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Texas: Chiropractic board pulls proposed rule to create specialties in nutrition, neurology

Home/Scope of Practice/Texas: Chiropractic board pulls proposed rule to create specialties in nutrition, neurology

From an article in August 19th, 2012

The Texas Board of Chiropractic Examiners has said it will re-examine proposals to allow chiropractors to call themselves specialists in nutrition and neurology after hearing complaints from dietitians and physicians.

At a meeting in Austin on Thursday, the board heard from registered dietitians urging it to withdraw a proposal to create a specialty in chiropractic nutrition. The board also received letters from the Texas Medical Association and physicians strongly objecting to a chiropractic neurology specialty.

The board did not meet beforehand with the affected groups, as it is required to do, representatives of those groups said. Further, they have complained that the specialist training would be too little or vague and would confuse and potentially endanger the public.

Because Texas does not regulate nutritionists “anyone can call themselves a nutritionist,” said Jessica Coffee, a registered dietitian in the Dallas-Fort Worth area and public policy coordinator for the Texas Academy of Nutrition and Dietetics. “For most Texans, the term ‘specialist’ connotes an even higher level of training.”

The medical association’s president, Michael Speer, said in a letter that the state’s largest physicians’ group “is very concerned that not only will patients be deceived and misled, but many could also suffer injury and harm, for example by delayed diagnosis” of a serious condition, such as a brain tumor or stroke. He added that neurology was “beyond the scope of chiropractic.”

The medical association has been embroiled in litigation with the chiropractic board for several years over treatments physicians contend are in their purview to perform, not chiropractors’.

Chiropractors are mainly involved in treating conditions of the spine as well as muscles, tendons, ligaments, bones, joints, associated tissues and nerves that move the body and maintain its form. Definitions vary, however.

Earlier this year, acupuncturists lambasted the chiropractic board for seeking to create a specialty in acupuncture. The board withdrew the proposal.

Chiropractors at Thursday’s meeting said they are highly educated and resent being portrayed as potential dangers to the public.

“There seems to be a theme that any time the board tries to recognize any achievement, the quality of those people (chiropractors) is questioned,” said Thomas Hollingsworth, a Corpus Christi chiropractor.

But Hollingsworth and other chiropractors said they favored withdrawing the proposed rule so the board could improve its procedures.

Board members indicated that they would seek more input. They agreed to let stand specialty designations in orthopedics and radiology, which were created three years ago and have not caused problems, they said.

The earliest the issue is likely to return to the board is Dec. 4, the date of the next meeting, said Yvette Yarbrough, the board’s executive director.

Ongoing issues in Texas and a call to arms by James Edwards, DC appear in the article, “What Happens in Texas Won’t Stay in Texas”  . Dr Edwards serves on the board of directors of the National Chiropractic Legal Action Fund and is a member of the ACA Legislative Commission. He lives in Austin, Texas.

About the Author:

Dr Wiens created the very first chiropractic information page on the web in Nov 1994. In 1995 he joined as chief designer. He lives in Canada.


  1. Troy Holder, DC August 21, 2012 at 8:06 pm

    This seems ludicrous to me. There are already these specialties in Chiropractic!!! And, yes, they are very knowledgeable and those who are diplomates in these specialties DO have a much higher knowledge base than DC’s who have not completed the coursework involved with those diplomate programs. I think the biggest problem here is the ignorance on the part of the TMA and the Texas Academy of Nutrition and Dietetics. Maybe I’m wrong about this, but I feel very strongly that chiropractors who have undergone those programs (and even some who haven’t) are trained adequately to provide nutrition or neurology services safely, as well as, knowing when to make the proper referral.

    Case and point: I don’t even have a neurology diplomate, However, in my young career I have already had a case where we found the person had a brain tumor and made the proper referral (The CC: HA’s). It’s already part of our training at chiro college. The TMA and Texas Academy of Nutrition and Dietetics needs to catch up with all the other states.

    My two cents.


  2. Russell Berg D.C. August 21, 2012 at 8:08 pm

    Personally, I have been invited by neurologist to participate in roundtable meetings. Believe it or not it was productive for both parties. Why can’t we have specialist? Are we to remain subordinate to the medical profession. If a chiropractor has had the training and receives certification I believe they should be able to called specialist whether it is in neurology or nutrition. I have personally benefited from nutritional counseling that wasn’t from a “nutritionist” and feel that those chiropractors properly trained in nutrition can be a threat to the others and as such try to suppress us just as the AMA has tried to do for years!

  3. Frank M. Painter, D.C. August 21, 2012 at 10:03 pm

    I award the TCE 4 rotten eggs for their botched handling of this situation.

    The ACA has maintained diplomate programs in nutrition and neurology for years, and for a State group to think they can create their own accreditation is both shortsighted and disrespectful of diplomate programs.

    Needless to say, this is the biggest local screw-up since the BCA fiasco.

    Yup, 4 rotten eggs, and perhaps a fifth, awarded for cowardice in the line of fire!

  4. Russell Berg D.C. August 21, 2012 at 10:39 pm

    Why do chiropractors always have to acquiesce to the medical profession. That is not what we were built on. Several years ago the SPINE journal compared a study with chiropractic radiologists and medical radiologists. Guess who came up number one? The chiropractic radiologist. We need to stand our ground.

  5. Troy Holder, D.C. August 21, 2012 at 11:25 pm

    Dr. Berg, you wrote: “Why do chiropractors always have to acquiesce to the medical profession?”

    I feel the same way. In fact, there was a post on the ACA listserve e-mail recently showing how physical therapists in Europe had gained prescription rights. And, it was noted how people took that as a step back for us as a profession, because the PT’s got the rights to prescribe. (I don’t want to get into the whole debate as to whether we should have rights to prescribe as well – provided those who did had the post-graduate training) It seems to me that there are many in our profession (and I could be wrong…) that put the MD up on the pedestal; thinking that they are better than us.

    And, I completely agree with you, Dr. Painter, on how this situation was handled from their part. Why in the world would you even try to put together specialty programs for the state itself!? There’s already a NATIONAL specialty program in each of those!!!!! They should have immediately consulted with the ACA and ICA.

    To go along with Dr. Berg, radiologists is one, but how about the neuromusculoskeletal diagnosis tests? Where the resident MD’s were tested and the STUDENT DC’s were given the same test…who came out on top? DC Students.

    I’m sure each of us could go on and on.

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