues of stress management and But wellbeing and healthy stress management is integral other challenges facing medical practitioners as a whole. to practitioners’ ability to be effective caregivers, just as Any practitioner struggling with professional and life it is integral for us all as healthy humans. stressors for which they are seeking practical, scientifi- cally vetted solutions, is invited to join this meeting via TMB has joined with the Texas Physician Health Program Zoom. These stressors may include practice and profes- (TXPHP) to address wellness generally among medical sional issues like peer review or board investigations, practitioners and provide resources for practitioners so family issues like divorce, individual health concerns like that we are better able to take care of ourselves as we burnout, depression or suicidal ideation, spiritual issues continue to provide care for patients under increasingly such as existential crises, and financial difficulties, all of challenging conditions. which may be magnified by the Covid-19 pandemic. These issues will be discussed in complete confidence so A Wellness Pilot Program in Kerr-Bandera Counties participants can obtain peer support, find strength in numbers, and help connect fellow practitioners with ad- Their common suffering transmuted allows grace to en- ditional resources that may be available. Participants ter and dispel the despair, which drove them to depend will, without doubt, find that they will stand shoulder to on chemicals for release, connection and relief. They, shoulder beside one another as a partner to overcome together, have found what they, separately, could not obstacles they could not overcome on their own. Organ- achieve on their own. Leaving personal differences and izers are hoping to share this support model with other ambitions at the door, they share a common solution counties in Texas as interest and participation continues. and strive to pass on what has been freely given to them. Meetings will be every month on the last Tuesday through Feb 23, 2021. The following meetings are cur- Caduceus meetings, in Texas, are generally directed to- rently scheduled: wards practitioners who have substance use disorder. The principles for these meetings are rooted in legacy Oct 27, 2020 at 5:30 PM twelve-step recovery programs such as Alcoholics Anon- Nov 24, 2020 at 5:30 PM ymous. Dec 29, 2020 at 5:30 PM Jan 26, 2021 at 5:30 PM In Kerr-Bandera Counties, these meetings are held at Feb 23, 2021 at 5:30 PM 5:30 p.m. every Tuesday. These meetings welcome prac- titioners such as physicians, physician assistants, and Please use this link to access the meeting each month: nurse practitioners who are recovering from substance https://bit.ly/2EbOU9q use disorders. Many similar Caduceus meetings are held all over Texas. The meetings are a safe, confidential place to form and develop honest connections and rela- tionships with others who share a similar path. Beginning in September, every final Tuesday of each month will now be an open virtual Caduceus meeting— welcome to all practitioners who are dealing with in- creasing internal or external stressors. Instead of focus- (Continued on page 3) 2 Wellness & Stress Management Opportunities, Cont. Additional Stress Management Resources for Medical AMA advice on addressing stress: https://www.ama- Practitioners assn.org/delivering-care/public-health/6-ways-address- physician-stress-during-covid-19-pandemic Resilience, we know from research, is a key component of wellness and preventing and addressing physician Meditation App — Headspace (currently free for burnout. Resilience has physical, emotional, and spiritu- healthcare professionals with NPI#): https:// al components, so here are free resources for each of www.headspace.com/health-covid-19 these areas. Stop Breathe & Think App: http:// Remember that you don’t have to do all of these today app.stopbreathethink.org or at once. Choose one area or one site to explore at a time– take it easy, be gentle. Remember This is infor- Metropolitan Opera online broadcasts: https:// mation to assist you and provide some suggestions for www.metopera.org/ resources that may work for you—for example if one were to explore music, some may find solace in opera Spotify App – Music and podcast streaming (free with music (link to the right) while others may find rock or some access limits): https://www.spotify.com/us/ even heavy metal music a cathartic stress release. Still others may prefer the sounds of nature, a lively radio Podcasts and resources regarding healthcare provider show or podcast, or simply silence. burnout: www.nothinglefttogive.net What matters is that you find a few helpful outlets and Explore.org – livestreams of animals and nature from that you enjoy it. around the world: https://explore.org/livecams Free yoga videos: https://yogawithadriene.com/ Continuing Education Requirements Reminder Several new continuing medical education requirements best practices, alternative treatment options, and from the 2019 legislative session are now in effect for multi-modal approaches to pain management that licensees. These requirements apply to the renewal of may include physical therapy, psychotherapy, and a license on or after September 1, 2020. other treatments; Please note that when reviewing completion of continu- safe and effective pain management related to the ing medical education hours for the remaining 2020 li- prescription of opioids and other controlled sub- censure renewal periods, the Board will take into con- stances, including education regarding: sideration the effective dates of the related CME rules - standards of care; and ongoing COVID-19 pandemic. - identification of drug-seeking behavior in patients; and New Opioid CME Requirements - effectively communicating with patients regarding During the 86th legislative session, there were multiple the prescription of an opioid or other controlled bills passed requiring physicians and physician assistants substances; and to complete certain opioid-related continuing medical education. prescribing and monitoring of controlled substanc- es. At least 2 of the 24 formal hours required (per bienni- um) must involve the study of the following topics: These formal hours maybe credited towards the re- quirements for medical ethics or professional responsi- 3 Continuing Education Requirements, Cont. bility for any physician, or the (10) hours of pain man- The course must be approved by HHSC, and agement continuing education required for those physi- cians practicing in pain clinics. The course maybe credited towards the require- ments for medical ethics or professional responsibil- New Human Trafficking Prevention CME Requirement ity. House Bill 2059 (86th Legislature) requires physicians, physician assistants, and any licensee of the TMB’s advi- HHSC now has an approved course available, which is sory boards or committees that provide direct patient free of charge, that satisfies the requirements for all li- care, to complete a human trafficking prevention course censees impacted by HB 2059.