The Alliance For Natural Health

Threat to Texas Chiropractors’ Scope of Practice

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chiropractic

The Texas Board of Chiropractic Examiners (TBCE) wants to greatly limit the scope of chiropractic practice in Texas. Why? A state-based Action Alert.

The TBCE has proposed a change in its rules that would prohibit chiropractic doctors from diagnosing or treating any condition not explicitly related to the biomechanics of the spine and musculoskeletal system. This would make a “definitive opinion or diagnosis that a patient suffers from a disease or condition unrelated to the biomechanics of the spine or musculoskeletal system” outside the scope of permitted practice.

In effect, many of the services chiropractic doctors currently perform in Texas would become illegal. They would no longer be able to diagnose or treat extremities or peripheral neuropathies (damage to the nerves and peripheral nervous system), and any discussion of diet or supplements would have to be directly related to the patient’s symptoms connected with the biomechanics of the spine. Chiropractors certainly won’t be able to offer an integrated approach to health if they are forced to focus so narrowly on the spine.

Why would the TBCE want to limit their own scope of practice? Nationally, chiropractors have had to defend the legitimacy of their practice against state medical boards and the traditional medical community—often waging lawsuits and introducing legislation on both the state and federal level. The American Chiropractic Association offers a two-part video on chiropractic history. The video outlines its struggles, in particular against efforts by the American Medical Association, to stop competition from chiropractors—a battle that went all the way to the Supreme Court.

In Texas there has been a longstanding turf war—in which profits figure prominently—between the Texas Medical Association (TMA) and the TBCE. The Texas Chiropractic Association has a timeline of the conflict, which began in the early 1900s.

Just last year, the TBCE was sued by the TMA (a suit recently joined by the Texas Medical Board), challenging three broad points in the TBCE’s existing rules. The lawsuit claims that only medical doctors can diagnose medical conditions. Chiropractic doctors would need an order or protocol from a medical doctor to perform a diagnosis. However, as the TBCE said in their defense, you cannot treat unless you first diagnose. And without a diagnosis, you also can’t decide if a condition is beyond your scope of treatment and needs to be referred to another professional.

Another point of contention is needle electromyography (EMG). In 1995, the Texas legislature prohibited chiropractors from performing surgical procedures or making incisions into any organ, body cavity, or tissue. The TBCE allows needle EMG, even though it involves inserting needles under the skin, because the procedure is used to assess the health of muscles and diagnose conditions such as carpal tunnel syndrome and Lou Gehrig’s disease.

The 1995 law also prohibited the chiropractic board from certifying chiropractors to perform spinal manipulation under anesthesia. However, the board took the stance that while the law prohibited it from certifying chiropractors to perform the procedure, it did not prohibit chiropractors from performing it.

Clearly, the TBCE’s decision to limit chiropractors’ scope of practice in Texas comes as a result of all the litigation and pressure applied by the Texas Medical Association (the preamble to the proposed rules specifically mentions the “recent litigation brought by the TMA”). The Texas Chiropractic Association has filed constitutional challenges protecting chiropractors’ scope of practice, but these cases are still tied up in the courts.

So, the way we see it, the Texas chiropractors, under assault again by conventional doctors, are trying to compromise. But in their effort to compromise, they are throwing out the baby with the bathwater. In particular, their ability to suggest supplements or offer integrative solutions not directly related to the spine will be gone. Moreover these new rules would be murky. It would be easy to attack a chiropractor for doing just about anything and force him or her to the wall with heavy legal expenses. This is one compromise which we don’t need.

What we do need is for the Texas chiropractors to show some backbone! They need to fight back at what is a clear attempt by conventional doctors to carve up the medical market and prevent competition.

If you are a Texas resident, please contact the TBCE immediately to protect chiropractors’ scope of practice in Texas and reject the changes in the proposed rules.

TO SEND YOUR MESSAGE TO THE TEXAS BOARD OF CHIROPRACTIC EXAMINERS (TBCE)

Click THIS LINK to go to the Action Alert page. Once there, fill out the form with your name and address, etc., and customize your letter. We have a suggested message for you, but please feel free to add your own comments to the letter.

We’d also love to hear your comments about this article—just add your thoughts below—but remember that the messages below are only seen by our ANH-USA readers and not the TBCE.

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  • Gisella

    Swimming through a sea of scum bags is awfully tiring. If only the corporate really knew how to live, that is…to enjoy good health and nature!

  • Robert Cruder

    Texas is second only to Kansas in irrational (usually religious) laws and regulations but has strayed from their usual form.

    What peer-reviewed science actually supports chiropractic? It may well be “treating” imaginary or self-limiting conditions. Certainly those suffering from Münchausen syndrome or hypochondria would pay for the attention but chiropractic is neither cost-effective nor safe.

    CSICOP documented that chiropractors will claim to cure any condition that a credulous consumer might claim to have. See : http://www.csicop.org/si/show/skeptical_consumers_look_at_chiropractic_claims/

    Limiting chiropractors to spinal conditions (which is all that Daniel David Palmer claimed) appears entirely reasonable.

    In 2009, “Skeptic” magazine documented that chiropractic manipulation can kill. See http://www.skeptic.com/eskeptic/09-10-21/#feature

    There is no obvious cure for this second problem short of manslaughter charges. Licensed physicians are generally protected against criminal charges for iatrogenic death but faith healers are regularly prosecuted. Chiropractors appear to fall into the latter category.

    • Dustin Reif

      Well if you consider “skeptic magazine” a reliable source for your healthcare than I guess you are right chiropractic can kill.

      According to http://www.strokecenter.org/patients/stats.htm there are 143000 deaths from strokes each year. This girl happened to see a chiropractor before she had her stroke… that must mean the chiropractor caused it right??

      Do you know how many people are killed by iatrogenic causes each year??? Over 200,000 which makes it the 3rd leading killer behind heart disease (preventable through good nutrition, exercise and chiropractic) and cancer (also preventable).

      Daniel David Palmer used chiropractic to restore a man’s hearing, I don’t think he envisioned us being limited to the spine.

      Chiropractic allows the body to work at it’s highest potential, by increasing immune function and restoring proper communication! Many Chiropractors have vaccination and medicine free children who are sick less than the average person.

      I myself, after seeing a chiropractor, had no need for my asthma medication, stopped wearing the pads in my shoes (without theses pads prior to Chiropractic I was unable to walk because of the intense pain) and do not experience allergies or chronic sinus infections any longer.

      There are thousands of stories just like mine that I have personally heard so I am sure there are thousands out there that I haven’t heard about.

      Robert, do yourself a favor, research the topic and then find yourself a good chiropractor!
      If you have access to pubmed (a peer reviewed medical journal database) you can find hundreds of articles supporting the benefits of chiropractic.

      Dustin Reif

  • This information is not correct. Please check details with the TBCE and the TX Chiropractic Association

  • Cynthia Tays, D.C., DABCO

    This article is not accurate. Please go to http://www.tbce.state.tx.us to see the real facts. There is a statement from the chiropractic board on it’s website that gives the details that are accurate.
    Signed,
    Cynthia Tays, DC, DABCO
    President, Texas Board of Chiropractic Examiners

  • Donna Mae Travis

    It is our freedom and rights to continue to seek alternative medical practices and care from any type of services being provided in a community. They have undergone specialty training to help patients. Allow them to practice and serving us all if we so need it. They keep records for treatments and that is good enough. Keep your laws and hands out of their practices.

  • Richard Darr DC

    Addressing the supplements that we suggest to patients. Most of our recommendations help strengthen the muscles, ligaments and tendons helping the alignment of the spine. Proper diet and nutrition are also an important part of a chiropractor’s practice. Total body health is the goal.
    Dr Richard Darr

  • Kuno van der Post

    Only from a medical opint of view are there such things as ‘spinal conditions’. Chiropractors, osteopaths etc are seen as people who deal in the mechanics of the spine, as if it were a dead structure like the chassis of a car, only from a medical point of view. This is not how those practitioners see themselves. In fact the spine is living tissue, and its health depends on the coordinated action of every function of the body.

    Take a disc bulge – suppose that is caused by dehydration of the tissues: and this is also causing the patient to suffer from rheumatoid arthritis and asthma. And suppose their generally malnourished state is also a factor in their heart condition. (This is not a rare set of circumstances, but is very amenable to degrees of improvement by non-drug means.) Acceptance of the mechanical position assumes that the disc must be treated mechanically only, and the other problems are entirely seperate matters, to be dealt with by doctors, using drugs.

    In other words, accepting a limited scope of practice means 3 things:
    1) the direct treatment for the spine will at bestl be very limited in effectiveness.
    2) the underlying cause of the problem (malnutrition and dehydration) will not be treated, by anyone, so the patient will remain unnecessarily diseased.
    3) the patient will be condemned to life of poisonous medication, and pain.

    I agree with the statements in the article – the chiropractors must decide what they believe in, and stand up for it.

  • Dhyanna

    Stop interfering in our lives, we don’t need you to run our lives, we are freedom seeking spiritual beings.

  • P. York

    This is another redicilous “government take over”. Where do the politicians get that they are God and know more than anyone else? Sounds like Hollywood has really woven their “know it all” into the everyday stream of life.

  • Swan Thompson

    Well, I don’t know what “Hollywood” has to do with anything, but I think this Bill is a bunch of nonsense. Congress is slicing baloney by the pound in Washington – and all at taxpayer expense. Every piece of legislation seems to infringe more and more on individual privacy and civil rights. I want to maintain the personal freedom to consult my family practitioner, my chiropractor, my acupuncturist, and my massage therapist – and anyone else I want. I don’t need the government deciding who can tell me what. It’s bad enough that Big Insurance is running our medical plans. We cannot allow Congress to meddle more with our personal decisions! Come on, chiropractors of Texas! Don’t submit to this! Stand up and kick some behinds! And take some names!