An Austin appeals court sided with TMA and the Texas Orthopaedic Association (TOA) and said the Texas State Board of Podiatric Medical Examiners was wrong when it adopted a rule that expanded the definition of the foot to include the bones in the ankle.
"We conclude that the board exceeded its authority when it promulgated the rule and that the rule is invalid," the judges on the Texas Court of Appeals, Third District, said in upholding medicine's appeal of a lower court ruling. The judges sent the case back to an Austin state district court that had ruled in favor of the podiatrists.
TMA President William W. Hinchey, MD, said he is pleased with the ruling and that TMA will continue to defend the practice of medicine. "This is a ruling for patient safety and for appropriateness of care. I'm glad the appeals court recognizes that the proper medical care of patients is too important to be left to people who are not adequately trained to perform certain procedures," he said.
The legal battle began in 2000 when the podiatry board defined the foot as "the tibia and fibula in their articulation with the talus, and all bones to the toes, inclusive of all soft tissues (muscles, nerves, vascular structures, tendons, ligaments and any other anatomical structures) that insert into the tibia and fibula in their articulation with the talus and all bones to the toes."
TMA and TOA objected. So did then-Attorney General John Cornyn when he issued an opinion that said the podiatry board acted outside its authority. He added that only the Texas Legislature, not an unelected administrative board, can establish or change the scope of practice for podiatrists, physicians, or any other health care practitioners.
In August 2005, an Austin district judge issued an order in favor of the podiatrists. TMA and TOA appealed.
"Although there was extensive testimony and evidence presented during trial showing that treating the ankle was within the scope of podiatry, no evidence was introduced showing that treating structures found within the leg were within the scope of podiatry," the appeals court said in its March 14 decision.
The court also held that the "rule authorizes podiatrists to treat parts of the body outside the traditional scope of podiatry without satisfying the requirements of the Medical Practice Act. This authorization exceeds the limited exemption given to podiatrists and would constitute the unauthorized practice of medicine."
TMA expects the podiatry board and podiatry association to ask for a rehearing and, if unsuccessful, appeal to the Texas Supreme Court.
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