Medicine v. Chiropractic, a Timeline
Written by Editor   
Sunday, August 07, 2016 08:43 AM

The Texas Medical Association (TMA) is continuing its over-a-century-long quest to eliminate the chiropractic profession.  For a decade now they have been challenging the chiropractic doctor’s right to diagnose – all the way to the Texas Supreme Court.  

The TCA and its legal team continue to intervene on behalf of the chiropractic profession.  The latest TMA lawsuit was heard August 2 in Austin.  While the chiropractic team has done well explaining the job of the chiropractor in the area of diagnosis, the TMA’s experts have admitted their lack of expertise on the chiropractic profession that they deem themselves qualified to regulate.

We thought we would present a brief synopsis of this 120+ year old battle in Texas.

  • From 1800 to 1850 new schools of thought about how to practice medicine developed.  These “new schools” rapidly produced practitioners and the states deregulated the practice of medicine.  By 1849 only one state and the nation’s capitol had medical regulation legislation.
  • By 1847 common physicians began to seek ways to standardize the practice of medicine. The American Medical Association (AMA) emerged in 1847. One of its first actions was to accept a code of ethics that distinguished its doctors from “new school” doctors.
  • In 1853 35 medical physicians organized the TMA, allowing every gentleman of the Medical Profession” to become a member, but irregularly trained (non-AMA approved) doctors were specifically excluded.
  • In 1873 the first modern medical practice act was passed in Texas.  By 1905, 39 states were again licensing physicians.
  • In 1876 the Texas State Constitution states: the Legislature may pass laws prescribing the qualifications of practitioners of medicine in this State, and to punish persons for malpractice, but no preference shall ever be given by law to any schools of medicine.
  • The Medical Practices Act of 1901 created three medical boards, including the Texas Board of Medical Examiners (now called the Texas Medical Board– TMB).
  • In 1903 the AMA reorganized itself and membership grew dramatically.
  • In 1906 both D.D. and B.J. Palmer are sued for practicing medicine without a license. In Dallas, Texas, Palmer graduate Andrew P. Davis, MD, DO, DC, perhaps the first chiropractic doctor in Texas, was teaching, practicing and marketing his new book, Neurology.
  • In 1907 the 1901 Medical Practice Act was discarded and all three medical boards were supplanted by the TMB to administer the examination and licensing of physicians and surgeons, prescribe their qualifications, and provide procedures for the registration and revocation of licenses.  The American Medical Association inspected and rejected 32 medical schools and conditionally approved another 46.
  • In 1909 the Carnegie Foundation commissioned Abraham Flexner to visit medical schools and write a report on the status of medical education in the United States and Canada.  The report found that many of the schools were substandard.  With 1) the Flexner Report in hand, 2) approval from the American Medical Association (AMA) and its close partner, the Association of American Medical Colleges (AAMC), along with 3) the financial backing of Carnegie and Rockefeller, medical education reform was in full swing. One medical doctor stated that the combination of the monies from the Rockefeller Foundation  and the influence of the AMA and AAMC virtually gave birth to the strongest professional monopoly in the United States – Organized Medicine.  They now held the cards for governing all health professions.  So it should come as no surprise that they strenuously fought every effort by chiropractors to obtain licensure.  
  • The first chiropractic college in Texas was chartered by the state in April 1910.
  • By 1913, a chiropractic doctor was successfully prosecuted in San Antonio, by the Bexar County Medical Society, for practicing medicine without a license.
  • By 1916 chiropractic doctors from the Texas State Chiropractic Association to seek a chiropractic licensure law for Texas.
  • Attorney Pat M. Neff, future president of Baylor University and governor of Texas, found himself under fire in May 1917, because he was such a supporter of the Texas State Chiropractic Association and constantly legally defended a Waco DC.  That same year the first chiropractic bill passed the house by a vote of 82 to 57, but failed to overcome resistance in the Senate and was defeated.
  • By 1919 the “chiropractic fight for medical liberty in Texas” is known throughout the country.
  • Beginning in 1922 the medical doctors began an aggressive program of public education against chiropractic.  In 1923 attorney general Dan Moody met with the Texas Medical Association in a convention at Ft. Worth and promised them in an address that he would, “Run all the chiropractors in Texas into the Gulf of Mexico.”  The Lamar County Medical Association ran a series of ads in the daily newspaper, warning the people about such “quacks” being a menace to the “Public Health.” The 1927 convention of the TMA dedicated a large part of its time to the “concerns of the association with strengthening the State Health Department and with controlling the increasingly powerful chiropractors.”  The Dallas County Medical Society supported the creation of a new court, which they felt could better handle all the “practicing medicine without a license” charges, and they went after the chiropractors again. In 1928 the Executive Committee of the TMA reported that a bill had been introduced into the legislature to employ a chiropractor in the San Antonio Hospital for the Insane. Calling it a “new aspect of the chiropractic threat” the council was “tortured by the thought of chiropractors working on those incompetent to choose physicians."
  • In 1943 the first chiropractic act passed.  The TMA persuaded the Senate to attach crippling amendments which set impossible standards for the colleges.  The bill passed and was signed into law, but was soon found to be unconstitutional in 1944.
  • In 1949 the second chiropractic act passed. The basic science law was also passed and added two years of college outside of chiropractic college and specified the required subjects.  The Medical Practice Act was amended to set chiropractic doctors apart as a distinct field having a separate board of examiners and a distinctive area of practice.
  • The AMA forms the committee on Quackery 14 years later in 1963.  It’s primary goal was to contain and eliminate the profession of chiropractic.  By 1968 the AMA influenced the Health Insurance Advisory Council to deny chiropractic entrance into the Medicare system. Such inclusion is delayed until 1972.
  • In 1969 the AMA purchased the book At Your Own Risk: The Case Against Chiropractic and distributed the book to over 1000 of the nation’s largest libraries. In 1971 four Chicago area chiropractors sue the AMA for restraint of trade.  The suit is titled Wilk v. AMA.  In 1976 it discovers an AMA memo on the Committee on Quackery states it is on its way to containing chiropractic’s push to be covered by health insurance and worker’s compensation by opposing chiropractic efforts to get into hospitals, by containing chiropractic schools, by encouraging “ethics” complaints against chiropractors, by warning that professional association between medical doctors and chiropractors would be deemed unethical, by discouraging colleges, universities, and faculty from cooperating with chiropractic schools by deeming it unethical for medical doctors to refer to chiropractic doctors and unethical to accept referrals from chiropractic doctors, and by resisting chiropractic efforts to enhance its position through legislation.
  • It was only in 1972 that osteopathic physicians were admitted into the TMA
  • In 1979, because of the Wilk suit, the AMA tells all state medical associations to PURGE any documents related to chiropractic.
  • In 1983 the jury rules against chiropractic in the Wilk suit, but the US Court of Appeals overturned the decision and sent the case for retrial.  The US Supreme Court refused to intervene.  In 1987, after the second trial, on September 25, 1987, a federal judge declared that the AMA had violated the Sherman Act, and that it had entered into a long history of illegal behavior. She then issued a permanent injunction against the AMA to prevent such future behavior. In 1990 both sides in the Wilk Case appealed, and the district court’s decision was affirmed by the U.S. Court of Appeals.  The AMA petitioned the U.S. Supreme Court three times, but each time the Court declined to take up the matter.
  • In 2001 the TCA was actively included and consulted in legislative negotiations regarding Texas Workers’ Compensation Commission overhaul compromise bill HB2600.  
  • In 2002, however, TCA files a lawsuit against the University Interscholastic League for discrimination against chiropractors by prohibiting them from performing and signing school physicals, and against the Texas Workers’ Compensation Commission for discriminatory regulations against the chiropractic profession regarding their use of Designated Doctors.  
  • In 2003 the Texas lesgislature passes, and the Governor signs into law, the inclusion of Chiropractic Doctors as those who may be protected from liability when performing voluntary school physical examinations. The UIL reverses its discriminatory policy against Chiropractic Doctors and informs school administrators that chiropractors ARE allowed to sign school physical examination forms.
  • In 2005 the Texas legislature mandates that the Texas Board of Chiropractic Examiners (TBCE) adopt rules clarifying what activities are included in the practice of chiropractic.
  • In 2006 the AMA announced an industry consortium known as the “Scope of Practice Partnership” (SOPP), which included as one of its founding members the TMA. The SOPP monitors state legislation and regulation on scope of practice to prevent non-MD or DO providers from advancing their professions.  The TMA and TMB file suit against the TBCE for allowing chiropractic doctors to provide manipulation while a patient was under anesthesia and for performing needle EMG.  This case is nicknamed TMA v. TBCE #1.  Later TMA amends the lawsuit to challenge the chiropractic doctor’s ability to render a diagnosis of any sort.  Without the ability to determine their own diagnosis the chiropractic doctor would be entirely dependent upon the referral of a common physician.
  • On November 24, 2009, the trial court rules that the TBCE rules regarding Needle EMG and MUA are invalid but that the rules regarding “diagnosis” are valid with respect to those matters within a doctor of chiropractic’s scope of practice.
  • In 2010 a Texas district court rules against chiropractic in TMA v. TBCE #1.  In 2011 TBCE appeals the EMG/MUA portion decision, and the TCA appeals all three matters to the Third Court of Appeals.  TMA then files another suit against the TBCE for its rule allowing chiropractic doctors with special training to perform instrument assisted Vestibular Ocular Nystagmus Testing (VONT).  This is nicknamed TMA v. TBCE #2A. This suit sat inactive while TMA v TBCE #1 was tried and appealed, when, in 2012, the appeals court rules that diagnosis is legal within the Chiropractic Act, but that MUA and Needle EMG are invalid.  In 2013 the Texas Supreme Court denied the TMA and TMB appeal of the TMA v TBCE #1 decision on diagnosis.
The TMA then files its first amended petition to the TMA v. TBCE #2A VONT case challenging the TBCE for its rule defining the words “musculoskeletal” and “subluxation complex” because of the inclusion of nerves in those concepts.  They again raise the issue of the chiropractic doctor to render a diagnosis so this appealed case now becomes nicknamed TMA v. TBCE #2B.
  • In 2014 the Texas Association of Acupuncture and Oriental Medicine (TAAOM) files suit against the TBCE, claiming that acupuncture is outside the scope of chiropractic practice.  The medical acupuncture board is under the umbrella of the TMB.  
  • The 419th District Court, in 2015, rendered its final order in the lawsuit filed by TAAOM.  The TAAOM filed for a Summary Judgement, but was DENIED The TBCE also filed a motion for summary judgement and the court granted the TBCE’s motion.  Also in 2015 the US Supreme court, in a suit against the North Carolina Board of Dental Examiners, states “When a state empowers a group of active market participants to decide who can participate in its market, and on what terms, the need for supervision is manifest.”
  • As of 2016 the TMA again amends TMA v. TBCE #2B to expand its attack on diagnosis.  Now nicknamed TMA v. TBCE #2C.  This case at the time of this writing is currently being heard in court.  Appeals are expected.
Having offered zero evidence in TMA v. TBCE cases #1, #2A, #2B, #2C or the acupuncturist suit of any harm to the public it becomes apparent that the “public health” argument is a red herring and is, rather, evidence of the effort to monopolize and contain a non-MD or DO health care provider.  It appears to be a continued violation of the federal injunction imposed as a result of the Wilk v AMA lawsuit more than a quarter of a century ago.