Judge Backs TMA on Patient Safety Issue

An Austin state district judge ruled in TMA's favor in early December and granted the association's motion to stop chiropractors from performing vestibular testing. Judge Rhonda Hurley's ruling invalidates the Texas State Board of Chiropractic Examiners' (TBCE's) vestibular testing rule by declaring it to be beyond chiropractors' lawful scope of chiropractic.

TMA took the TBCE to court to protect patient safety after TBCE adopted rules allowing chiropractors to perform the procedure. TMA argued that state law does not authorize chiropractors to perform vestibular testing. The vestibular system is a component of the inner ear and communicates with the central nervous system. Tests of vestibular function are diagnostic tests designed to evaluate the function and structure of the inner ear and/or brain. The tests include hearing evaluations because the hearing and balance functions of the inner ear are closely related. 

"The vestibular apparatus is not part of the musculoskeletal system because the muscles that connect the eyes to the skull do not 'move the body' or 'maintain its form,'" TMA said in its motion. "Chiropractors are not authorized to diagnose medical conditions, including defects in the vestibular apparatus, because the Chiropractic Act does not include the diagnosis of diseases within the definition of chiropractic. Even if chiropractors can use the word 'diagnosis' in a rule, any such diagnosis must be limited to the biomechanical condition of the spine and musculoskeletal system." 

The TMA motion added that the issue of whether "diagnostic testing by chiropractors is important for patient safety or for chiropractors to be able to be primary care doctors is a question for the legislature and not the court." 

This is the fourth part of TBCE’s Scope of Practice Rule that a court has declared invalid and void because it exceeded the scope of chiropractic as defined by law. The first three parts of the rule unlawfully authorized chiropractors to perform manipulation under anesthesia and needle electromyography and to diagnose diseases.  

Action, Dec. 16, 2011