Saturday, May 10, 2008

Dr. Shirley Pigott Response to TMB Disciplinary Findings

Shirley Pigott MD
1412 E Red RiverVictoria, Texas 77901
March 29, 2007
Roberta Kalafut DO, President, Texas Medical Board
PO Box 2018Austin, Texas 78768-2018
Regarding Licensee F-7054: Shirley Pigott MD; formal response to a proposed public order.

Dear Dr. Kalafut,I must decline to sign the proposed public Texas Medical Board Order delivered to my medical office at 1412 E Red River, Victoria, Texas, by certified mail on or about March 5, 2007.

The complaint leading to the Board's recent order is an alleged failure to release uninterpreted lab results within 15 business days of written request by one patient (CH) who sought medical advice to assist her with health risk reduction.

Determining someone's health risks requires a history, physical exam, and interpretation of medical tests, a process we explain to new patients. Ms H visited my office once, in March, 2006. After my evaluation, I ordered lab. Instead of returning for the interpretation as she had agreed to do, Ms H began calling our office. For one of her calls, I left another patient to talk with her. She demanded that I locate her financial records immediately to explain a $20 unpaid release of records charge.

Literature on workplace safety reports an increased risk of violence in medical facilities. The Occupational Safety and Health Administration requires me to provide a safe working environment for my employees, myself, and my patients. Ms H's behavior alarmed me and I consulted the Victoria Police Department; the officer issued a criminal trespass warning. The Board findings of fact : "There is no evidence that CH made or posed any sort of threat whatsoever, except by the filing of the complaint with this Board".

A physician directly involved in a clinical situation has an advantage over one who is not present. The Board's insensitivity to the vulnerability of a medical facility is disturbing. In several points the Order is inflammatory, exaggerated, or false. It is inconsistent with the missions of the Texas Medical Board and the Federation of State Medical Boards. Enforcement of the order would violate basic civil rights guaranteed me by the Texas and United States Constitutions.

This incident is an egregious example of what is commonly termed sham peer review. Without conscience, certain members of the Board have defamed my character and have determined to cause me harm. A single question begs to be answered: What is a possible motive?

The Board is aware of my family's advocacy for persons with bipolar disorder from its previous investigations of my family. The board knows my teen-age son and I have stable bipolar disorder and have been under expert care for years. My patients with psychiatric conditions are encouraged when I freely talk about how well we have coped. Although my son and I are not impaired, and although I have never been impaired, the Board continues to make regular intrusions into my personal affairs.

The board has not acknowledged repeated inquiries by my own physicians and the board's appointed psychiatrist as to why their frequent reports are justified. When I questioned the TMB as to why it might be focusing its limited resources on such an inconsequential complaint as CH's, the Board's attorney remarked to no one in particular as to whether Ms H's complaint "might be related" to my bipolar disorder.

Rather than speculating at my hearing, why were the two psychiatrists the Board requires me to see several times a year not asked their expert opinions in advance?

Their answers should have provided enough information to permit even an over-zealous regulatory agency to focus on matters of greater import. If something causes something else (A => B), one would expect to find at least one case where A => B.

The Board has fallen short. Another option would be to trick someone into agreeing that under some theoretical circumstance "A causes B" might be a true statement. That is exactly what the Board has determined to do with regard to my bipolar disorder causing a delayed release of a single lab report, and I won't fall for it.

Stating that 'not releasing a lab report to someone who could have just as easily called the lab' is 'an indication that a physician is a danger to the public' is a bit of a stretch. The Board would coerce me to waive unspecified civil rights and consent to intrusive monitoring of my patients' personal health and financial records indefinitely, at my own expense. It would deny me any right of future appeal and require me to concur with the Board's accusation that I am a danger to the health of Texans, and swear, incredibly, that I am signing it voluntarily!

At my hearing, a member of the panel stated that I should "assist in paying for" the Board's investigation. Under the circumstances, the $500 'administrative penalty' the Board wishes to impose on me is extortion. I will cite two recent examples where perhaps I actually protected the good health of Texans. A personal friend, not a patient, will testify upon request as to my role in the diagnosis and successful treatment of his florid mania.

I am privileged to have been present during his time of need. A young woman was recently brought to me by her worried mother after she had been in a serious motor vehicle accident. Although she was not physically hurt, she didn't remember what had happened. Two previous physicians had dismissed her concerns as 'hormones'. Fortunately I was present when she needed me.

This young woman, her mother and father, and RN brother all are are satisfied with my diagnostic acumen and urgent referral to qualified care. I have included a copy of the mother's statement. The neurosurgeon at the University of Texas Health Science Center in Houston who successfully removed her temporal lobe bleeding arteriovenous malformation in a timely manner is reluctant to testify in my behalf because of his fear of retaliation by the Board. The Board's actions are so outrageous as to convince me there must be another agenda, hence my suspicions of sham peer review.

Shirley Pigott MD

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