Title: Johnson v. State ex rel. Wyoming Bd. of Medicine

State: wyoming

Issuer: Wyoming Supreme Court

Document:

Johnson v. State ex rel. Wyoming Bd. of Medicine1999 WY 112986 P.2d 157Case Number: 98-353Decided: 07/27/1999Supreme Court of Wyoming

DEAN 
L. JOHNSON, D.C., and CINDY R. MARTENS, Ph. D., C. N.C. R. A.,

Appellants (Defendants),

v.

THE STATE OF WYOMING ex rel. WYOMING BOARD 
OF

MEDICINE, Appellee (Plaintiff).

 

                                 

 

Appeal from the District Court of Laramie County, The 
Honorable

Nicholas G. Kalokathis, Judge.

 

Tom C. Toner of Yonkee & 
Toner, Sheridan, Wyoming, representing appellants.

 Don W. Riske, Special Assistant Attorney General, 
Cheyenne, Wyoming, representing appellee.

 

Before LEHMAN, C.J.; 
THOMAS & MACY, JJ.; and JOHN D. TROUGHTON, D.J., & DAN R. SPANGLER, D.J. 
(RET.)

 

    SPANGLER, District 
Judge (Retired).

   
[¶1]      Summary judgment was granted in favor of 
the appellee, which enjoined the appellants from practicing medicine in Wyoming 
and enjoined Appellant Dean L. Johnson, D.C., from using the term "chiropractic 
physician."

 

   [¶2]   We reverse and 
remand.

 

                               
ISSUES

 

  [¶3]      The appellants present these 
issues:

 

1. When a school district's throat culture policy 
does not require a strep throat to be treated by antibiotics or by a medical 
doctor, are a mother and a grandfather guilty of the unauthorized practice of 
medicine when they treat a family member using a nutritional supplement and tell 
the school district that the family member has been so treated in order to 
secure the family member's readmission to school?

  

2. Is a licensed Wyoming chiropractor guilty of the 
unauthorized practice of medicine if he treats a person for a possible viral or 
strep condition using clinical nutritional methods?

 

3. Do Wyoming statutes prohibit a licensed Wyoming 
chiropractor from using the term "chiropractic physician"?

 

4. If Wyoming statutes prohibit a licensed Wyoming 
chiropractor from using the term "chiropractic physician," are the statutes 
constitutional?

 

  The appellee phrases the issue as 
follows:

 

            Whether the 
district court erred in granting Appellee's motion for summary 
judgment[.]

 

                                
FACTS

 

  [¶4]      Kevin Martens was nine years old and 
attending school in Crook County. On January 26, 1998, his mother, Appellant 
Cindy R. Martens, received a call from the school nurse, who said that Kevin was 
not feeling well and had a fever. Cindy picked up Kevin at the school and took 
him home. On January 28th, Cindy received a call from the school nurse, who reported that 
Kevin's throat culture was positive for strep.

 

  [¶5]      Cindy talked to her father and Kevin's 
grandfather, Appellant Dean L. Johnson, who is licensed to practice chiropractic 
in Wyoming. Dean recommended that Cindy give Kevin immuplex and congaplex, 
natural food supplements for which a prescription is not 
required.

 

  [¶6]      The school district's throat culture 
program contained these provisions:

 

            In order to 
implement a throat culture program, the following procedures and regulations 
apply:

 

            1. Throat 
cultures may be given only to those students demonstrating illness or 
infection.

 

2. If a student receives a positive throat culture, 
the student, the parent, the teacher and respective administrator will be 
notified. The student may not reenter school until treatment has been secured or 
a negative culture is demonstrated.

 

3. Students with positive cultures may be re-cultured 
in 14 days at parental request or if symptoms exist in the judgment of the nurse 
or teacher. If positive again, the above procedure will be followed. When a 
repeat positive occurs, all immediate family members shall be encouraged to come 
to the school for a throat culture. Siblings in school will be 
cultured.

 

            4. Cost of the 
throat culture program will be assumed by the district.

 

            
Adopted: October 17, 1985

 

When Kevin returned to 
school, Cindy sent a note with him which contained the signatures of Cindy and 
Dean and was written on Dean's instruction pad having this heading: "Dean L. 
Johnson, D. C. - Chiropractic Physician." The note stated: "Please excuse Kevin 
from school 1/23/98-1/29/98, due to a viral strep syndrome. He has been treated by me for this." Cindy 
also sent a letter written on Dean's letterhead and signed by her, stating in 
part: "I have enclosed copies of the prescribed therapeutic supplements 
routinely used for this viral syndrome which constitutes 
treatment."

 

                         
STANDARD OF REVIEW

 

  [¶7]      Summary judgment is appropriate when 
there are no genuine issues as to any material fact and the prevailing party is 
entitled to a judgment as a matter of law. Davis v. Black Hills Trucking, Inc., 
929 P.2d 532, 533-34 (Wyo. 1996). No deference is given to the district court's 
decision. State Board of Control v. Johnson Ranches, Inc. (Matter of North 
Laramie Land Company), 605 P.2d 367, 373 (Wyo. 1980).

 

                             
DISCUSSION

 

  A. Family Remedy 
Exemption

 

  [¶8]      Wyo. Stat. Ann. § 33-26-103(a)(vii) 
(LEXIS 1999) of Wyoming's Medical Practice Act - Wyo. Stat. Ann. §§ 33-26-101 to 
-511 (LEXIS 1999) - provides as follows:

 

            (a) 
This chapter does not apply to:

 

            . . 
.

 

                        
(vii) The gratuitous domestic administration of family 
remedies[.]

  

The appellants and the 
appellee agree that the giving of nutritional supplements by the mother and 
grandfather is protected by the family remedy exemption. However, the appellee 
contends that, when the appellants wrote the note and letter to the school, this 
took them outside the family remedy exemption and constituted the practice of 
medicine.

 

  [¶9]      The appellee's theory would be an 
unrealistic impediment to the use of the family remedy exemption. The purpose of 
the exemption would be frustrated if family members were allowed to do no more 
than give remedies to the child. In 
cases such as this one, it is essential that the family report the treatment to 
the school so that the child can be readmitted. Basically, the appellants did no 
more than tell the school the truth, that Kevin had been given nutritional 
supplements. It does not constitute the practice of medicine for family members 
to report the gratuitous administration of family 
remedies.

 

  [¶10] 
  The appellee also contends 
that the appellants were wrong in using the term "viral strep syndrome" and in 
treating streptococcus infection with therapeutic supplements. However, these 
points are not at issue in this case. This is not a malpractice suit. The 
statute does not condition the family remedy exemption upon whether the 
diagnosis and treatment are correct.

 

  B. Licensed Chiropractor 
Exemption

 

  [¶11] 
  The appellee contends that 
Dean violated the Medical Practice Act by "practicing medicine" as defined in § 
33-26-102(a)(xi)(B):

 

            (xi) "Practicing 
medicine" means any person who in any manner:

 

        
    . . 
.

 

(B) 
Prescribes or provides medical diagnosis or medical treatment for human disease, 
injury, deformity, ailment, pregnancy or delivery of infants; . . 
.

 

The appellants and the 
appellee agree that a licensed chiropractor is exempt from the Medical Practice 
Act when he is practicing "chiropractic" as defined by Wyo. Stat. Ann. § 
33-10-101 (LEXIS 1999):

 

Chiropractic is the system of specific adjustment or 
manipulation of the joints and tissues of the body and the treatment of the 
human body by the application of manipulative, manual, mechanical, 
physiotherapeutic or clinical nutritional methods for which those persons 
licensed under this chapter are trained and may include the use of diagnostic 
x-rays. A chiropractor may examine, diagnose and treat patients provided, 
however, chiropractors shall not perform surgery, direct the use of or 
administer drugs required by law to be 
dispensed on prescription only, practice obstetrics or prescribe or administer 
x-ray therapy.

 

   [¶12] The appellee argues that a 
chiropractor is not allowed to diagnose and treat a disease by applying clinical 
nutritional methods. Section 33-10-101 specifically allows a chiropractor to 
diagnose and treat patients by applying clinical nutritional methods. The 
language is clear. There is no ambiguity. To say that a chiropractor can 
diagnose and treat patients by applying clinical nutritional methods but not for 
diseases would defeat the purpose of the 
statute. That would limit the chiropractor's use of clinical nutrition for 
healthy patients who do not need treatment or to patients who have problems with 
joints or tissues. The statute does not contain these limitations. The statute 
says that a chiropractor can treat "the human body," not just the joints and 
tissues. To accept the appellee's contention, we would need to amend the 
statute, which we cannot do.

 

  [¶13] 
  Section 33-10-101 
enumerates the things which chiropractors are not allowed to do. They cannot 
perform surgery, direct the use of or administer prescription drugs, practice 
obstetrics, or prescribe or administer x-ray therapy. Diagnosis and treatment of 
disease by applying clinical nutritional methods is not among the prohibitions. 
Therefore, we hold that a chiropractor licensed to practice in Wyoming does not 
violate the Medical Practice Act by diagnosing a disease and by then treating 
the patient by the application of clinical nutritional 
methods.

 

  C. Use of the Term ""Chiropractic 
Physician""

 

  [¶14] 
  The appellee claims that, 
by using the term "chiropractic physician," Dean violated § 33-26-102(a)(xi)(C) 
of the Medical Practice Act, which includes in the definition of practicing 
medicine any person who "[a]ttaches the title of M. D., D. O., physician, 
surgeon, osteopathic physician or osteopathic surgeon, doctor, or any other 
words, letters or abbreviations which represent the person as being engaged in 
the practice of 
medicine."

 

  [¶15] 
  The statute is clear as to 
what is prohibited. It does not prohibit the use of the term "chiropractic 
physician." That term does not represent that the person is engaged in the 
practice of medicine. We hold that a chiropractor licensed to practice in 
Wyoming does not violate the Medical Practice Act by using the reference 
"chiropractic physician."

 

  [¶16] 
  In light of our holding 
that the statute was not violated, it is not necessary for us to discuss the 
issue of whether the statute violates a constitutional 
right.

 

                             
CONCLUSION

 

  [¶17] 
  There is no factual 
dispute. The appellants are entitled to a judgment as a matter of law. Their 
gratuitous domestic administration of family remedies and reporting of that 
treatment to the school are exempt from the Medical Practice Act. Dean, as a 
chiropractor licensed in Wyoming, did not violate the Medical Practice Act by diagnosing a disease and providing 
treatment by the application of clinical nutritional methods. He did not violate 
the Medical Practice Act by referring to himself as a "chiropractic physician." 
The district court's order granting summary judgment and a permanent injunction 
is reversed, and the case is remanded 
for entry of a judgment in favor of the appellants.