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Texas Board of Chiropractic Examiners v. Texas Medical Ass'n

Citations: 375 S.W.3d 464; 2012 Tex. App. LEXIS 5428; 2012 WL 2742554Docket: No. 03-10-00673-CV

Court: Court of Appeals of Texas; July 6, 2012; Texas; State Appellate Court

Narrative Opinion Summary

The Texas Court of Appeals addressed the validity of administrative rules adopted by the Texas Board of Chiropractic Examiners (TBCE), which attempted to expand the scope of chiropractic practice to include Manipulation Under Anesthesia (MUA) and needle electromyography (EMG). The Texas Medical Association and Texas Medical Board contested these rules, arguing they exceeded statutory limits and constituted unauthorized medical practice. The district court invalidated the provisions concerning needle EMG and MUA, determining that they fell outside the statutory scope of chiropractic practice as defined by Texas law. The court highlighted that needle EMG involved 'incisive' procedures, thereby exceeding permissible chiropractic activities. Additionally, it ruled that MUA is categorized as a surgical procedure, which chiropractors are not authorized to perform. The court also examined the authority of chiropractors to diagnose conditions, affirming that they may do so within the biomechanical scope but not for diseases outside this realm. The appellate court upheld the district court's rulings, emphasizing the statutory framework's clarity and the boundaries set by the Legislature on chiropractic practice.

Legal Issues Addressed

Chiropractic Diagnosis Authority

Application: Chiropractors are permitted to diagnose conditions within the biomechanical scope, but not diseases outside this realm.

Reasoning: Chiropractors are authorized to diagnose and evaluate subluxation complexes of the spine and musculoskeletal system, as outlined in the Texas Administrative Code § 75.17(d)(1).

Interpretation of 'Incisive' Procedures

Application: The court found that needle EMG procedures are 'incisive' as they involve cutting tissue, which is outside the chiropractic scope.

Reasoning: The insertion of a beveled-edge needle for electromyography (EMG) is classified as an 'incisive' procedure, as it cuts tissue, which contradicts the Chiropractor Parties' interpretation.

Manipulation Under Anesthesia (MUA)

Application: The court ruled that MUA is a surgical procedure, which chiropractors are prohibited from performing under Texas law.

Reasoning: Chiropractors do not have the authority to perform Manipulation Under Anesthesia (MUA) as it is classified as a surgical procedure, which is explicitly prohibited under section 201.002(a)(4) of the Occupations Code.

Regulation of Medical Practice

Application: The court emphasized the constitutional authority granted to the Texas Legislature to regulate medical practitioners, ensuring no school of medicine is preferentially favored.

Reasoning: The constitutional authority granted to the Texas Legislature to regulate medical practitioners, emphasizing that no school of medicine can be preferentially favored.

Scope of Chiropractic Practice

Application: Chiropractors are allowed to perform actions classified as 'practicing medicine' if within the statutory scope of chiropractic as defined by the Texas Occupations Code.

Reasoning: A chiropractor licensed by the Texas Board of Chiropractic Examiners (TBCE) but not by the Texas Medical Board (TMB) may legally perform actions that would typically be classified as 'practicing medicine,' provided these actions fall within the statutory scope of chiropractic as defined under Chapter 201.

Statutory Construction and Deference

Application: Statutory construction is reviewed de novo, focusing on the Legislature’s intent primarily through the statutory text.

Reasoning: Statutory construction is reviewed de novo, focusing on the Legislature’s intent primarily through the statutory text.