Vet
Law Challenged - Round 3
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 Maryland-based “Hands
On Horses” practice. To read her letter in full, please visit “News
& Resources” on equiery.com.
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.
|
