Doctors, Chiropractors Square Off Over Bill

After a fierce fight, the state’s leading physician groups won a change in legislation backed predominantly by Texas chiropractors that could have prevented one health care licensing agency from challenging the ruling of another in court. The bill reached final passage on the Senate floor today after addition of an amendment added by Sen. John Carona, R-Dallas, who authored the bill, reflecting a compromise between the Texas Medical Association and the Texas Chiropractic Association.

As originally drafted, SB 1001 would have prohibited one health care licensing agency — say, the Texas Medical Board — from suing a practitioner who was overseen by a second licensing agency — say, the Board of Chiropractic Examiners — if the second agency had already determined the practitioner was in compliance with state law.

Carona's amendment removed those provisions.

SB 1001 is designed to let health care practitioners create business partnerships with practicing physicians. Right now, podiatrists and optometrists, for example, can, but chiropractors cannot. In the original draft, everyone operating under Texas’ Occupations Code — from midwives to acupuncturists — would be allowed to partner with physicians, but the amendment adds specific language to allow only chiropractors to partner with physicians.

Opponents of the original measure, including the Texas Medical Association (TMA) and the Texas Academy of Family Physicians (TAFP), said the drafted bill could have endangered patients, because the Texas Medical Board would have no authority to go after chiropractors overstepping their training, but given an “all clear” from the Chiropractic Examiners. In essence, they say, chiropractors would be able to expand their scope of practice with no repercussions — and without proper safeguards.

“There is no intention whatsoever to expand scope of practice in this bill,” said Carona, who ensured the amendment would allow health care licensing agencies to continue suing each other.

“The chiropractic board could determine that performing needle electromyography is within the scope of education, training and licensure of a chiropractor,” TAFP chief executive Tom Banning wrote in an Apr. 12 letter, “in effect immunizing the chiropractor from violating his or her practice act.”

The groups were negotiating last night and again this morning. The talks fell apart, then came back together, finally producing the compromise Carona presented as an amendment.