At Lype, Dest & Smith, our Texas Medical Board lawyer team regularly hear from physicians who assume the words negligence and malpractice mean the same thing and are caught off guard when they discover that the Board operates under an entirely different set of rules from a civil court.
Understanding negligence vs. malpractice matters because the Board’s view of your conduct may have nothing to do with whether a patient’s lawsuit succeeds or fails or whether the patient suffered actual harm from the alleged conduct. In Texas Medical Board investigations, negligence can be a failure to meet the standard of care. The term “malpractice” refers to a breach of professional standards in the context of a civil suit.
The two terms carry distinct meanings in the Texas legal and regulatory context:
Each system also pursues a different goal:
From a patient’s perspective, the bar for filing a civil malpractice suit against a physician is significantly higher than for filing a Medical Board complaint. A civil malpractice suit requires that the patient/plaintiff find an attorney that believes the malpractice claims can be demonstrated, that damages can be proven, and that the amount of damages and likelihood of prevailing is acceptable. A Texas Medical Board investigation, since it is not primarily concerned with compensating the patient, frequently proceeds in circumstances where a civil malpractice suit is unlikely.
In case you still have questions about how a civil claim and a Medical Board Investigation work, see our blog Medical Board Investigations vs. Malpractice Claims: What’s the Main Difference?

Standard of care issues are a frequent subject of Texas Medical Board complaints and investigations. In these cases, a licensee is faced with defending the care provided regardless of whether the patient was injured and regardless of whether the treatment was successful.
A comprehensive and reasoned response to the initial complaint letter is vital, as it is the earliest opportunity to rebut the standard of care allegations and prevent a formal investigation, where the care is subject to greater scrutiny and expert review.
Once a formal investigation is initiated into standard of care concerns, the TMB assigns the case to an Expert Panel, board-certified physicians in the same or a similar specialty, who will review the medical records and all other relevant materials. If the panel finds the physician’s actions did not meet the generally accepted standard of care, the case moves to the Litigation Section and is scheduled for an Informal Settlement Conference (ISC). Prior to the ISC, the licensee will have an opportunity to submit additional rebuttal evidence for the Panel’s consideration, and the ISC itself gives an opportunity for the physician to directly address the care provided.
If a standard of care violation is found by the ISC panel, the scope of potential discipline is wide and depends on many factors. Where an isolated standard of care violation with little to no actual patient harm might warrant a sanction of continued medical education courses and a small fine, a pattern of standard of care violations involving multiple patients and greater levels of harm might yield a license restriction, license suspension, or even revocation in the most severe circumstances.
Under Texas Occupations Code Section 164.001, the Board can take any of the following actions against a physician’s license:
Public orders appear on TMB profiles and trigger reports to the National Practitioner Data Bank, which Houston-area hospitals and insurers use for credentialing. Statutory guidelines require the Board to impose harsher penalties, including permanent revocation, for physicians with previous disciplinary records.
Whether the concern involves a negligence allegation, a standard of care dispute, or a civil filing running at the same time, our Medical Board Defense attorneys bring experience from inside and outside the TMB process to every Houston case we handle. Call Lype Dest Smith Lawyers at 512-881-3556 to schedule a consultation before your next deadline.
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