Who counts as a 'team physician' under the Texas athletic trainer licensing law?

Texas AG Opinion DM-0021: "Physician" in the Athletic Trainer Act Means a Medical Doctor Only

Plain-English summary

The Commissioner of Health asked the Attorney General to pin down a single word in the athletic trainer licensing statute. Under article 4512d, an athletic trainer works "upon the advice and consent of his team physician." The question was whether "physician" there is broad enough to include dentists, chiropractors, podiatrists, and optometrists, or whether it means only a medical doctor.

The Attorney General concluded it means only a medical doctor, that is, a person licensed by the State Board of Medical Examiners under article 4495b. The statute itself did not define "physician," but it used the word in another section, the exemption provision, that lists "physicians licensed by the Texas State Board of Medical Examiners" right alongside a separate roster of other practitioners: dentists, optometrists, occupational therapists, nurses, chiropodists and podiatrists, physical therapists, and others. Because the statute set physicians apart from that list, "physician" carried the narrow, medical-board meaning. Applying the rule that a word used in different parts of a statute keeps the clear meaning it has in one place, the Attorney General read section 1(1) the same way. So an athletic trainer's "team physician" had to be a doctor licensed by the Board of Medical Examiners, not one of the other listed health-care practitioners.

Currency note

This opinion was issued in 1991. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. The athletic trainer statute (then article 4512d, V.T.C.S.) and the Medical Practice Act (article 4495b) have since been recodified into the Occupations Code. Verify current law before relying on any specific rule or citation mentioned here.

Common questions

Who is a "team physician" under the Texas athletic trainer law?
Under this opinion, a doctor licensed by the State Board of Medical Examiners. The Attorney General read "physician" in section 1(1) of article 4512d to exclude dentists, chiropractors, podiatrists, and optometrists.

Why doesn't "physician" include those other practitioners?
Because the statute's exemption section listed physicians (those licensed by the medical board) separately from dentists, optometrists, podiatrists, and others. That separation showed the legislature used "physician" in the narrow sense throughout the act.

Background and statutory framework

Article 4512d licensed athletic trainers and defined an athletic trainer as a qualified person who, on the advice and consent of "his team physician," carries out prevention and physical rehabilitation of athletes' injuries. The statute did not define "physician," but section 1(4), the exemption clause, used the term to describe practitioners "licensed by the Texas State Board of Medical Examiners" and then listed a series of other health-care practitioners separately, including dentists, optometrists, podiatrists, physical therapists, and nurses. The Attorney General invoked the canon, drawn from Boriack v. Boriack, that a word used in different parts of a statute carries the clear meaning it has in one instance, and concluded "physician" in section 1(1) meant only a person licensed by the Board of Medical Examiners under article 4495b.

Citations

Statutory provisions:

• V.T.C.S. art. 4512d, §§ 1(1), 1(4) (athletic trainer definition and exemptions)
• V.T.C.S. art. 4495b (Board of Medical Examiners)

Cases:

• Boriack v. Boriack, 541 S.W.2d 237 (Tex. Civ. App.—Corpus Christi 1976, writ dism'd)

Prior opinions referenced: Attorney General Opinion JM-1279 (1990).

Source

• Landing page: https://www.texasattorneygeneral.gov/opinions/dan-morales/dm-0021
• Original PDF: https://www.texasattorneygeneral.gov/sites/default/files/opinion-files/opinion/1991/dm0021.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain — the linked PDF is authoritative.

Office of the Attorney General
State of Texas

May 2, 1991

Robert Bernstein, M.D., F.A.C.P.
Commissioner of Health
Texas Department of Health
1100 West 49th Street
Austin, Texas 78756-3199

Opinion No. DM-21

Re: Scope of the term "physician" for purposes of the article 4512d, V.T.C.S., which provides for licensing of athletic trainers (RQ-12)

Dear Dr. Bernstein:

You ask about article 4512d, V.T.C.S., which provides for the licensing of athletic trainers. Specifically, you ask about the scope of the term "physician" in section 1(1) of article 4512d:

"Athletic Trainer" means a person with specific qualifications, as set forth in Section 9 of this Act, who, upon the advice and consent of his team physician, carries out the practice of prevention and/or physical rehabilitation of injuries incurred by athletes. To carry out these functions the Athletic trainer is authorized to use physical modalities such as heat, light, sound, cold, electricity, or mechanical devices related to rehabilitation and treatment. (Emphasis added.)

Your question is whether "physician" in that section includes dentists, chiropractors, podiatrists, and optometrists. We conclude that the term "physician" in section 1(1) of article 4512d was intended to refer only to persons licensed by the Board of Medical Examiners.

The term "physician" is not defined in article 4512d. However, the term is used in another section of the statute, along with references to a number of other health-care practitioners:

The provisions of this act do not apply to physicians licensed by the Texas State Board of Medical Examiners; to dentists, duly qualified and registered under the laws of this state, who confine their practice strictly to dentistry; nor to licensed optometrists, who confine their practice strictly to optometry as defined by statute; nor to occupational therapists, who confine their practice to occupational therapy; nor to nurses who practice nursing only; nor to duly licensed chiropodists or podiatrists who confine their practice strictly to chiropody or podiatry as defined by statute; nor to physical therapists who confine their practice to physical therapy; nor to masseurs or masseuses in their particular sphere of labor; nor to commissioned or contract physicians or physical therapists or physical therapists assistants in the United States Army, Navy, Air Force, Public Health and Marine Health Service.

V.T.C.S. art. 4512d, § 1(4) (emphasis added).

The term "physician" is used in the first sentence of section 1(4) to describe health-care practitioners licensed by the Board of Medical Examiners. The same sentence lists separately a number of other health-care practitioners, including dentists, podiatrists, and optometrists. See generally V.T.C.S. art. 4495b (establishing Board of Medical Examiners); cf. Attorney General Opinion JM-1279 (1990) (regarding use of title "chiropractic physician").

When a word or phrase is used in different parts of a statute, a clear meaning appearing in one instance will be attached to the same word or phrase used elsewhere. Boriack v. Boriack, 541 S.W.2d 237, 240 (Tex. Civ. App.—Corpus Christi 1976, writ dism'd). By setting out separately a long list of various health-care practitioners, section 1(4) sets apart physicians from other categories of health-care practitioners. Section 1(4) specifically refers to "physicians" as those practitioners who are licensed by the State Board of Medical Examiners. Applying the principle of statutory construction set forth in Boriack, we therefore conclude that the term "physician" as used in section 1(1) only refers to practitioners licensed by the State Board of Medical Examiners, not to other health-care practitioners who are not so licensed.

SUMMARY

The term "physician" in section 1(1) of article 4512d, V.T.C.S., refers to persons licensed by the State Board of Medical Examiners under article 4495b, V.T.C.S.

DAN MORALES
Attorney General of Texas

WILL PRYOR
First Assistant Attorney General

MARY KELLER
Executive Assistant Attorney General

JUDGE ZOLLIE STEAKLEY (Ret.)
Special Assistant Attorney General

RENEA HICKS
Special Assistant Attorney General

MADELEINE B. JOHNSON
Chair, Opinion Committee

Prepared by Sarah Woelk
Assistant Attorney General