Sunset Commission Issues TBCE Report – Issue 5
Written by Editor   
Sunday, October 09, 2016 12:00 PM

Issue 5 of the Sunset Commission’s Staff Report recommendation is that Texas should continue regulating chiropractors, but decisions on the structure of the Texas Board of Chiropractic Examiners await further review of the Sunset process.

If there were doubts that the chiropractic profession in Texas was in jeopardy of drastic change, here it is in black and white from the government itself.  Take particular note that report observes that "the Texas Board of Chiropractic Examiners would be a likely candidate for consolidation."   If DCs don't participate in the governmental process they may find themselves as a true minority regulated by an overbearing and dismissive majority.

The staff report notes that “the review found that the board has operational deficiencies ... that raise questions about the best structure to regulate chiropractic.”  They summarize these as:

  • Slow complaint resolution.
  • Unknown criminal history of more than 3,000 chiropractors.
  • Risk to continued operations.
  • Manual processes lack sophistication.
  • Limited stakeholder involvement.
  • Stakeholders continue to raise concerns about the board not garnering their input or considering their concerns.

The report also notes that "the board does post rules in the Texas Register and opens their meetings for public comment, as required. However, the board does not engage stakeholders early or regularly enough in the process to demonstrate true consideration of stakeholder input, such as through regular stakeholder meetings or workgroups.”

The report agrees that doctors of chiropractic should be regulated. Says the Sunset staff, "improper practice may not just impact patients’ health and safety, but may also impact patients’  financial well-being due to the costs of unnecessary treatment or the costs of fixing poorly performed treatment. If improper practice is suspected, the state is best positioned to investigate complaints about chiropractors or individuals posing as chiropractors and take disciplinary action as necessary.”

Sunset staff note that currently DCs are well trained, well educated, and well vetted:  “the board requires chiropractors to demonstrate competence by graduating from an accredited four-year college of chiropractic, successfully completing all parts of the National Board of Chiropractic Examiners examinations, and passing Texas’ jurisprudence exam. In addition, applicants must pass criminal background checks and maintain continuing education credits.”  They have concerns about the TBCE's capability to regulate the profession.  

A major factor in this is that “the board’s statute does not reflect standard language typically applied across-the-board during Sunset reviews.  While the agency’s functions should continue, its organizational structure must be evaluated in conjunction with the Sunset Commission’s review of other comparable health licensing agencies.”  It is time for the Texas Legislature to modernize the Chiropractic Act.  The Sunset staff agree and recommend changes in the Chiropractic Act.  They recommend “continue the regulation of chiropractors, but postpone the decision on continuation of the Texas Board of Chiropractic Examiners until completion of the Sunset reviews of other health licensing agencies. … the Texas Board of Chiropractic Examiners would be a likely candidate for consolidation. As shown in the findings, the agency struggles to ensure the most effective and efficient regulation of chiropractic, and consolidation could allow for a focus on the implementation of best practices and more robust regulation designed to better protect the public.”