The Texas State Board of Medical Examiners (TSBME) has the authority to investigate its licensees, including physicians, to determine whether the Medical Practice Act (“the Act”) has been violated (1). Violations of the Act include practice inconsistent with public health and welfare generally a failure to act in accordance with the standard of care), unprofessional and dishonorable conduct, disciplinary actions against a licensee by another state board or peer group, repeated and recurring meritorious health care liability claims against a licensee (3 or more claims in any 5-year period), and crimes by a licensee that involve moral turpitude (2). If a violation is determined to exist, the board can impose penalties that include reprimands, administrative fines, and license restriction, suspension, and revocation (3). Physicians’ chances of being investigated by the board and having some action taken against them appear to be increasing. The statistics published by the TSBME on its website (http: www.tsbme.state.tx.us) show that the board has become more aggressive in the investigation and discipline of licensed physicians. These statistics include data by fiscal year (FY) since 1994, through February 28, 2003. In FY 2002, there were 832 pending physician investigations compared with 556 in FY 2001. During the first 5 months of FY 2003, less than half of that year, there were 742 pending physician investigations (4).