Twelfth Night
Fort Worth District Dental Society
September 2006
S.B.D.E. Enforcement: An Agency Run Amok or Implementing Necessary Procedures
By Bill Purifoy, SBDE member, 2005-2011
Since 1897, the Texas Legislature has provided for licensure of dentists. The first Board of Examiners and Dental Practice Act (DPA) were created in 1911. Between 1911 and the present, various alterations have been made to the DPA. We should never forget that our privilege to practice dentistry is both controlled and provided by our state legislature.
In 1977, the Texas Legislature created the Sun set Advisory Commission to identify and eliminate inefficiency in government agencies. This commission is a legislative body that reviews the policies and programs of more than 150 state agencies every 12 years. Agencies are abolished unless specific legislation is enacted to continue their existence. Unfortunately, this occurred to the SBDE in 1993, in part because of disagreement s between the dental and dental hygiene associations over the proposed legislative reauthorization bill. Although the DPA remained in effect, this was a regrettable period in our history which tarnished our professional image in Austin.
The SBDE was re-established by the 74th legislature in 1995, but less than one sunset cycle later, ill winds were blowing through Austin again. Governmental dissatisfaction with the SBDE’s enforcement record was the primary reason that the legislature decided to hasten the sunset date from 2005 to 2003.
The Sunset Review Report concluded in 2002 that the SBDE’s enforcement of existing dental laws was inefficient and that the agency provided poor accountability of complaints against dentists. These factors, along with ineffective enforcement procedures, were considered to result in infrequent and weak disciplinary action. Key findings pertaining to SBDE enforcement were as follows:
- The Board is responsible for processing, investigating, and prosecuting complaints filed against regulated dental professionals and entities.
- The Board takes too long to resolve complaints.
- The Board does not appear to address violations of the Dental Practice Act adequately.
- Some of the Board’s enforcement procedures and available remedies may affect its ability to resolve complaints.
- Other agencies use staff or experts to perform enforcement functions, and some have stronger enforcement authority.
As a result, specific recommendations were developed which were intended to give the Board additional authority to enforce the DPA, resulting in improved accountability and better protection of the public. The culmination of these Sunset Review recommendations was Senate Bill 263 which continues the SBDE until September 1, 2012. It also established specific alterations to the complaint resolution and enforcement process.
The tangible effect of these legislative actions is evident. By law, the SBDE is required to enforce the DPA and to resolve complaints in a more efficient manner. The upswing in SBDE enforcement activities and disciplinary actions simply reflects the legislative mandates which came out of the 2002 Sunset Review Report. These mandates include:
- More timely resolution of current complaints and strong emphasis on adjudication of the backlog of older pending cases.
- Fewer dismissals of cases against dentists.
- Increased disciplinary action against dentists (only three states had a lower percentage of disciplinary actions than Texas, which was 7 percent).
- Less leniency in Board actions (previous decisions did not appear to match the Board’s penalty schedule).
- Authorization for restitution for patients as part of the settlement process.
Just as it is the Board’s responsibility to enforce the DPA and Board rules, it is our responsibility as practicing dentists to abide by the rules and to uphold the standard of care in our therapy. While this may require ongoing education and effort, it can and should be done. More on that in a future article.
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