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LEGISLATIVE AFFAIRS
Safety concerns TMA opposes chiropractors performing sports exams
BY KEN ORTOLON In 2011, Texas lawmakers focused much attention on school sports injuries, passing leg- islation to set protocols for athletes to play following concussions and a bill re- quiring schools to replace or recondition aging foot- ball helmets. But Texas Medical Asso- ciation officials believe the Texas Legislature likely is not done with school sports injuries. They say it is pos- sible legislators will revisit sports concussions in 2013, as well as whether pre-par- ticipation physicals should look more closely for heart conditions that could ex- clude students from sports activities.
And, TMA officials say
lawmakers may also ex- amine who is conducting those physicals. Current University Interscholastic League (UIL) rules allow physicians, physician assis- tants, nurse practitioners, and chiropractors to perform physicals. But a special TMA sub- committee that vetted sports injury-related bills last session questions whether chiropractors have the necessary training to adequately conduct sports physicals. “Chiropractors should not be involved in pre-participation sports physicals,” said Keller pediatrician Jason Terk, MD, who served on the TMA subcommittee as chair of the TMA Council on Science and Public Health. “They simply do not have that skill.” During its meeting in May, the TMA House of Delegates adopted a resolution that says only licensed physicians or
their appropriately super- vised physician assistants, or advanced practice nurs- es should perform sports physicals.
Chiropractor a physician? Current UIL guidelines require pre-participation physical examinations at least before junior high school and in the first and third years of high school. In 2002, the UIL Medi- cal Advisory Committee recommended removing chiropractors from the list of health care profession- als who could perform the exams. Mark Cousins, PhD, director of athletics for UIL, says that followed a legal opinion from the at- torney general’s office. “The rule at that time said it [the physical exam form] was to be signed by a physician,” Dr. Cousins said. “There continued to be questions about wheth-
er a chiropractor qualified as a physician. So we got an unof- ficial opinion from our lawyer, who was an assistant attorney general, and he concluded that a chiropractor did not meet the definition of a physician.” The Texas Chiropractic Association (TCA), however, suc- cessfully sued to block the change in UIL rules. At the time, TCA argued that chiropractors are qualified to perform the physicals and that UIL lacks the authority to decide which health care professionals could perform them. The Texas Board of Chiropractic Examiners also contended that UIL was attempting to usurp its authority, saying that it
July 2012 TEXAS MEDICINE 43
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