PROFESSIONAL ISSUES

Texas court finds board exceeded its authority and podiatrists' scope

Physicians and podiatrists disagree on the impact of the appellate court's ruling.

By Myrle Croasdale, AMNews staff. May 5, 2008.

A Texas appeals court ruled the state's podiatric board overstepped its authority by redefining podiatrists' practice scope beyond the foot to include the ankle and leg.

The Texas 3rd District Appellate Court overturned a lower court decision on March 14 and determined that such a change would need to come from the state Legislature and could not be made by the Texas State Board of Podiatric Medical Examiners.

Discuss on Sermo

Case at a glance
Clarification
See related content
Region: South

The Texas Medical Assn. and the Texas Orthopaedic Assn. sued the Texas State Board of Podiatric Medical Examiners and the Texas Podiatric Medical Assn. in 2001, declaring that the podiatrists' change in definition illegally expanded their scope.

The decision confirms a 2001 opinion from then-Texas Attorney General John Cornyn stating that the podiatry board acted outside its authority when it adopted a rule redefining podiatrists' scope of practice.

The rule in dispute defines the foot as including "the tibia and fibula in their articulation with the talus, and all the bones to the toes, inclusive of all soft tissues ... that insert into the tibia and fibula in their articulation with the talus and all bones to the toes."

State law allows podiatrists to treat only the foot, the physicians said, not the ankle and leg.

Physicians and podiatrists disagreed on the impact of the Austin court's decision.

William W. Hinchey, MD, TMA president, said it upheld the physicians' stance that the definition of the foot did not include the bones in the ankle.

"TMA physicians are extremely pleased with the court's ruling on this issue. Today's ruling protects Texas patients," Dr. Hinchey said.

David Teuscher, MD, speaking for the Texas Orthopaedic Assn., said the decision confirmed that boards for limited-license professions cannot bypass the legislative process to expand their profession's scope. (See clarification)

"This means that the treatment of the ankle and leg is the practice of medicine," Dr. Teuscher said. He said hospitals and other credentialing bodies would need to revise privileging forms, and podiatrists authorized to do foot and ankle surgery would be limited to the foot alone.

Brian Carpenter, DPM, president of the Texas Podiatric Medical Assn., disagreed. "The only thing this document says is that we should not be treating the leg, and we agree with that," Dr. Carpenter said. "Our legal counsel feels this decision does not restrict us from the ankle. This will not change our credentialing or practices."

To clarify this, the podiatric association plans to ask the appeals court for a rehearing, Dr. Carpenter said, and it will take its case to the Texas Supreme Court if necessary.

Discuss on Sermo Back to top.

ADDITIONAL INFORMATION:

Case at a glance

Did the Texas podiatric board go too far?

The Texas Medical Assn. and the Texas Orthopaedic Assn. asked the 3rd District Appellate Court to overturn a decision that validated action from the Texas State Board of Podiatric Medical Examiners to expand the definition of "foot." The appellate court agreed the podiatric board exceeded its authority and ruled the revision of podiatric scope of practice invalid.

Impact: The TMA and TOA hold that this decision limits Texas podiatrists' scope of practice to the foot, excluding the ankle. The Texas Podiatric Medical Assn. contends that while the court did find that the podiatric board had exceeded its statutory rule-making authority, the court did not alter podiatrists' authority to treat the foot and ankle. The podiatrists will ask for an appellate court rehearing for further clarification.

Texas Orthopaedic Assn., Texas Medical Assn. and Andrew M. Kant, MD, v. Texas State Board of Podiatric Medical Examiners, Texas Podiatric Medical Assn., and Bruce A. Scudday, DPM

Clarification

This story did not mention that the Litigation Center of the American Medical Association and State Medical Societies in 2006 filed a friend-of-the-court brief in support of the Texas Orthopaedic Assn. and the Texas Medical Assn. in their lawsuit against the Texas State Board of Podiatric Medical Examiners and the Texas Podiatric Medical Assn.