Vet Law Challenged - Round 3

September 2008

 

The Equiery first reported on massage therapist Mercedes Clemens' lawsuit challenging the constitutionality of Maryland's Vet Practice Act in the July issue. Earlier this year, the Maryland Board of Chiropractic Examiners ("Chiropractic Board") issued Clemens, a licensed human massage therapist and a certified equine massage therapist, a "cease and desist order," noting that a license from the Chiropractic Board (which regulates human massage therapists) prohibits her from practicing on animals.

The Chiropractic Board included a memo from the Maryland State Board of Veterinary Medical Examiners that states, in part, "There is no exclusion under [the Vet Practice Act] to allow for... massage therapy, physical therapy or other manual techniques on animals. Consequently, an individual who is not a licensed veterinarian who performs any of these procedures on an animal would be considered to be practicing veterinary medicine without a license.

" The Chiropractic Board's letter said that if Clemens did not immediately cease practicing on animals, the Chiropractic Board would revoke her license to practice on humans.

Clemens ceased her equine massage practice and subsequently, through the Institute for Justice, filed a lawsuit against both Boards for violation of her constitutional rights. (See equiery.com for complete copies of all the documents and prior articles.)

In July, the Vet Board attempted to distance itself from the Chiropractic Board by issuing a statement stating that it had no problem with Clemens' massage practice, implying that the Chiropractic Board had not only acted alone, but had acted inappropriately in using its [the Vet Board's] memo (see equiery.com).

Since then, the Associated Press has picked up the story, with news outlets from USA Today to CNN Radio to the Australian Broadcasting Company running articles or interviewing Clemens. In addition, an AOL poll pulled in thousands of participants.

In August, the Chiropractic and Vet Boards filed a Joint Motion to Dismiss based on improper venue. The Institute for Justice filed the suit in Montgomery County Circuit Court, and the Motion to Dismiss notes that the "domiciles" of the two Boards are Baltimore City (for the Chiropractic Board) and Anne Arundel County (for the Vet Board), and that therefore, Montgomery County is an inappropriate venue (see equiery.com for a copy of the motion).

Does the Maryland Vet Practice Act Need to be Changed? A Mechanism For Licensed Massage Therapists Already Exists

- submitted by a Maryland Vet

The letter that Clemens received was based upon a human health regulation, not the Veterinary Practice Act, and [the fact that] she was not told that she could not do massage on horses, but rather that she could not do massage on horses while retaining her license to do massage on people.

According to the Annotated Code of Maryland, Article - Health Occupations, §1-211: A person who is licensed, certified, or otherwise authorized to practice a health occupation under this article may not practice the health occupation on an animal unless the person: (1) Is a licensed pharmacist practicing pharmacy under Title 12 of this article; (2) Is a licensed acupuncturist practicing in accordance with § 2-301(g)(11) of the Agriculture Article; or (3) Provides care to an animal in accordance with § 2-304(e) of the Agriculture Article.

These rules govern the conduct of human health care professionals, not lay people working on animals-and altering the Practice Act would have no effect on this situation.

In item (3) of the above section, provisions are given for exceptions, if done within the following framework (§ 2-304(e) of the Agriculture Article): (e) (1) The Board may authorize the practice of a health occupation on an animal by a health care practitioner licensed, certified, or otherwise authorized under the Health Occupations Article. (2) If the Board authorizes the practice of a health occupation on an animal under paragraph (1) of this subsection, the Board may: (i) Impose requirements for education, training, and supervision by a veterinary practitioner; and (ii) Require the registration of each health care practitioner authorized to practice a health occupation on an animal in accordance with this subsection.

This provision seems as though it could be a reasonable mechanism to allow people like Mercedes Clemens who are already licensed in a human health profession to work on animals using existing law.

My Story
- Courtney Molino (ESMT, CMT) is a certified equine sports massage therapist and owner of the Marylandbased "Hands On Horses" practice.

I am trained in equine anatomy, massage techniques, gait analysis, muscle function and common musculoskeletal disorders. I studied equine science and anatomy at Virginia Tech before pursuing my equine massage certifi- cation in 2004. I believe I bring a much needed alternative service to my clients of all riding disciplines and levels, from competitive athletes and pleasure horses to aging equines and those recuperating from illness or injury.

I have always been careful to ensure that my clients realize that massage therapy does not equate with veterinary medicine. In fact, I very clearly state the following on my website and in all promotional materials.

In no way are massage services meant to be construed as the diagnosis or treatment of injury or disease, but rather as an aid to promote and improve the animal's overall wellness. A massage program is not a substitute for medical treatment, and it is always recommended to consult your veterinarian prior to beginning a massage program.


However, my disclaimer apparently was not clear enough to the Maryland State Board of Veterinary Medical Examiners, who sent me a letter in January 2008, stating that I may be in violation of the Maryland Veterinary Practice Act and therefore practicing veterinary medicine without a license. Specifically, the Board was taking exception to certain phrases I used on my website, such as being trained to "identify muscle spasms," "alleviate sore backs, stiffness and lameness" and "relieve pain." According to the Board, only licensed veterinarians are legally qualified to do these things.The Board requested that I "cease and desist immediately from activities constituting the practice of veterinary medicine." They further informed me that I should give a "thorough and thoughtful revision" to my website and promotional materials to "avoid giving the appearance" that I was practicing veterinary medicine. I was surprised, to say the least, as I honestly believed I was only offering massage services to my equine clients.

The Vet Board was "particularly concerned about the barn call aspect of the business, which is without the benefit of direct veterinary supervision." I agree a good massage practitioner is able to work with the veterinarian as part of a comprehensive healthcare team, but it is unreasonable to expect the veterinarian to serve as a "direct, standing-over-your shoulder, watching every move" supervisor. In fact, many of my clients come from veterinary referrals, and most of the veterinarians I have talked with express no desire to massage horses. Their expertise is best utilized elsewhere.

And, apparently, since there is no exclusion under the Practice Act for "certified massage therapists," the state of Maryland "views a certified equine massage therapist no differently than any individual having no training whatsoever." Because the state does not "regulate or license massage therapists for animals" nor certify "equine/canine massage therapists," then those of us who have spent vast amount of time and money learning this trade apparently are bad people who must be reeled in and banished from the animal world! I'm sure my fellow qualified practitioners who, like me, have dedicated themselves by expending the time and resources to learn the skills of this trade would disagree.

Luckily for me, I was able to continue serving my equine clientele by making the terminology changes the Vet Board suggested.

As horse owners, we have the right to self-determine the type of care our horses receive, as long as the care (or lack of care) does not constitute animal abuse. This includes having access to trained professionals who successfully demonstrate their ability to promote overall wellness and keep the entire equine body in peak physical condition. Holistic and alternative services for our horses should be available to all of us and provided by individuals qualified to provide those services, [which does not necessarily mean] four-plus years in medical school.

As the profession of equine massage continues to grow, it is a given that we will all suffer from growing pains. However, there is a better way to handle this. With the recent outpouring of animal massage certifications schools, some better than others, it is imperative and the responsibility of horse owners to do their homework to ensure only trained professionals work on their animals. It is critical for practitioners to supplement the knowledge gained in massage school with continuing education, and for the practitioners and public to demand this level of expertise. None of us should ever stop learning!

While we all wait for the outcome of the current lawsuit brought against the Board of Veterinary Medical Examiners and the Board of Chiropractic Examiners, you can make a difference. Contact the Maryland State Board of Veterinary Medical Examiners (Laura Downes, Executive Director, 410-841-5862, downeslc@mda.state.md.us) and let them know that you want free access to the healthcare practitioners of your choice. Contact Christopher J. Kelter, M.P.A., Deputy Director/Massage Therapy Program, Manager of the Chiropractic Board at 410-764-4738. Let the Boards know that you, as the primary advocate for your horse, want and will demand access to trained professionals of alternative services as you determine yourself! There is strength in numbers. It is up to all of us to make a difference!


Call to Boycott Chiropractors
- Elizabeth Rowland, owner of the Maryland-based Half Halt Press, publisher of equestrian-related books and manuals

I am writing regarding the unwarranted interference of Maryland Board of Chiropractic Examiners, in collusion with the Maryland Board of Veterinarians, that affects my rights and abilities to select the best care options for my horses- specifically equine massage therapy. I am the OWNER of said horses, not the Chiropractic Board, and to have my options blocked by a group who in all likelihood doesn't even know which end of a horse eats is simply outrageous.

Horse people, almost by definition, have back problems and use chiropractors with some frequency. Until that is, they come to know that chiropractors are blocking them from receiving the equine massage therapy they may desire for their horses. Let's see, what do you think will happen? Who will be blamed? Can you spell B-O-Y-C-O-T-T? What will your chiropractors think of their own board if it causes such problems for them?

I, for one, will not set foot in my chiropractor's door until they back off , and I will do my level best to make sure every horse person in Maryland is aware of this situation.

 

 

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