Response From the Texas Medical Board (TMB) – Insanity From Bureaucrats

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=127 October 2021, I complained to the Texas Medical Board (TMB) about an incident with a Texas Medical Doctor and his unethical treatment of me, the patient.  The full complaint can be reviewed here.  The file number for this action: #22-1620, and the response I received is a textbook case of bureaucratism from beginning to end, in a letter dated 02 November 2021.

  1. The author of the letter, writing on behalf of the TMB, cannot even use my appropriate title, name, and the letter dismissing my concerns is a form letter of the worst design, surpassed only by the VA whose form letters cut off almost an extra inch in the right-hand margin.
  2. An investigation into the issues with the Dr. AAMR Arif Herekar MD was not launched as the actions by the provider “do not fall below the acceptable standard of care.” The letter references “Sec. 154.058” as the legal standard.

Texas Occupations Code – OCC § 154.058. Determination of Medical Competency is a truly interesting document, designed, I can only surmise, to protect the asininity of the bureaucrats.  A point-by-point breakdown is discussed.

  • Each complaint against a physician that requires a determination of medical competency shall be reviewed initially by a board member, consultant, or employee with a medical background considered sufficient by the board.”

Nowhere in the letter does it reference an individual who reviewed my complaint.  If I read this section of the code correctly, all that has to happen is a living person check to ensure Dr. Herekar has a license to practice medicine in Texas.  Essentially, Dr. Herekar has met the basic competency for this section.  Dr. Herekar is living, paying his dues, and a living bureaucrat has assured us he is licensed properly by the State of Texas.  As a side note, do you feel better that a bureaucrat assures the general population a doctor is appropriately licensed and dues-paying; I do not!

  • If the initial review under Subsection (a) indicates that an act by a physician falls below an acceptable standard of care, the complaint shall be reviewed by an expert physician panel authorized under Section 154.056(e) consisting of physicians who practice in the same specialty as the physician who is the subject of the complaint or in another specialty that is similar to the physician’s specialty.”
  • The expert physician panel shall report in writing the panel’s determinations based on the review of the complaint under Subsection (b).  The report must specify the standard of care that applies to the facts that are the basis of the complaint and the clinical basis for the panel’s determinations, including any reliance on peer-reviewed journals, studies, or reports.”

Yet, my complaint was somehow satisfied under section (a), so sections (b) and (c) do not apply.  Leading me to wonder, but not to question enough to “file an appeal.”  What I wonder about is the professional and ethical standards allowing for a provider to lie about a patient’s actions and then dismiss that patient from receiving further care, based upon the lies generated, and dismiss the patient using Facebook instant messenger.  As the bureaucrat cannot, and will not, respect me sufficiently to explain, expound, and address me correctly, one must wonder about the rest of the State of Texas and the bureaucrats who call their actions competent.

  1. Consider with me the problems of a medical provider lying about a patient’s actions, and ask yourself, would you trust that medical provider?

The Department of Veterans Affairs (VA) and the American Taxpayer is paying for me to visit a non-VA or “Community Based” provider.  That provider does not want me as a patient and makes this clear from the moment he introduces himself.  Why; possibly because I cannot wear a mask. Perhaps because the VA chooses how much that provider will be paid. Maybe because the provider simply does not want more military veterans as patients.  Fundamental core reason never provided, but the provider is at best passively hostile and willing to invest the barest of minimums in care to receive the maximum amount from the VA possible.

Because the provider must provide the VA with patient notes, the easiest way to rid himself of a military patient is to lie about that person’s conduct.  Thus, the doctor can play the victim, receive payment, and continue the veteran abuse perpetuated by the VA.  The lies of this provider are reported to the VA, and providers at the VA consider the veteran a “behavioral problem,” further reducing the quality of care.

Yet, the TMB considers the actions of this provider above the “acceptable standard of care.”  It must be a good gig to be a liar and thief in medical practice in Texas, for the bureaucrats at the TMB will protect you and assure the community that care was above the “acceptable standard.”  Tell me, TMB, what is below the acceptable standard of care?  If a medical provider can lie, cheat, and dismiss patients using unsecured methods of communication, and this is above “the acceptable standard of care,” what are actions below the “acceptable standard of care?”

Explain to the community, dear bureaucrat, how HIPAA was protected and the patient’s rights protected as part of “acceptable standards of care.”  Relate how trust in medical providers is enhanced when a medical provider can lie about a patient’s behavior, slander and ridicule that patient, causing more issues in receiving healthcare for that patient.  The Texas Medical Board is supposed to be the arbitrator and settler of problems; yet, this problem is not resolved, simply pushed on to other bureaucrats.  That is the epitome of job security for bureaucrats, not properly fulfilling your duties.cropped-bird-of-prey.jpg

I repeat, only for emphasis, “Houston, we have a problem!”  That problem is internal malfeasance and misfeasance on the part of bureaucrats.  To the Governor of Texas, to the Texas State Legislator, what are you willing to do to fix these despicable actions of useless bureaucrats?

© Copyright 2021 – M. Dave Salisbury
The author holds no claims for the photos or images used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

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Blood is Blood – The Logic is Flawed!

Exclamation MarkLast night, during one of my frequent periods of wakefulness, a headline blew my mind, “There is no difference between blood and blood – Horowitz removes restrictions on gay men donating blood,” as reported by the Jerusalem Post.  Using this logic, then going maskless is not a problem, and being vaccinated or not vaccinated is not a problem either, for blood is blood.  Worse, consider the ramifications; the safety and integrity of the blood supply have been a critical problem from the first day humans realized we could take blood from one person and put it into another person successfully.  Mistakes in the integrity and safety of the blood and blood product supply cost people their lives!

I am not here to discuss the political aspects of this move.  The Health Minister of Israel (Horowitz) will be measured and weighed by his electorate for good or ill.  How and when the Health Minister will be measured and weighed will be up to the people in Israel, and I hope they will choose wisely.  I have no further comments on the political side and wish Israel the best of luck on this issue.

However, on the practical aspects of blood and blood product, safety and security, I have a LOT of concerns and have some authority, knowledge, and ability; thus, I will speak to this issue.  As I begin, I will state, again for the record, I do not care about your bedroom choices (hetero-, homo-, etc.), keep them to yourself and your legal age of consent consenting partner, and I could care less.  However, medical professionals should know some risks as they handle body fluids, especially when donating those fluids for others to use in an emergency.

Pin on Signs and SymbolsDuring the 1980s, both the American Red Cross and the Canada Red Cross Society suffered blood tainted scandals due to insufficient testing of, knowledge of, understanding of, and the dimensions inherent to donating blood and blood products where sexually transmitted diseases were concerned, especially AIDS/HIV.  AIDS/HIV was not the only sexually transmitted disease that crossed through blood transfusions, Herpes, Gonorrhea, and many more all had their times in the spotlights as diseases making their ways into donated blood and thence into patients without risky lifestyles, who contracted these diseases after receiving transfusions of blood or blood by-products.  The first cases were noticed in the US Military, where patients started having problems with these sexually transmitted diseases after being wounded and receiving life-saving blood or blood by-products and then catching an infectious disease.  Even Malaria has records of being passed through blood and blood by-products, so just presuming that sexually transmitted diseases are the only diseases to worry about is not acceptable.

Claiming “blood is blood” is the height of exaggerated ineptitude for a political cause.  Yes, red stuff oozing from a mammalian host can generally be typified as blood, but not all blood is the same, nor is all blood equal.  This is why monkey blood is not harvested for use in humans, why Ape blood is not transferred into elephants, and human blood has a letter classification system.  Whale blood cannot be used in dolphins, nor is it compatible with human use; thus, claiming “blood is blood” remains a thoroughly ignorant comment of the highest magnitude!

The 17th AnnualGive the Gift of Life Holiday Blood Drive | B104 WBWN-FMTake a minute, those of us who lived through the 1980s health scares and blood scandals.  By the way, that is plural for a reason; blood scandals keep happening because blood security and integrity and politics do not mix, and every time some politician thinks they can mix safely, we have another blood integrity scandal, and people die!  Do you want to take the risk of being in an auto accident, being rushed to a hospital, receiving blood or blood by-products, and coming home with a transfusion disease?  What about dialysis patients who regularly receive blood or blood by-products; do you want to add another worry to your list of health concerns when receiving care?

Sign Donation Blood Heart Donor Icon Stock Illustration - Illustration of icon, design: 79488667Now, suppose the findings on a medical record were being made public, and the patient’s rights trampled, where disclosure of lifestyle risks kept that person from donating blood and were being published. In that case, I might believe there was a “rights” concern to be vocal about.  However, this is not the case, and refusing a population with known high risks for passing multiple communicable diseases through all types of body fluids, from donating said fluids to the general population, is just sane and common sense medicine.  It is not discriminatory to exclude those who choose a higher-risk lifestyle to participate in specific activities where the health and welfare of the general population are concerned.Blood Donation Sign Wall Poster Background Material, Love, Blood, Donation Background Image for ...

Case in point.  If I travel to Thailand, whether I engage in the sex trade or not, I am refused from donating blood for a specific period after I return home, and I will have to pass a blood test before my blood is accepted at the blood bank.  Plus, because I prefer to give plasma, I will have to prove I am clean twice before I can give plasma again.  This is not discriminatory; this is a safety precaution to protect the rest of the blood and blood by-product supply from contamination.  Now, if I engaged in the sex trade in Thailand, I would be banned indefinitely from donating blood, regardless of condom usage, and the remarks would be permanent across the entire records of the Red Cross.  All because the threat is too great to risk allowing this heterosexual male access to donate blood and run the risk of contaminating it with a disease from Thailand.  I know people in South Korea, who caught unique diseases during the Korean War, who cannot return to the United States, ever.  The United States made this decision not to run the risk of contaminating America with what they caught.  Not discrimination, simple public health policy.

Knowledge Check!Now, we return to the crux of the argument.  If “Blood is blood,” then being vaccinated does not matter because blood is blood and public health and safety are not issues where communicable or infectious diseases are concerned.  If this is correct, why do we still have COVID restrictions?  If blood is not blood, why bow to political pressure on something that is definitely not a political but a medical safety issue?  Politicians and those who cling to the government for an answer to every single problem cannot have this issue both ways.  Either blood integrity and safety is a medical issue where common sense practices trump individual rights for the common good and safety of donating life-giving fluids, or life requires taking risks, and we can shut down the regulatory boards and panels, reducing the costs of medicine.  I am all for reducing the size and cost of government; while I might not argue fully for making all those cuts in medicine regulation, a choice needs to be made and then supported.  Choose wisely!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.