Jan/Jun 2010 Journal

Texas Chiropractic Association

Texas Journal of Chiropractic Volume XXIV, Issue 1 First Quarter 2010

WE’RE BACK! The Texas Journal of Chiroprac tic Returns!

Chiroprac tic Communi cation Chiroprac tic Rules chan ges Contested Election

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Texas Chiropractic Association

Texas Journal of Chiropractic First Quarter 2010

Volume XXIV, Issue 1

Texas Journal of Chiropractic The Official Publication of the Texas Chiropractic Association

1122 Colorado, Suite 307 Austin, TX 78701 Phone: 512 477 9292 Fax: 512 477 9296

Featured in this Issue Dr. Dan Murphy to Speak at Mid-Winter Conference 5 Presidentʼs Message--Chiropractic Communication

E-mail: info@chirotexas.org www.chirotexas.org Executive Officers President: Kevin Kanz D.C. President Elect: Ed Fritsch D.C. Secretary: Jorge Garcia D.C.

6 Just a Word From the Editor--The Journal Returns 6 Insurance Should “Oversupply” Chiropractic

TCA Staff Executive Director: Patte Kent Communications Director: Chris Dalrymple D.C.

7 Kind Words From the Executive Director 9

Legislative Director: Chip Kent

Board of Directors District 1!!

District 2!!

District 3!!

District 4!!

District 5!!

District 6!!

District 7!!

District 8!!

District 9!!

District 10!

District 11!

District 12!

Dan Petrowsky D.C. Jon Blackwell D.C. Jason Clemmons D.C. Greg Carter D.C. Dr. John Quinlan D.C. Cody Chandler D.C. David King D.C. Robert Hoffman D.C. Debra White D.C. Thimios Partalas D.C. Ed Kieke D.C. Yvonne Landavazo D.C.

Policies Unless otherwise identified, the use of “Dr.” refers to “Doctor of Chiropractic”.

Annual subscription to the Texas Journal of Chiropractic is included in TCA membership dues.

Contact the TCA for non-member subscription rates.

The Texas Journal of Chiropractic is published by the Texas Chiropractic Association.

Opinions expressed are those of the contributors and do not necessarily reflect the policy of the Texas Chiropractic Association or the Texas Journal of Chiropractic.

Senator J. P. Word Passes Away 10 TMA Sues Chiropractic: TMA vs. TBCE Lawsuit 11 TCA Secretary Race--Contested Election 15 TBCE Reports 19 Chiropractic Rules Changes 26 Invest in Chiropractic 29 Publication of an advertisement does not imply approval or endorsement by the Texas Chiropractic Association.

The association shall have the absolute right at any time to reject any advertising for any reason.

Copyright 2010 All Rights Reserved: Texas Chiropractic Association

For advertising rates contact the TCA Office. All advertising material must be in graphics ready format and submitted as a .pdf, .tiff .jpg, .jpeg, .gif, .swf, or .png file type.

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NCMIC is now offering a premium dividend to its D.C.s for the 14th year in a row. Though not guaranteed, NCMIC’s outstanding track record of offering a premium dividend is due to careful fiscal management, excellent service and an unwavering focus on chiropractic defense. And our D.C.s share in this success.

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Call for Keeler Award Nominations Established in 1934 by Dr. Clyde Keeler, The Texas Chiropractic Association’s award designating the Chiropractor of the year, The Keeler Plaque, is Texas Chiropractic’s most prestigious award.

Nominations for the Keeler Plaque should be sent to:

Dr. Dan Murphy at TCAʼs Mid-Winter Conference Dan Murphy D.C., will present the TCA Mid-Winter License Renewal seminar in Ft. Worth at the end of February.

Sponsored by NutriWest of Texas, Dr. Murphy will present a program on Nutrition and Chiropractic Practice, a review of the basic chiropractic neurological model.

D r. M u r p h y ʼ s t e a c h i n g objectives are: • Learn the neurophysiological difference between cell membrane fluidity v. stiffness.

• Learn the relationship between omega-6 v. omega-3 essential fatty acids.

• Review the articles relating to essential fatty acids and joint function.

• Review recent articles relating to omega-3 fatty acid and antii n fl a m m a t o r y e f f e c t ,

Texas Journal of Chiropractic

Curtis McCubbin D.C. Secretary, Keeler Plaque Committee P. O. Box 272 Hunt, Tx 78024 This year’s award will be presented June 12, 2010, in Austin, Texas, during the President’s Banquet of the TCA’s 95th Annual Convention All nominations will be held in strict confidence to assure that the recipient will be surprised when their name is announced.

A candidate shall be: A member in good standing in the TCA Of good moral character A promoter of chiropractic advancement in at least one of the three years immediately proceeding the year in which the award is to be presented. Such advancement may be in research, public relations, school participation, promotion or support.

The candidate’s main endeavor must be in the practice of chiropractic and must have promoted chiropractic throughout their career.

Civic, church or community involvement, individually or within organizations or groups, and holding offices in local, state or national chiropractic organizations, chiropractic boards, and chiropractic college boards may also be considered.

cardiovascular function, and brain function.

• Learn about the nutritional influences on immune system function.

Learn about trans-fatty acids.

• Learn about excitotoxins and neurodegenerative 5

diseases and about free radicals,antioxidants, and micronutrients.

• Learn the anti-oxidant network to protect the double bonds of essential fatty acids. ✮

Welcome to the Texas Journal Of Chiropractic By: Kevin Kanz D.C., President It is my distinct pleasure to welcome you to the return of t h e Te x a s J o u r n a l o f Chiropractic. The TCA board of directors is pleased to bring you return of the printed Journal. With the support of our advertisers this has been made possible. Thank you!

Dr. Chris Dalrymple, who served as editor-in-chief of the Journal for nearly a decade, has taken on the responsibility of creating the Journal. Bear with us while we get this project ironed out.

Expect minor errors and glitches. It will take the production team a bit of time before all the bugs are shaken out. In the meanwhile I encourage you to enjoy the Journal and the information that we are now able to bring to you.

I also invite you to regularly check the TCA website and the online Journal which is linked to it. Here you will find up-to-the-minute news and information pertaining not only to chiropractic, but health care news in general, district news and information.

We are developing a communications

Call for Nominations for Young Chiropractor of the Year Established over half a century ago, this award is for the purpose of recognizing doctors who have shown outstanding dedication and who have made long-lasting contributions to the profession and their community, and who are under 40 years of age at the time of the award’s receipt.

This year’s award will be presented June 12, 2010, in Austin, Texas, during the President’s Banquet of the TCA’s 95th Annual Convention Send nominations to 2009 recipient: Thimios Partalas D.C. 2425 Babcock Rd., Ste. 111 San Antonio, Tx 78229 or via email at tpardc@yahoo.com.

system where we can all be aware of what is happening in and around the chiropractic profession. We invite you to participate, to enjoy, and to support the profession through your membership and/or contributions. It helps us to get the job done.

Just a Word By: Chris Dalrymple D.C., F.I.C.C., Editor I hope that you enjoy the return of the print version of t h e Te x a s J o u r n a l o f Chiropractic.

The Texas Chiropractic Association has 6

had a printed newsletter or magazine for many decades.

About five years ago, however, The TCA chose not to produce a regular print communication due to rising costs.

The desire for print news was so strong, however, that the TCA began plans to restore the printed Journal on a limited basis.

While we won’t be a monthly magazine will will provide a print Journal to TCA members, and occasionally non-members, several times per year, as long as it is sound business to do so.

It was my honor and privilege to serve as the editor-in-chief for nearly a decade, I am doubly honored to be recalled to service to help to create TCA’s communication in the Texas Journal of Chiropractic

new millennium. I hope to accomplish five things in the coming years: 1. Help the TCA website at www.chirotexas.org become a useful tool for the public and for TCA members. This will be an ongoing task and I welcome your assistance and suggestions.

2.

Help the online Texas Journal of Chiropractic be a source of information that you turn to first to find out news about chiropractic. This tool is a very powerful web based news journal.

3. Publish a print Journal several times per year with important news.

TCA nonmembers will NOT always receive the print Journal. We hope that you will find the information we communicate to be of such help that you will want to be a part of the TCA experience in the support of the chiropractic profession.

4. I have a few other ideas up my sleeve that will take some time to work up. So always keep checking the web sites.

There will frequently be something new and better.

5. I w a n t t o i n c r e a s e communication through the internet. It is a most efficient and cost effective way for us to stay in touch.

I have developed a simple members forum at the TCA website, and we are working with independent vendors to bring you a communications network that will be a superb internet communications tool.

Texas Journal of Chiropractic

What I ask of you now is to be patient and understanding as we work to take what we have now and work to make it better.

Like our patients, results will not necessarily come instantly.

Enjoy the news and information that we bring to you.

If you have news or information that we need to share with others send it to us.

Above all I want these communication instruments to be for the betterment of all of chiropractic. I want these to become your district newsletter, your district forum, a place where people of like interests within the profession of chiropractic may council together to promote their interests.

These are your communications tools, and I hope that you will assist me by using them.

Our profession is our way of using our skills and knowledge to help others. I want us to become aware that we also need to use our skills and knowledge to help our profession. There are other people out there that are actively working to reduce your profession, into a meaningless occupation.

Communication, the effective exchange of ideas, is the ONLY way that people can protect, defend, and improve their group. Using and improving our communication for the betterment of the profession is our objective.

Let’s talk...

Editor@chirotexas.org 7

Insurance Should “Oversupply” Chiropractic A quote from an article by R.P. Ellis, and T. G. McGuire in Journal of Health Economics 26 (2007) 25-48 notes: "At the other extreme are chiropractic care, gynecology, d e r m a t o l o g y, and ophthalmology/optometry, which are services plausibly associated with higher rates of use among rather healthy rather than unhealthy M e d i c a r e b e n e fi c i a r i e s .

Chiropractic care is interesting in that it is the one provider specialty that is negatively correlated with contemporaneous total spending....Our conceptual model suggests that it would be an attractive service for an HMO to oversupply in that people who use this service have (slightly) lower average spending on total health care."

Weʼve been trying to get this message across for decades.

Check www.chiro texas.org and click o n “Texas Journal of Chiroprac tic” to go to our onli ne Journal!

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Kind Words

By Patte Kent, Executive Director If youʼve been a practicing Chiropractor in Texas for more than ten years, you know me; but, the newer Doctors wonʼt remember my days at the TBCE when I spoke openly and bluntly on behalf of the Chiropractic profession, even though my job was to be a r e g u l a t o r.

So, let me introduce myself. I serve as the executive director of the Te x a s C h i r o p r a c t i c Association, still working to defend this profession.

As some of you already know, I am enamored with people who make you laugh and who at the same time make you think; people like George Carlin.

Texas Journal of Chiropractic

I ran across these thoughts he wrote years ago---and having enjoyed it so much the first time I read it, I wanted to share it because it speaks to the heart.

It is a good reminder that kind words are more productive than hateful rhetoric. So think about the kind words attributed to George Carlin: The paradox of our time in history is that we have taller buildings but shorter tempers; wider freeways, but narrower viewpoints. We spend more, but have less; we buy more, but enjoy less. We have bigger houses and smaller families; more conveniences, but less time. We have more degrees but less sense; more knowledge, but less judgment; more experts, yet more problems; more medicine, but less wellness.

We've learned how to make a living, but not a life. We've added years to life, not life to years. We've been all the way to the moon and back, but have trouble crossing the street to meet a new neighbor. We've done larger things, but not better things.

We have multiplied our possessions, but reduced our values. We talk too much, love too seldom, and hate too often.

We've cleaned up the air, but polluted the soul. We've conquered the atom, but not our prejudice. We've learned to rush, but not to wait. We build more computers to hold more information, to produce 9

more copies than ever, but we communicate less and less.

These are the times of big men and small character, steep profits and shallow relationships. These are the days of two incomes but more divorce, fancier houses, but broken homes. These are days of quick trips, disposable diapers, throwaway morality, one night stands, overweight bodies, and pills that do everything from cheer, to quiet, to kill.

Carlin suggests: Remember, spend some time with your loved ones, because they are not going to be around forever.

Remember, say a kind word to someone who looks up to you in awe, because that little person soon will grow up and leave your side.

Remember, give a warm hug to the one next to you, because that is the only treasure you can give with your heart and it doesn't cost a cent.

Remember, say "I love you" to your loved ones, and mean it. A kiss and an embrace, when it comes from deep inside of you, will mend hurt.

Remember, hold hands and cherish the moment, someday that person will not be there.

Give time to love, and give time to share the precious Continued page 10

Continued from page 9

thoughts in your mind, and always remember: Life is not measured by the number of breaths we take, but by the moments that take our breath away.

I encourage you to remember to be kind to one another.

Poorly Performing Health Providers are NOT Chiropractors The Texas Department of Insurance-Department of Workers Compensation states: "Of the 274 health care providers reviewed in the 2009 PBO assessment process, 4 had scores placing them in the high performer tier, 51 were in the average performer tier, and 219 had scores placing them in the poor performer tier."

Statistics from the 2008 Workers’ Compensation Network Report Card Results

note that the distribution of injured workers receiving professional services by provider type six months post injury are:

Former TCA Executive Director

• Medical doctors treated 87% to 88% • Physical/occupational therapists treated 22% to 39% • Other providers treated 20% to 55% • Osteopathic doctors treated 20% to 30% • Chiropractic doctors treated 7% to 9% THEREFORE, it is not statistically probable for doctors of Chiropractic to be the driving force behind the "poor performance tier."

DONATE TO THE TEXAS CHIROPRACTIC LITIGATION FUND at www.chirotexas.org

J.P. Word Passes Away Former State Senator J. P. Word passed away at his home on October 12, 2009.

Senator Word Served in the Te x a s S e n a t e f r o m 1963-1973. He served in the capacity of lobbyist, legal counsel and executive d i r e c t o r f o r t h e Te x a s Chiropractic Association for over a decade.

Dr. John Martin D.C. in the July 1998 issue of the Texas Journal of Chiropractic noted: When this tall, silver haired man enters a room, everybody turns to look. They instantly recognize one of Texas' top political lobbyists

Texas Delegate Elected ACA Officer On Thursday, September 24, Dr. Cynthia Vaughn of Austin, TX was elected the Secretary of the ACA Council of Delegates. While this does not assure any future offices, this places Dr. Vaughn in the position of beginning to move through the ACA chairs and possibly becoming the first female president of the ACA.

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Texas Journal of Chiropractic

and executive directors. His quiet dignity, commanding presence and reputation for honesty has gained J.P. Word the respect that very few lobbyists can equal. Most of u s k n o w h i m a s Te x a s Chiropractic Association's executive director and chief legislative council. We are fortunate to have had him on our side for the past 19 years.

J.P. Word was born in Bosque County in the early 1930s, and attended high school in Meridian, Texas, where he played center on the football team and was captain during his senior year. Following a tour of duty with the Army in Korea, he returned to Meridian and married his high school sweetheart, a beautiful young member of the pep squad, Bobbye Warren.

J. P. left Meridian to attend college and after graduating, enrolled at Baylor Law School in Waco. While he was a senior, he ran for County Judge in Meridian County and won before he graduated law school!

This started his political career. In 1962, he was elected to the Texas Senate and served for the next ten years. There he gained his reputation for honesty and integrity.... While in the Senate, he represented his constituents well and passed many pieces of legislation. Two that were of the longest term impact on Te x a s w e r e t h e t u i t i o n Equalization Grants that gave all school districts equal funding and the Texas Marital Texas Journal of Chiropractic

Property Act, which gives married women the right to manage and control their own businesses and property.

After serving as a legislator, Senator Word moved into consulting for various legal firms in Austin. Then he was hired as director of the Consulting Engineers Council of Texas, the professional civil engineers. He also worked as a consultant to the Texas Association of Taxpayers.

In 1979, Senator Word was hired to assist the TCA in their lobbying effort to gain passage of the insurance equality law that mandated that chiropractors would get paid by insurance companies equally. without discrimination among providers because of their license. This legislative act did more to help chiropractors than any other, short of being licensed....The result was that more young people could make a respectable living as a D.C. and started chiropractic college.

In July of 1991, the TCA hired J . P. a s t h e i r f u l l t i m e executive director following the death of H. Ford Johnson, TCA's previous executive director. Three words sum up how we will remember J. P. Word--integrity, effectiveness, and honesty, you will be missed...

Check the TCA Website for the latest news at

TEXAS MEDICAL ASSOCIATION SUES CHIROPRACTIC Background

On May 11, 2006 the TBCE (acting in response to a legislative mandate made in the Chiropractic Act) adopted rule 75.17 regarding the scope of practice for licensed doctors of chiropractic in Texas. Shortly thereafter, the Board was sued by the Texas Medical Association, which contended that the board's rule 75.17 allowed DC's to practice medicine.

Their basic contention was that the rules of the TBCE regarding Manipulation Under Anesthesia (MUA) and Needle EMG (NEMG) were a v i o l a t i o n o f t h e Te x a s Constitution because it was an infringement of the authority of the Texas Board of Medical Examiners.

F u r t h e r, t h e M e d i c a l Association challenged the right of chiropractic doctors to "diagnose", opining that only medical doctors have the right to diagnose patients.

The Texas Medical Board later joined the suit on behalf of the T M A a n d T h e Te x a s Chiropractic Association joined on behalf of the TBCE.

www.chirotexas.org Continued page13

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A JUDGE MAY DECIDE WHAT, WHEN, AND HOW YOU ARE PERMITTED TO DIAGNOSE! The Texas Medical Association again tries to limit the scope of practice of OTHER practitioners.

The TCA is helping to prepare for battle, and a litigation "war chest" is sought by the chiropractors of Texas.

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The TCA website at www.chirotexas.org will update the profession.

Continued from page 11

On November 23, 2009, the trial court held a hearing for “summary judgment" regarding the validity of the Boardʼs rules on Needle EMG, on MUA, and on diagnosis.

accompanied the order indicated that the trial court b e l i e v e d t h a t t h e Te x a s Legislature intended that MUA and Needle EMG are not within scope of practice for a doctor of chiropractic.

On November 24, 2009, Judge Stephen Yelenosky handed down his ruling that the Boardʼs rules regarding Needle EMG and MUA are invalid.

The court stated, however, that the Boardʼs rules regarding “diagnosis” are valid with respect to those matters within a doctor of chiropracticʼs scope of practice. The letter that

As part of Judge Yelenosky's judgment he writes "the statute excludes surgical procedures from the practice of chiropractic, and it is undisputed that MUA is d e fi n e d a s a s u r g i c a l procedure." He also reports that "Given the legislative ambiguity of the statutory language, the legislative history is pertinent.

The transcript of the debate in the legislature clearly reveals that the majority...intended to

Texas Journal of Chiropractic

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prohibit the Board of Chiropractic from allowing any chiropractor to perform MUA."

J u d g e Ye l e n o s k y a l s o "granted in part as to the Chiropractic Board's use of the word 'diagnosis' in its rule.

However, the court reserves judgment regarding as it relates to scope of practice."

Says the judge, "Turning to the Board's use of the word 'diagnosis' in its rules, the statutory language does not preclude it.

There is no statutory definition of the word, and its ordinary meaning is the identification of the nature or cause of a condition, which is not

Continued page 14

Continued from page 13

different substantially from 'evaluation' or 'analysis'. The issue is not the word, but the scope of practice-diagnosis of what and for what purpose." Says Judge Yelenosky, "I am reserving judgment on TMA and TMB's claim that construing the statute to permit particular rules of diagnosis would impermissibly allow the TBCE to authorize the practice of medicine. Expert testimony is pertinent to that question."

Discussion

This ruling is not yet final and is subject to appeal. If the summary judgment remains in effect the TBCE rules pertaining to MUA and NEMG will be removed and chiropractors will have no rule authorizing the use of MUA or NEMG. The TBCE says: "The Board of Chiropractic Examiners will appeal the judge's adverse rulings on Needle EMG and MUA and our legal counsel has issued the following statement: "The case of Texas Medical Association, et al. v. Texas Board of Chiropractic Examiners, et. al. (hereinafter referred to as the TMA vs.

TBCE case) is pending in district Court in Austin. On November 24, 2009, the Court made a ruling on three of the pending issues involved.

Basically, the Judge ruled on two of the issues that MUA

and Needle EMG are outside of the scope of Chiropractic practice as defined by the legislature in the statute. That raises the following question: ...What does the judge's opinion of MUA and Needle EMG mean? Do I have to cease doing them immediately?

Contribute to the Litigation Fund at www.chirotexas.org

There is nothing in the Judge's order that requires Chiropractors to immediately cease performing MUA's and Needle EMG's. The decision is not final and enforceable.

Accordingly, no action is presently planned by the staff of the TBCE to penalize DC's who perform MUA's and Needle EMG's until such time a final order requires us to do so. However, we urge you to consult your private attorney about possible ramifications of performing these procedures including but not limited to possible actions by insurance companies based on this ruling."

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As per the above, DC's are not required to stop performing MUA or Needle EMG at this point, as the legal d e c i s i o n s a r e n o t fi n a l .

However, the Board urges each DC who performs these procedures to consult with his or her attorney concerning any possible legal implications of performing these procedures while this case is on appeal. The Board has no power to determine whether or not insurance companies will pay for the procedures while a final legal outcome is being determined.”

The TCA has constitutional claims that will be brought to trial before the court: Firstly there is a denial of due process issue, in that if the legislature intended to remove MUA and NEMG, they did so without due process in the form of a “grandfather” clause.

Secondly, the delegation of authority to "legislate" to the federal government in the form of the Centers for Medicare and Medicaid Services, which in turn has adopted the CPT manual (a manual regulated by the medical profession), is unconstitutional "in that it is a delegation to a private party and a delegation without standards." There are not sufficient standards to prevent the abuse of the legislative authority, for with just a "reclassification" by the AMA whole scopes of practice may be affected. It appears that t h e Te x a s l e g i s l a t u r e Texas Journal of Chiropractic

abdicated its responsibility to define practice limitations by referring this decision to another source without i n c o r p o r a t i n g s u f fi c i e n t standards to allow the legislature to be able to exert its legislative control.

Thirdly, while the legislature may define the procedures acceptable to be practiced by limited scope of practice practitioners, the legislature cannot adopt differing definitions of a word and apply it selectively. It may not adopt a definition of “surgery” that applies differently to similarly situated health care providers. If NEMG is surgery and prohibited to chiropractic doctors, then it is also surgery and prohibited to physical therapists, and to nurses as well.

The TMA claims that the Texas Constitution prohibits anyone other than medical doctors from “diagnosing” medical conditions.

Potential

It appears that Texas is the first state to encounter this potential scope-limiting delegation of legislative authority to the AMA. The outcome of this litigation will have an effect on other states as well.

This Summary Judgement is NOT final and will not BE final until all avenues of appeal have been exhausted.

Texas Journal of Chiropractic

This specific Judgement applies only to the TBCE's rules regarding MUA and NEMG. Should the rules be finally upheld to be void, it basically means that the chiropractic application of MUA or NEMG would be "at risk" and challengeable. BUT it should also mean that neither could PTs or nurses perform either of these services.

proceed as scheduled, or a continuance (a delay) still may be granted to a later date.

Election for Office of TCA Secretary to be Contested For the first time in seven years the election for the office of TCA Secretary will be a contested election.

Earlier in the administrative year Dr. Jack A lbr a c ht (District 2; Past State Director, Current Scientific Affairs Dept. Coordinator) announced his candidacy for the office of TCA Secretary.

“The issue is not the word, but th e scope of practice...”

--Judge Yele nosky

Any of the multiple parties could appeal any decision of the judge which could take one-to-several years to resolve, therefore this battle is FAR from over, and in fact is just beginning.

The battle for "diagnosis" is a bit more murky. It is possible that the Medical Association may attempt to try to have the court, rather than the legislature, establish diagnostic limitations.

The trial on the constitutional claims in this case was scheduled for January 19, 2010 but has been postponed until April.

The trial may 15

On January 28, 2010, Dr. Max Vi g e ( D i s t r i c t 11 , Vi c e Director) announced that he was seeking nomination to the office of TCA Secretary.

Continued page 17

District Elections The TCA Policy Manual in section 12.4 states that "The district at a duly noted district election meeting elects a state director. Elections for State Directors shall be scheduled in the even numbered districts in the even numbered years, and those in the odd numbered districts shall be elected in the odd numbered years….The TCA board must ratify the election of a state director."

TCA District Two Is PROUD to submit our hardworking member

Dr. Jack Albracht Doctor of Chiropractic

for

TCA Secretary

We encourage your support and invite you to

Vote For

Dr. Jack Albracht

!

Max Vige, D.C. For TCA Secretary

Leader. Experienced. Proven.

Distinguished. Recognized.

Right Choice!

!

!

(District 11), and PresidentE l e c t , D r. J o r g e G a r c i a (District 12).

Dr. Jack Albracht Continued from page 15

Dr. John (Jack) S. Albracht, D.C., of Pampa, Texas, was born October 20, 1961, in Amarillo, TX. Graduating Parker College of Chiropractic in 1989, he married Jana Lee Spratt and is the father of three daughters and one son.

He has served as Past President of the St. Vincent School Board, and is a past board member of the Pampa Rotary Club, the United Way, the Knights of Columbus, and his local chamber of commerce.

A member of the TCA since 1989, and also of the ACA, Dr. Albracht is a Past Governor of the Upper Cervical Council of the TCA, and served as State Director of District 2 from 2002 to 2007. Currently he is the Coordinator of the TCA Scientific Affairs Department.

A member of the Parker College of Chiropractic Alumni Association, he is a Fellow of the International Academy of Clinical Acupuncture, and has his Certification from the Spine Research Institute of San Diego.

Dr. Max Vige Dr. Vige, D.C. of League City, Texas is a native of Eunice, LA where, while playing high school football, he was introduced to Chiropractic through an injury. He is a 2002 graduate of Texas Chiropractic College. Dr. Vige and his wife, Melyssa, have one son.

TCA members in good standing as of January 31 will have a ballot mailed to them with a special return envelope.

Ballots must be postmarked

by March 31, 2010, to be v a l i d .

The TCA parliamentarian will determine ballot validity, open, and count the ballots at the TCA offices during the first part of April.

The parliamentarian will notify the TCA president, who will notify the candidates of the election results.

He has served as chair of various organizations within his community including Toastmasters, Rotary, and Lions Club.

A TCA member and an ACA member, Dr. Vige has served as President/vice director of District 11 (Houston area) since 2003, and the TCA PAC Committee since 2008.

Dr. Vige holds certification in acupuncture and Graston Technique. He has received several community awards for service within his community organizations.

At the TCA Convention in June 2010, as Secretary one of these candidates will join the executive committee of the TCA to make up a 2 0 1 0 / 2 0 1 1 T C A administration of: President, Dr. Ed Fritsch 18

Too Few Primary Care Physicians in Texas Advocacy groups say the number of primary care physicians in Texas isn't keeping pace with the state's

Texas Journal of Chiropractic

growing population, with rural areas taking the hardest hit.

A c c o r d i n g t o t h e Te x a s Department of State Health Service, there are twentyseven Texas counties that have no doctor at all, many of them in West Texas or along the border with Mexico, Some residents must travel across counties to find basic medical care.

T h e C E O o f t h e Te x a s Academy of Family Physicians notes that the state's high birth rate and the influx of new residents from other states also come as about one in four Texas residents goes without health insurance.

The Austin AmericanStatesman reported that the problem is not confined to rural areas. "In Texas, 114 of the 254 counties, including urban counties such as Dallas, have been designated by the federal government as primary-care shortage areas because they have fewer than one primary-care doctor per 3,500 people."

To encourage doctors to practice in underserved areas, Texas lawmakers this year enhanced the state's medical school loan repayment program. The amount of money available to each doctor was increased from $45,000 over five years to $160,000 over four years.

VOTE

Dr. Jack Albracht Chiropractor for

TCA Secretary

Dr. Kevin Raef

Doctor of Chiropractic Encourages you to consider that with the challenges now imposed upon our profession, we need an executive officer with EXPERIENCE.

As an experienced TCA member, Past President & Keeler Award Winner I can recommend Dr. Albracht. He has the experience that our profession needs.

VOTE FOR

Dr. Jack Albracht

TBCE Reports on Accident Solicitation Law T h e Te x a s B o a r d o f Chiropractic Examiners reports that "It is now illegal for chiropractors and certain other professionals to contact victims of accidents or disasters or the relatives of those victims before the 31st day after the event."

Says the the TBCE "...the 81st Legislature amended the Texas Penal Code to prohibit people in certain professions or occupations or their agents from contacting accident or disaster victims before a certain amount of time has elapsed. Effective September 1, 2009, it is illegal for a doctor of chiropractic or anyone acting on the doctors behalf to contact an individual who is a victim of an accident or a disaster before the 31st day after the date on which the accident or disaster occurred. It is also illegal to contact a relative of the injured person before the 31st day after that date."

The TBCE also says that "Doctors of chiropractic, their employees, or their agents who violate the prohibition against contacting accident or disaster victims or their families before the 31st day after the accident or event may be subject to discipline b y t h e Te x a s B o a r d o f Continued on page 20

Texas Journal of Chiropractic

19

TCA Annual Convention June 10-12, 2010 Sheraton Austin Hotel, Austin, TX. 701 E. 11th Street (78701) 512-478-1111 Watch www.chirotexas.org and your e-mail for more information Continued from page 19

Chiropractic Examiners and to prosecution by local and state law enforcement officials."

In general, all chiropractors who engage in telemarketing directly, through their staffs or outside parties must abide by the following requirements: • Do not make any false, fraudulent, misleading, or unfair statements or claims.

• Do not promise successful treatment of any injuries or conditions.

• Do not offer or describe services that are not within the scope of practice of chiropractors in Texas.

• Licensees and facilities engaging in telemarketing shall not misrepresent to the person called any association with an i n s u r a n c e c o mp a n y, o r another DC, chiropractic group or facility.

• Licensees, facilities or their agents engaging in telemarketing must identify themselves at the start of each call to inform the person being called who they are and what DC or clinic they represent.

• You must keep a copy of each script used in telemarketing and you must keep a log of all individuals called, including the date, telephone number and the name of each person called; copies of the scripts and logs must be kept for a minimum of two years.

• If you use a testimonial, a copy of the testimonial signed by the person or group providing the testimony must be kept for a minimum of two years from the date the testimony was published.

• Licensees and clinics must clearly differentiate a chiropractic clinic, office or 20

facility form a n y o t h e r business enterprise in any form of public communication.

• Licensees must identify themselves as either "doctor of chiropractic", "DC", or "Chiropractor" in all forms of public communication.

Why Do You Think They Call Them “Dangerous Drugs"?

USA Today reported in a story reported in the online Te x a s Journal of Chiropractic that "addiction to prescription painkillers — which kill thousands of Americans a year — has become a largely unrecognized epidemic, e x p e r t s s a y. I n f a c t , prescription drugs cause most of the more than 26,000 fatal overdoses each year, says Leonard Paulozzi of the Centers for Disease Control and Prevention….The number of overdose deaths from opioid painkillers...more than tripled from 1999 to 2006, to 13,800 deaths that year, according to CDC statistics..."

An interesting twist reported by the article is that "in the past, most overdoses were due to illegal narcotics, such as heroin, with most deaths in big cities. Prescription painkillers have now surpassed heroin and cocaine, however, as the leading cause of fatal Continued on page 23

Texas Journal of Chiropractic

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For solid, experienced leadership

VOTE FOR Jack Albracht D.C. TCA District One Endorses and Supports

Dr. Jack Albracht of District Two for

TCA Secretary

Hard working - Experienced He has served as State Director representing his district on the board He is highly aware of the issues our profession faces.

He currently serves as a Department Coordinator.

He is a dedicated Team Player for TCA and the chiropractic profession.

In Texas, Section 483.001 defines what constitutes such prescription medicines: "'Dangerous drug' means a device or a drug that is unsafe for self-medication…”

Now folks, WHY do you think that they call them dangerous drugs?

Continued from page 11

overdoses, Paulozzi says.

And the rate of fatal overdoses is now about as high in rural areas — 7.8 deaths per 100,000 people — as in cities, where the rate is 7.9 deaths per 100,000 people, according to a paper he published last year in Pharmacoepidemiology and Drug Safety."

"Experts say it's easy to see why so many Americans are abusing painkillers. There are lots of the drugs around, and they're relatively easy to get...more are asking for pain relief to cope with joint problems, back pain and other ailments" the article notes.

Further, "the rise in fatal overdoses almost exactly parallels a corresponding rise in prescription painkiller sales."

Report on TBCE Enforcement Committee The Enforcement Committee o f t h e Te x a s B o a r d o f Chiropractic Examiners (TBCE) met on Tuesday, October 20, 2009. The Open Meetings, Open Records Act insures that the meetings of the TBCE and its committees are open to the public, and TCA members are encouraged to attend these meetings when they can, so that they may better understand the workings of the state regulatory agency.

The article notes that "there are many reasons why the public — and even doctors — don't realize the seriousness of the problem [including that] many people underestimate how lethal painkillers can be, assuming that anything prescribed by a doctor must be safe."

A number of cases were reviewed by the Enforcement Committee (EC); most dealt with persons who have not renewed their chiropractic license or who have not registered their clinics. TCA reminds chiropractic doctors and facility owners to insure that their license to practice chiropractic AND their facility registrations are current.

Don't forget that you must post your license and clinic registration in a place visible to persons entering your office.

Texas Journal of Chiropractic

23

Several of the chiropractic doctors who had been scheduled to appear for the committee did not attend. The TCA would remind you that if a complaint is filed against you, you must respond to a complaint that is sent to you b y t h e T B C E .

If the enforcement committee deems it necessary for you to appear before them to provide additional information, you are strongly encouraged to attend that hearing, bring all pertinent documentation with regard to the complaint and secure an attorney to attend the meeting with you.

The TBCE has adopted new rules which have changed some of the requirements for practice in Texas. Among these changes are new rules pertaining to documentation.

You are encouraged to check out the www.tbce.state.tx.us web site and see rule 75.2 and 80.5.

Your records are the evidence that must be presented in your behalf if a complaint is filed against you. Be sure that those records are legible, are compliant with the TBCE rules and provide your best defense against an unwarranted complaint.

The Committee met again on Tuesday, January 12, 2010.

The first case observed involved a practitioner of several decades. A complaint had been filed regarding Continued page 24

Continued from page 23

some real or imagined business infraction, but in the process of reviewing the case it was noted that some of the forms utilized contained the phrase “resulting in unprecedented lifetime benefits."

The committee is considering whether this violates the prohibition of Sec. 201.502. "(a) The board may refuse to admit a person to examinations and may revoke or suspend a license or place a license holder on probation for a period determined by the board for:...(11) advertising professional superiority, or advertising the performance of professional services in a superior manner, if that advertising is not readily subject to verification..."

The committee has not yet made its determination and this instance may, or may not, be an instance of "advertising superiority", but the point to take away ladies and gentlemen is that you need to be very careful in what you advertise.

You also need to remember that "advertisement" does not merely refer to that which you pay for; it extends to that which you profess, that which you declare openly. I guess, to paraphrase a well known Supreme Court admonishment--"what you say can and may be used against you..." Be ready to defend what you profess.

The next case observed involved an allegation that a massage therapist working for a chiropractor had "caused" an inguinal hernia. Leaving aside the particulars of the case, the issue at work here was miscommunication on the part of all parties involved.

The patient did not clearly communicate with the therapist, the therapist did not clearly communicate with the doctor, the doctor did not clearly communicate with the patient, and the patient did not communicate effectively with his doctor. The result is likely to be a malpractice suit against the parties involved, but the point to take away from this case is "work to communicate effectively".

Make sure that all staff, doctors, and patients are communicating clearly and effectively with one another.

Ask questions, seek solutions, seek to be of assistance.

Miscommunication could lead to undesired consequences.

The final case demonstrates the need for answering the license renewal and facility registration application in a truthful and accurate manner.

A doctor who was dealing with issues arising from a less than amicable divorce ended up as an involuntary accessory to a crime.

He incorrectly answered a question pertaining to his legal status which resulted in a violation.

The moral of this case is take your answers to the renewal 24

questions SERIOUSLY. Don't just go through the motions, answer the questions accurately, and truthfully.

TBCE and Documentation The TBCE points out that "Board Rule 75.2 says that it is a lack of proper diligence for a DC to fail '...to assess and evaluate a patient's status...'Rule 80.5..in paragraph (f) states: Licensees shall maintain patient and billing records in a manner consistent with the protection and welfare of the patient. A licensee's patient records shall support all diagnoses, treatments, and billing. Records shall be timely, dated, accurate, signed or initialed by the licensee or the person providing treatment, and legible.

Electronic signatures are acceptable."

TBCE states: "It should be possible for any qualified doctor of chiropractic to review the patient files and documentation of another DC's patient and have a reasonably clear understanding of the treating DC's assessment or diagnosis of the patient, the course of treatment decided on by the treating DC, the actual treatment provided (when, what, how much, by whom) and the outcome of that treatment. It should also be possible to clearly track the charges for treatment back to Texas Journal of Chiropractic

the actual treatment documented in the patient's files."

DONATE TO THE LITIGATION FUND at www.chirotexas.org

"At this time, if you have a diplomate in radiology or orthopedics, you may use the terms "specialty" or "specializing" in your advertisements and other public communications," says the TBCE.

Anyone may submit an application to the TBCE for recognition of a chiropractic specialty. Check rule 71.13 for more information and check the TBCE website under forms and downloads for the appropriate form.

Chiropractic Specialties T h e Te x a s B o a r d o f Chiropractic Examiners in its August 2009 Newsletter reports that that new rule 71.13 now allows for the recognition of chiropractic specialty areas.

Says the TBCE, "It was and is the Board's intention to simply officially recognize that certain areas of practice are legitimate chiropractic specialty areas. The Board believes that its official recognition of legitimate chiropractic specialties will support the general acceptance of those specialities by the public and other interested parties....Most, if not all, specialty areas will already have a national organization or board that confers diplomate status on qualified individuals.

To date, the Board has received and approved specialty recognition for chiropractic radiology and chiropractic orthopedics. An application is pending for the recognition of chiropractic acupuncture as a specialty area."

Texas Journal of Chiropractic

TCA District Four Endorses and Supports

Dr. Jack Albracht Doctor of Chiropractic

for  TCA Secretary Having served as state director for District two, and TCA Department Coordinator, and his experience on civic boards, Dr. Albracht is very aware of the issues currently facing our profession. He is a dedicated team player for the TCA and the chiropractic profession.

District Four notes that for solid, experienced leadership

VOTE FOR Dr. Jack Albracht 25

The High Cost of Insurance Premiums "The White House kept insurance companies squarely in its sights...by releasing research showing that health insurance premiums have risen far faster than inflation in every U.S. state. U.S. states have experienced premium growth of 90 percent to nearly 150 percent in the past decade, while wages have risen 38 percent and inflation by 28 percent, the report by the White House's National Economic Council said."

"In every state, premiums have increased faster than wages and in every state, family budgets are consumed by an increasing share of

healthcare premiums," the report said.

"Vice President Joe Biden was...noted that premiums in Alaska increased 145 percent in 10 years while wages grew 35 percent, and in Florida premiums rose 121 percent while wages increased 43 percent. He said Michigan had the smallest gap, 37 percent."

'As of 2008 ... fewer than half of states required a full review when insurers wanted to increase premiums at the state level,'”

TBCE New Rules & Changes T h e Te x a s B o a r d o f Chiropractic Examiners has proposed and adopted several rules changes since last summer. These include:

www.chirotexas.org click on “Texas Journal of Chiropractic” 71.17 TEMPORARY FACULTY LICENSE

This "sets forth proposed requirements for issuing and renewing temporary faculty licenses to qualified faculty m e m b e r s a t Te x a s Chiropractic College and Parker College of Chiropractic."

RULE 75.17 SCOPE OF PRACTICE

This "updates language concerning the use of lasers to allow the use of 'therapeutic lasers' for the treatment of conditions within the scope of practice for DCs." The TBCE "adopted five (5) new rules and also adopted amendments to three (3) existing rules."

As an experienced TCA member, Legislative Coordinator, Past President, & Keeler Award winner

Mike Martin D.C. Encourages you to

VOTE FOR

Jack Albracht D.C. Texas Chiropractic Association Secretary 26

Texas Journal of Chiropractic

RULE 75.19 CEASE AND DESIST ORDERS

On August 16 2008, "the Board delegated to its Enforcement Committee the right to issue Cease and Desist Orders on behalf of the Board.

If the Enforcement Committee determines that a person is practicing chiropractic without a license, the Committee may--after notifying the person and giving him/her the opportunity for a hearing--order that person to stop engaging in that activity." Says the TBCE "delegating this responsibility to the Enforcement Committee allows the agency to take action quicker against people who are practicing chiropractic without a license."

RULE 80.11 CODE OF ETHICS

On August 16, 2008, the Board adopted new rule 80.11. "This rule encourages chiropractors to practice with a high level of ethics to enable patients to make informed choices about their chiropractic treatment, consult with other health care professionals as appropriate, serve patients without discrimination, help others in the profession acquire knowledge, and to maintain high standards of scholarship, education, training and in the dissemination of accurate and complete information."

RULE 80.5 MAINTENANCE OF CHIROPRACTIC RECORDS

On August 16, 2008, the Board amended Rule 80.5 to read:

Texas Journal of Chiropractic

“(f) Licensees shall maintain patient and billing records in a manner consistent with the protection and welfare of the patient. A licensee's patient records shall support all diagnoses, treatments, and billing. Records shall be timely, dated, accurate, signed or initialed by the licensee or the person providing treatment, and legible.

Electronic signatures are acceptable.�

Says the TBCE, "Notice that the patient's records shall support all diagnosis, treatments, and billing. They must also be signed by the licensee or the person providing the treatment.

27

Failure to properly document the diagnosis, treatment and billing for each patient is a significant shortcoming for many chiropractors in Texas."

RULE 75.17 PRACTICE

SCOPE OF

On May 14, 2009, the Board amended rule 75.17 to state "in order to provide therapeutic care for a patient or patient population, licensees are authorized to use...(O) manipulation under anesthesia..."

RULE 75.21 ACUPUNCTURE

On May 4, 2009, the board adopted new rule 75.21 to "establish the requirements Continued page 28

Continued from page 27

that must be met by any licensed DC in Texas who wishes to include acupuncture in his/her chiropractic practice."

In summary, DCs licensed BEFORE January 1, 2010, must meet any ONE of the following requirements: 1. Complete 100 hour course in acupuncture provided by a chiropractic college, or by an acupuncture school that is approved by the Texas Board of Acupuncture Examiners.

2. Successfully complete the acupuncture examination of the National Board of Chiropractic Examiners (NBCE) 3. Successfully complete the examination offered by the National Certification Commission for Acupuncture and Oriental Medicine.

4. D o c u m e n t t r a i n i n g i n acupuncture and "have been practicing acupuncture for at least the past ten (10) years."

5. Successfully complete at least 100 hours in acupuncture training in a course approved by the Board.

All NEW Texas DCs licensed AFTER January 1, 2010, "must successfully complete either the NBCE acupuncture examination or the examination offered by the

National Certification Commission for Acupuncture and Oriental Medicine."

RULE 71.15 RECOGNIZED SPECIALTIES On August 13, 2009, the Board adopted new rule 71.15

to "contain a listing of those areas of chiropractic practice that the Board has officially recognized as being a legitimate chiropractic specialty field of practice.

Recognition of a chiropractic speciality by the Board is a

VOTE FOR Chiropractic Doctor

Dr. Jack Albracht for TCA Secretary With the legislative and litigative challenges our profession is facing, we need an executive officer with EXPERIENCE. As an experienced TCA member, Legislative Coordinator, Past President, & Keeler Award winner

Dale White D.C. Encourages you to

VOTE FOR

Dr. Jack Albracht He has the experience that our profession needs.

28

Texas Journal of Chiropractic

multi-step process in which the Board reviews an application from a recognized organization that represents the specialty area."

member services, research, continuing education, lobbying, litigation, and political contributions every year.

RULE 76.21 EXTENSIONS OF TIME On August 13, 2009, the Board adopted new Rule 76.21 which delegates to the TBCE executive director "the authority to enter into certain agreements on behalf of the Board for the purpose of expediting matters between the agency and the State O ff i c e o f A d m i n i s t r a t i v e Hearings (SOAH).

The Bottom Line is If you hold a Texas license, the TCA is protecting and advancing the profession on your behalf.

We sure would appreciate your help in the ongoing struggle to keep the chiropractic profession from being eliminated altogether.

That very thing has almost happened on more than several occasions in the life of this profession, and as this TMA vs TBME lawsuit demonstrates, our medical counterparts would do away with us if they had their way.

RULE 75.7 REQUIRED FEES AND CHANGES On August 13, 2009, the board adopted changes to this rule "to adopt fees for issuing and renewing temporary faculty licenses for qualified faculty at Texas Chiropractic college and Parker College of Chiropractic..."

The Board also adopted an increase in fees for approving continuing education courses, but did not increase any licensing fees.

TCA ENCOURAGES YOU THE CHECK THE TBCE WEBSITE FOR THE SPECIFIC DETAILS YOU NEED.

DONATE TO THE TEXAS CHIROPRACTIC LITIGATION FUND at www.chirotexas.org

Texas Journal of Chiropractic

Invest in Chiropractic By: Chip Kent, Legislative Coordinator Are you a member of the TCA? As a TCA doctor? As an affiliate member? As a Friend of Chiropractic?

The TCA fights for the rights of all Doctors of Chiropractic, members and non-members.

We work to advance and defend this great profession because we know that Chiropractic makes a difference in the lives of its patients and its practitioners.

R e c e n t l y, t h e T C A h a s intervened in a legal case brought by the Texas Medical Association (TMA) against the Texas Board of Chiropractic Examiners (TBCE). This case will have an impact upon ALL chiropractic doctors in Texas, not just TCA members, or non-members. We need the s u p p o r t o f A L L Te x a s Chiropractic Doctors, to help in prevailing in this lawsuit.

To ensure that YOU, doctor, can serve your patient’s needs to the fullest extent of your education, training and experience, the TCA spends huge amounts of money on 29

TCA membership dues are more than just another business expense. Our staff has put together numerous member benefits including a comprehensive member website, a campaign of constant communication with our membership, an online Journal website, annual events designed to bring the profession together, significant discounts on goods and services, and many others. These benefits, and the successful outcome of TCA actions, make your membership dues an investment in the chiropractic profession. The greater the number of investors, the greater an impact we may have. It sure seems to work

Continued page 30

Continued from page 29

For the Next

for the other large medical/ insurance/financial industries!

Texas Journal of Chiropractic

Here are some action steps that I would recommend:

Weʼd Love to see YOUR ad!

JOIN NOW: We cannot continue to fight all the Insurance carriers, educate the public, and bring you services without having a strong membership. Visit www.chirotexas.org and apply today to join the TCA. Your investment in the chiropractic profession, along with the investment of many others, can help to insure the future of your profession, and your membership dues can be easily offset with our discounts and services, and possible tax deductions.

512-477-9292 CONTRIBUTE: Visit www.chirotexas.org/donate and give money to the PAC for our work on your behalf in the halls of government, or to the Litigation Fund for our work in the courts. We need money right now for both lawsuits and political efforts.

Your patients choose to see you because they believe in your abilities and they believe in Chiropractic. NOW IS THE

TIME FOR YOU TO MAKE A CHOICE. Will you choose to invest in and support your profession by joining the TCA? The TCA is the single largest advocate in Texas for the profession of Chiropractic--PERIOD. Our dollars and hard work yield huge results year in and year out. Your investment in the chiropractic profession will return to you many benefits; some of them immediately tangible, many of them intangible but just as important.

Please join with us and participate in making the chiropractic profession better.

Help to insure the future of your profession. ✯✯✯

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Texas Journal of Chiropractic

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