No to Chiros Use of Parking Placards

TMA Testimony by T.J. Spinks, MD

HB 406 in the House Transportation Committee

Tuesday, February 19, 2013

Mr. Chairman and members of the Committee, I am Dr. T.J. Spinks. I am a neurosurgeon with Southwest Orthopedics here in Austin. I am testifying on behalf of the nearly 50,000 physician, resident physicians, and medical student members of the Texas Medical Association.

I speak in opposition to House Bill 406.

Under current law, and according to the Texas Department of Motor Vehicles, a person is eligible for a disabled parking placard if they meet the legal definition of “disability”:

  • Visual acuity of 20/200 or less in the better eye with correcting lenses, or
  • Visual acuity of more than 20/200 but with a limited field of vision in which the widest diameter of the visual field subtends an angle of 20 degrees or less, or
  • Mobility problems that substantially impair a person's ability to move around; these problems can be caused by:
    o Paralysis
    o Lung disease
    o Cardiac deficiency
    o Wheelchair confinement
    o Arthritis
    o Foot disorder
    o Other medical condition causing a person to use a brace, cane, crutch or other assistive device.

Patients with these conditions are predominantly cared for directly by or under the supervision of a licensed physician.

HB 406 proposes to create a new class of eligible individuals – those with a “temporary mobility problem” and to allow chiropractors to issue the parking placard for these individuals. 

Part of the issue is that the bill does not define a “temporary mobility problem,” nor does it hint at how temporary the issuance of a disabled parking placard might be. Another and the more concerning part for physicians is that some people may delay proper medical treatment.

For example, back pain is a common complaint for which people seek care from chiropractors and bypass a physician’s visit. However, back pain may not necessarily be musculoskeletal in origin. Back pain may manifest itself as referred pain from kidney stones, kidney infection, hip problems, or even metastatic cancer, among many others.

My colleagues and I strongly believe that if a patient is acutely injured or has a medical condition with significant mobility restriction – to the point of needing a disabled parking pass – that patient should be seen by a physician who can diagnose the patient’s apparent and underlying medical conditions.

TMA and physicians cannot support this bill or any other that interferes with timely and proper diagnosis of acute injuries and chronic conditions. 

I do want to acknowledge that there is a perception among my colleagues that there is misuse of the current system and that many who don’t need the benefit of a disabled parking placard use them improperly. Real or not, this perception has led many of my colleagues to become more wary about prescribing a placard.

I would imagine that broadening the availability of these to those with “temporary mobility problems” would further crowd out those spaces that have been reserved for those with significant disability.

Members, I thank you for your time.

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