Doing Right at the Sunset Commission
Tuesday, September 09, 2014 09:36 AM
By: Chris Dalrymple
 

At the Sunset Commission hearing on Wednesday, August 13, 2014, the commission voted seven-to-five to recommend to the legislature that doctors of chiropractic be removed from the list of providers eligible to perform University Interscholastic League pre-participation physical examinations.

Representative Four Price raised the motion to exclude doctors of chiropractic, and it generated a number of objections from other members of the Commission.  What is clear from the following exchanges at this meeting are that:

  • The legislators want input from their constituents regarding the training and experience regarding chiropractic in the school pre-participation examination arena.
  • The chiropractic scope of practice can be expected to be on the floor for discussion during the next legislative session.
  • The legislature will be considering pre-participation issue in the next legislative session.
  • The misinformation provided by the Texas Medical Association, and their financial contributions continue to hold sway over a significant number of legislators.
  • The Texas Senate, with nearly 10% of its members being M.D.s, will certainly have a bias against the chiropractic profession.
  • We can expect to hear more of the rhetoric used in the TMA’s lawsuits during the legislative session in 2015.
Let’s look at the comments of those legislators that stood for doing right.  Here’s what they said:

“Under present practices a chiropractor is a part of the process in terms of providing a physical exam to a student.  [In this modification] We allow nurses to provide and conduct a physical exam but not a chiropractor … to me it seems more like a turf fight than in terms of policy.  ... I have my doubts about specifically excluding chiropractors from the process.   I believe that is a choice that it made by the parents and we shouldn’t take away their choice as long as the person conducting that physical examination is licensed by the state…”  

– Sen. Jose Hinojosa

“I tend to agree with Senator Hinojosa. … Although I understand Representative Price’s desire to be protective of our children, and I’m right there with you, I also know many parents that tend to have a more holistic approach to their health care and that they consider their chiropractor their main health care provider. … I hate to take away the freedoms of our constituents to make that choice.  And because of that, because we currently have chiropractors that are performing these physicals and are doing a good job at it, this is something that needs to be vetted seperately during our regular session where we can have an open discussion with chiropractors, with parents that may be involved, I think that this is looking at a scope of practice and I think that this needs to be thoroughly vetted out."  

 –Rep Cindy Burkett

“I’m not sure I understand completely what the problem is with chiropractors performing these physicals. …  that’s what makes me a little bit reluctant to jump all the way into eliminating chiropractors, because if chiropractors aren't a problem I don’t guess it would change much of anything, but if a significant number of parents are choosing to use chiropractors I’d certainly like to hear from them whether or not they would like to continue to do that.  I guess more importantly, the question is … Is there anything on that list that chiropractors can’t do? … there’s always this fight between the doctors and the chiropractors … I’m concerned about making that leap without enough information that would help me form an opinion ..."

–Rep Harold Dutton

“I think what’s clear to me is that there is enough … uncertainty, and there are things floating around that we just need a lot more clarity on. This is a new issue that I think it deserves a lot more vetting and I think it deserves to be it’s own piece of legislation …. There are so many unanswered questions … my House colleagues are asking me why we are pushing a scope of practice issue in Sunset."

–Rep Larry Gonzales

“I wanted to put on the record my thoughts as well.  I share a similar immediate trepidation with Senator Hinojosa and Representative Burkett that we are affecting the marketplace. …  I’m prepared to support it with the work of Senator Schwertner …. what Senator Schwertner and I worked out is working in the regular session and with chair Price on the House side to provide some sort of provision that allows those chiropractors who wish to continue in this arena to receive additional training that allows them to meet the minimum standards … .”

–Sen Brian Birdwell 

“Dr. Buckingham mentioned the heart-wrenching stories, I bet if we looked at those heart-wrenching stories most of those kids that have died or had a problem went to a physician, and were examined by a physician, and they didn’t catch it, apparently. … I think that this is something that we should be looking at as a free-standing bill, it is a scope of practice issue. … Senator Birdwell, I appreciate your comments too, but short of a chiropractor going back and becoming a licensed physician, a physician assistant, or an advanced nurse practitioner I don’t know what chairman Schwertner could do to accommodate your consitutent or others out there who feel like they have the experience or qualifications …. I think that this effectively says that we are going to limit the scope of chiropractic practice so that they cannot do this…."

–Rep Richard Raymond

“It seems to me that we are using the sunset process to add additional educational requirements of a health care provider profession.  That’s what I see."

– Sen. Jose Hinojosa

“It seems like on the one hand we said that there is nothing that seems to be different in terms of this checklist for these physicals that are provided by either profession, but now we are going to add something to chiropractors …"

–Rep Harold Dutton

“What I’d like to do is to bring back up the modification and take a vote on the modification with the commitment that I will, certainly if it passes, work with Senator Schwertner, Senator Birdwell to craft language as we go forward in the bill, if its accepted, to address those concerns to the best of our ability.”   

– Rep. Four Price.

“Representative Price, can you guarantee us that Senator Birdwell’s [Chiropractic] Constituent will be able to conduct these physicals when you’re done with your amendments, or whatever you work out with Senator Schwertner?"

–Rep Richard Raymond

Absolutely not.”

– Rep. Four Price.