Janie Morales And Terrie Secaida, Community Administrator of the Estate of Edward Secaida v. Chard Richard Craig Wheaton Van Lines, Inc. And Johnnie P. Williams

Court of Appeals of Texas·Decided March 14, 2008·No. 03-99-00553-CV·Published

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN

NO. 03-05-00620-CV

Texas Orthopaedic Association, Texas Medical Association and Andrew M. Kant, M.D., Appellants

v.

Texas State Board of Podiatric Medical Examiners; Texas Podiatric Medical Association; and Bruce A. Scudday, D.P.M., Appellees

FROM THE DISTRICT COURT OF TRAVIS COUNTY, 345TH JUDICIAL DISTRICT NO. GN204022, HONORABLE DARLENE BYRNE, JUDGE PRESIDING

OPINION

Various statutes over the years have described the practice of podiatry as the treatment

of the foot, but the term “foot” has never been statutorily defined. See, e.g., Tex. Occ. Code

Ann. § 202.001(a)(4) (West 2004). In 2001, the Texas State Board of Podiatric Medical Examiners

(the “Board”) promulgated a rule defining the word “foot.” See Tex. Occ. Code Ann. § 202.151

(West 2004) (authorizing Board to adopt rules governing practice of podiatry); 22 Tex. Admin.

Code § 375.1(2) (2007) (defining foot) (the “Rule”). The Rule included in its definition, among

other things, portions of what in layman’s terms is called the ankle. In response, the Texas

Orthopaedic Association, the Texas Medical Association, and Andrew M. Kant, M.D. (“appellants”)

sought a declaration that the Rule impermissibly expanded the scope of podiatry. The district court concluded that the Rule was valid and did not exceed the Board’s authority. The appellants appeal

the judgment of the district court. We will reverse the district court’s judgment.

BACKGROUND

In general, the statutory provisions governing the medical treatment and diagnosis of

diseases and disorders of the human body and the individuals authorized to engage in those

practices are found in the Medical Practice Act. See Tex. Occ. Code Ann. §§ 151.001-165.160

(West 2004 & Supp. 2007). Although the Act requires compliance with its provisions to practice

medicine, see id. § 155.001 (West 2004), the Act exempts certain individuals from compliance,

id. § 151.052 (West 2004). The exemption relevant in this case is found in subsection 151.052(a)(5)

and exempts “a licensed podiatrist engaged strictly in the practice of podiatry as defined by law.”

Id. § 151.052(a)(5) (emphasis added). By providing the exemption, the legislature acknowledged

that there is some degree of overlap between podiatrists’ and physicians’ scopes of practice.

The practice of podiatry in Texas has been governed by statute since 1923. At that

time, podiatrists were referred to as chiropodists, and chiropody was defined as “the diagnosis,

medical and surgical treatment of ailments of the human foot.” Act of March 6, 1923, 38th Leg.,

R.S., ch. 169, § 1, 1923 Tex. Gen. Laws 357, 357-60. In 1951, the statute was amended and defined

chiropody, in relevant part, as the treatment of “any disease or disorder, physical injury or deformity,

or ailment of the human foot, by any system or method.” See Act of April 18, 1951, 52nd Leg., R.S.,

ch. 132, § 1, 1951 Tex. Gen. Laws 219, 219. In 1967, the legislature renamed chiropodists as

podiatrists. See Act of April 12, 1967, 60th Leg., R.S., ch. 96, §§ 1, 2, 1967 Tex. Gen. Laws 181,

181-82. The current statute provides, in relevant part, that podiatry “means the treatment of or offer

2 to treat any disease, disorder, physical injury, deformity, or ailment of the human foot by any system

or method. The term includes podiatric medicine.” Tex. Occ. Code Ann. § 202.001(a)(4); see

Senate Comm. on Health & Human Services, Bill Analysis, Tex. S.B. 673, 74th Leg., R.S. (1995)

(stating that changes were made to statute governing podiatry because former statutes contained

“antiquated and limiting language”).

Pursuant to statutory authority, the Board announced in 2000 that it intended to adopt

an administrative rule defining the term “foot.” See Tex. Occ. Code Ann. § 202.151(2) (“The board

shall adopt reasonable or necessary rules and bylaws consistent with the law regulating the practice

of podiatry, the law of this state, and the law of the United States to govern: . . . (2) the regulation

of the practice of podiatry”); see also id. § 202.051 (West Supp. 2007) (detailing requirements for

Board membership). In describing the need for the definition, the Board stated that there was

“uncertainty among various groups resulting from the lack of a definition” and that, without a

definition, podiatrists, insurance companies, and hospitals were uncertain as to the limit of the

practice of podiatry. See 26 Tex. Reg. 2385, 2385 (March 23, 2001). After receiving comments

regarding the proposed definition, including objections from the Texas Orthopaedic Association and

the Texas Medical Association, the Board adopted the Rule in 2001. See 22 Tex. Admin. Code

§ 375.1(2); 26 Tex. Reg. at 2390. The Rule provides as follows:

The foot is 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.

3 The tibia is “the shin bone” or “the inner and larger bone of the leg below the knee.”

Dorland’s Illustrated Medical Dictionary 1911 (30th ed. 2003). The fibula is “the outer and smaller

of the two bones of the leg.” Id. at 698. The talus is “the highest of the tarsal bones and the one that

articulates with the tibia and fibula to form the ankle joint” and is also called the ankle. Id. at 1853;

see also id. at 1855 (explaining that tarsus is “the region of the articulation between the

foot and the leg”).

In response to concerns regarding the validity of the Rule, the attorney general issued

an opinion stating that the Rule was invalid because it impermissibly expanded the practice of

podiatry to the extent that it allowed podiatrists to treat the tibia and fibula. See Tex. Att’y Gen. Op.

No. JC-441 (2001). The attorney general reasoned that the tibia and fibula are leg bones, not bones

of the foot, and, therefore, outside the scope of podiatry. See id. Shortly after the attorney general

opinion was released, the appellants filed a declaratory judgment action, asking the district court to

determine the validity of the Rule. See Tex. Gov’t Code Ann. § 2001.038 (West 2000) (allowing

plaintiff to seek declaration regarding validity of rule); Tex. Civ. Prac. & Rem. Code Ann. § 37.001-

.011 (West 1997 & Supp. 2007) (Uniform Declaratory Judgment Act). The Texas Podiatric Medical

Association and Bruce A. Scudday (cumulatively “the Association”) intervened.

The district court declared that the Rule was valid and did not exceed the Board’s

statutory authority. The appellants appeal the judgment of the district court.1

1 Before addressing the merits of the case, we will address a jurisdictional argument made by the Board. On appeal, the Board contends that the appellants did not have standing to seek the declarations regarding the propriety of the Rule. In a previous opinion, we addressed the issue of the appellants’ standing. See State Bd. of Podiatric Med. Examiners v.

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Janie Morales And Terrie Secaida, Community Administrator of the Estate of Edward Secaida v. Chard Richard Craig Wheaton Van Lines, Inc. And Johnnie P. Williams (Janie Morales And Terrie Secaida, Community Administrator of the Estate of Edward Secaida v. Chard Richard Craig Wheaton Van Lines, Inc. And Johnnie P. Williams) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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