Does the delegated authority of a physician, as outlined by the Texas Medical Practice Act, allow unlicensed individuals to practice orthotics or prosthetics in the State of Texas?
The delegated authority of a licensed physician does not allow unlicensed individuals to practice orthotics or prosthetics in the State of Texas.
The Texas Orthotics and Prosthetics Act (Texas Occupations Code, Chapter 605) requires licensure for individuals practicing orthotics and prosthetics within the state. The Act does provide exemptions to several licensed and certified professionals as outlined in Subchapter G, these include physical therapists, occupational therapists, chiropractors, podiatrists, pharmacists, and certified pedorthists.
In comparison, the Texas Medical Practice Act (Texas Occupations Code, Chapter 151) authorizes licensed physicians to diagnosis, treat, or offer to treat a mental or physical disease or disorder or a physical deformity or injury by any system or method. These provisions include the practice of orthotics and prosthetics in the performance of a physician’s duties. In addition, a physician may delegate authority to individuals; however, there are specific guidelines that govern delegated authority. Texas Occupations Code, Chapter 157, §157.001(a)(1)(C) states that a physician may delegate authority if the delegation, “…is not in violation of any other statute…”.
Because the practice of orthotics and prosthetics is protected by statute, the Texas Medical Practice Act prohibits a physician from delegating authority to an unlicensed individual to perform any act within the scope of practice defined by the Texas Orthotics and Prosthetics Act.
Who can fit and sell diabetic shoes in Texas?
The Texas Orthotics and Prosthetics Act (Texas Occupations Code, Chapter 605) includes in its definition of the practice of orthotics, the fitting of a custom-fitted or custom-fabricated device.
These definitions are outlined in Sections 605.002 (3), (4), (12), and (14).
Any individual who custom fits a diabetic or other shoe through means of moldable inserts or other methods, regardless of where the final shoe is manufactured, is practicing orthotics and must be licensed under the Texas Orthotics and Prosthetics Act, unless exempt (see below).
Professional certifications from private educational companies do not constitute Texas licensure. Any unlicensed individual who is discovered to be practicing orthotics in this manner will be subject to enforcement action which may include administrative, civil, and criminal penalties.
The Act does recognize several professions that are exempt from these provisions. Exempt professions are limited to licensed podiatrists, chiropractors, occupational therapists, physical therapists, and pharmacists. Certified pedorthists are also exempt from licensure under the Texas Orthotics and Prosthetics Act.
Furthermore, the sale of retail shoes, over-the-counter or out of the box, is not subject to the Texas Orthotics and Prosthetics Act.
Any questions or concerns regarding this matter may be referred to the Board through the contact information provided below.
Texas Board of Orthotics & Prosthetics
Mail Code 1982
P.O. Box 149347
Austin, Texas 78714-9347
Telephone: (512) 834-4520
Fax: (512) 834-6677 ATTN: Texas Board of Orthotics & Prosthetics