At first glance, the TMA’s legal battles seem a little silly. It waged an eight-year fight with podiatrists over the definition of the word “foot.” Does a foot include the ankle and lower shin? Because if it does, that might allow podiatrists to treat ankle patients who might otherwise visit an orthopedist.
The doctors won that suit. But they’re still fighting chiropractors over the exact meaning of the word “diagnose.” David Bragg is the TMA’s lead attorney.
“We say that because the Legislature specifically listed things that a chiropractor can do: ‘examine, evaluate and analyze’ and did not include the word ‘diagnosis;’ therefore chiropractors cannot diagnose, as the term is defined, meaning the identification of disease.”
The TMA sued the state chiropractic board because it issued a rule saying chiropractors could diagnose. Bragg says that small word could open up a can of worms, allowing chiropractors to do things far beyond their training.
“You can examine a person’s spine. You can determine that that person’s spine needs manipulation or adjustment, all within the scope of a chiropractor’s license. When you go beyond that though, when you start saying ‘Okay, you have cancer of the spine of some kind, that’s when you get into medical issues.'”
So what’s really at stake here? Doctors say it’s about patient safety, while chiropractors say it’s about money. Jack Christie is a Houston chiropractor.
“Basically this is a turf battle for 80 years, maybe even longer. Because we threaten them commercially. Every patient that we fix here in a chiropractic office, it takes away a forty, fifty-thousand dollar surgery from them.”
Last month, a district judge in Austin ruled that chiropractors can diagnose, but they must restrict diagnoses to the biomechanics of the musculoskeletal system. The chiropractic board is appealing.
These turf battles are being fought in many states. They pit nurse practitioners against physicians, ophthalmologists against optometrists.
Now there’s a new factor: the new national health care law. Dr. Susan Bailey is president of the TMA.
“The new health care bill is going to cause some confusion I believe in who does what in medicine. There is a role in the health care bill for expanded use of nurse practitioners, midwives and other types of non-physician health personnel to help solve the physician shortage and TMA’s position is if you want to practice medicine you should go to medical school.”
The TMA has also sued family and marriage therapists over whether they can diagnose mental illness.
From the KUHF Health Science and Technology Desk, I’m Carrie Feibel.