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LEGISLATIVE WRAP-UP

CRIMINALIZING

OF THE

PHYSICIAN

POLITICIANS NOW LEGISLATE HOW
WE PRACTICE MEDICINE

CONSEQUENCES FOR LACK OF
ADHERENCE IS JAIL

By Alex Kenton, MD

ealthcare is one of the most regulated and legislated
economies in the United States today. Texas is a prime ex-
ample. Texas has thousands of rules and laws in its books
already regulating how we practice, how we bill, and even how we
counsel patients. The number of laws has become too many to fol-
low. Indeed, it is estimated that every day an average person commits
three felonies but a physician inadvertently commits up to twice that
rate. As of 2019, the Texas legislature, not to be satisfied with es-
tablishing itself as a top tier state for healthcare regulation, is now
trying to establish itself as a top state for criminalizing the physician
in the practice of medicine.
To be clear, the state legislature has decided that physicians can
and should go to jail for providing what the physician believes is
the best standard of medical care, providing the most accurate
counseling and billing that we physicians would consider a fair fee
for our services. Basically our right to practice medicine and bill
for those services is being curtailed by the whim of the legislature,
with the threat of civil or criminal penalty, including jail time.
Without a push for our physicians to participate in advocacy ac-
tivities such as First Tuesdays and TEXPAC, physicians should be-
come familiar with the consequences of being convicted of a crime.
Just this session, Senate Bill 23 was proposed in which a physician
who failed to provide life-sustaining support to an infant who was
born alive despite an attempted abortion would be subject to a third
degree felony and a civil penalty of $100,000. A third degree felony ening condition in the mother. In other words, more physicians were
could result in imprisonment for 2 to 10 years! One may think that at risk with this bill than one might suspect. Senate Bill 1033 en-
most obstetricians and neonatologists would be spared as most sured that a physician who provides an abortion after the second
physicians do not perform abortions, but the definition of abortion trimester (only later were some medical emergency protections
itself is left unclear. Unfortunately, a fair number of pregnancies placed for physicians) would be subject to prosecution for a class A
are terminated before viability due to the presence of a life threat- misdemeanor. Consequences for such offenses include imprison-

22 San Antonio Medicine • August 2019