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Ten-Year Texas Battle Resolved in Favor of Chiropractic

On Friday, the Texas Supreme Court ruled in favor of the Texas Chiropractic Board and the Texas Chiropractic Association after a ten-year battle with the Texas Medical Association over whether chiropractors in the state of Texas may include the nervous system and brain, rather than the narrow focus of the spine, in their scope of practice.  TMA argued that any reference to nerves in the chiropractic scope of practice authorized chiropractors to diagnose any neurological condition, which TMA argued, was the practice of medicine.  The Court provided the necessary clarity in Texas, and perhaps throughout the United States, that the Board rule, “merely recognizes the reality that musculoskeletal dysfunctions cannot be diagnosed or treated without considering associated nerves.”  Id. at p. 23.  The Court went on to say, “Simply put, a healthcare provider cannot diagnose a problem without ruling out other potential causes of the problem.  In other words, making a differential diagnosis is an unavoidable part of making a diagnosis.  Virtually any problem that a chiropractor treats could potentially have a non-chiropractic source.”  Id. at 27.

 

The Texas Supreme Court opinion reversed the earlier Court of Appeals decision which struck the Chiropractic Board rules and found that including “nerve” exceeded the statutory scope of practice.  
 
The Court recognized that chiropractors are portal-of-entry healthcare providers in all 50 states, that Medicare and Medicaid cover chiropractic services, and that Texas’ workers’ compensation regulations authorize the more than 6,000 chiropractors in Texas to treat injured workers.  
 
The ten-year battle is yet another reminder of what might have been an insurmountable loss to the profession had the Texas Supreme Court ruled differently.  The decision calls us to remember the need for strong Association membership to assist with the governmental affairs in Florida that will continue to fight to maintain the profession’s ability to diagnose and the broad scope of practice provided to chiropractors in Florida. 
 
I personally would like to thank my fellow National Board of Chiropractic Medicine Board members along with the Federation of Chiropractic Licensing Boards who each provided the financial support for the filing of an Amicus brief to allow additional representation for the chiropractic profession.