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September 20, 2011

Texas makes it harder to be whistleblower

Daily Briefing

A new Texas law that took effect this month prohibits the state medical board from considering anonymous complaints against physicians like those filed by two Winkler County nurses who were at the center of an abuse-of-power case last year.

According to the Austin American-Statesman, about 4% of the 6,849 complaints submitted to the Texas Medical Board last year were anonymous. Although the new law would ban anonymous comments, individuals' identities would remain confidential and available only to the medical board. The law also will require the board to inform physicians when an insurer or pharmaceutical company files a complaint against them.

The law is the culmination of statewide efforts to end anonymous complaints after a physicians' group accused the medical board of abusing the process, the American-Statesman reports. In 2007, the group claimed that a former board president intended to manipulate the system to discipline her competitors.

Could the law affect patient care?

Although some lawmakers say the law will have little effect on the complaints process, patient groups are concerned that it will discourage people from filing complaints and lead to lower quality care. Alex Winslow, the executive director of advocacy group Texas Watch, called the law a "step in the wrong direction" that "could endanger the safety of patients."

Michael Beckham, a patient who recently filed a complaint, notes that members of the medical community also may be less likely to identify at-fault physicians for fear of repercussions similar to those experienced by two Winkler County Memorial Hospital (WCMH) nurses.

Last year, the two WCMH nurses were fired after anonymously reporting Dr. Rolando Arafiles to the medical board. The nurses believed that the physician practiced dangerous prescribing and surgical procedures, such as performing a skin graft—which ultimately failed—without surgical privileges and suturing a rubber tip to a patient's injured finger.

A sheriff, who has admitted his friendship with the physician, uncovered the two nurses as authors of the letter. Both nurses were fired by the hospital, and prosecutors filed a criminal lawsuit against them, citing harassment of Arafiles. The nurses subsequently won a $750,000 settlement from the county and the parties involved were indicted on charges, including misuse of official information, official oppression, and retaliation.

"Though I do not know if the Winkler County nurses would have filed their complaints if they had to attach their names, the new law would keep their names confidential," state Rep. Donna Howard (D) said. Meanwhile, James Willmann, general counsel and director of governmental affairs for the Texas Nurses Association, called the new law a "fair compromise," noting that few complaints are "truly anonymous" (Roser, American-Statesman, 9/18).

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