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"TMA is very concerned that not only will patients be deceived and misled, but many could also suffer injury and harm, for example by delayed diagnosis," TMA President Michael E. Speer, MD, said in a formal letter to Yvette Yarbrough, executive director of the Texas Board of Chiropractic Examiners. "A patient suffering headaches, syncope, or seizures could have a serious neurological disease, but that patient could easily find himself or herself in a 'chiropractic neurologist's' office. The patient could easily be deceived into believing that this chiropractor could diagnose or treat his or her medical condition, including a brain tumour, aneurism, or stroke. This proposed rule is not in harmony with the Texas Chiropractic Act, the Healing Art Identification Act, or the Health Professions Council Statute." He noted that some chiropractors are "already pushing the envelope" in their advertisements by burying the designations required under Texas law, thus confusing patients about whether the chiropractor is a physician. Dr. Speer added that the state Chiropractic Act "makes no reference to neurology. Neurology does not involve the biomechanics of the spine and musculoskeletal system. Neurology is clearly beyond the scope of chiropractic in Texas, and this proposed rule is a brazen effort by the board to circumvent Texas statutory law to expand chiropractors' scope." Texas Medical Association (1st August 2012) [Includes full text of letter]