Siegrist v. IwuagwaSiegrist v. Iwuagwa
Lead Opinion
Dr. Harry E. Siegrist III appeals from the trial court’s grant of summary judgment in favor of Augustine Iwuagwa in Siegrist’s suit to collect payment for the rendering of services which were outside the scope of chiropractic treatment. Siegrist, a chiropractor, claims he is entitled to payment from Iwuagwa, a former patient, for massages which are not authorized chiropractic treatment under
The facts show that after he was injured in an automobile accident, Iwuagwa prеsented himself at Siegrist’s office, a health care provider, for treatment of his injuries. According to the patient information form he completed prior to seeing Siegrist, Iwuagwa sought “lasting correction” of the soft-tissue injuries he had sustained in the collision. As a condition of receiving this treatment, he was required to sign, on “Chiropractic Health Clinic” letterhead, a statement guaranteeing payment to Siegrist for all charges incurred. The form made no reference to massages, the fact that services outside the statutory limits for chiropractic treatment might be given, or any indication of the charge for any treatment.
The record does not reflect that Siegrist and Iwuagwa had any discussion or negotiation regarding what specific services Siegrist would provide to Iwuagwa, including what types of treatments Siegrist would administer tо Iwuagwa. Nor does the record reflect that the parties ever discussed Siegrist’s provision of massages as part of Iwuagwa’s chiropractic rehabilitation. However, the record does indicate that on 18 of Iwuagwa’s
Iwuagwa had insurance which covered the injuries he received in the collision, and this insurance paid the majority of the cost of his treatments with Siegrist. However, when Iwuagwa’s insurer refused to pay for the massages, claiming they were outside the scopе of authorized chiropractic treatment, Iwuagwa also refused to pay for the massages, presumably on the same basis. Siegrist thereafter filed suit in magistrate court, and Iwuagwa prevailed. When Siegrist appealed this decision de novo to the state court, both parties moved for summary judgment. Iwuagwa’s motion for summary judgment was granted, and it is from this ruling that Siegrist appeals.
Our standard of review for this contention is well-established. “On appeal from a trial court’s grant of summary judgment, this Court conducts a de novo review of the evidence. In order to prevail at summary judgment under
1. Siegrist argues that the trial court erred in finding that, because massage is not listеd in
Because the statutes applicable to chiropractors and the practice of chiropractic hold otherwise, Siegrist’s argument is without merit.
Pursuant to
Statutory construction of this sort is so frequently relied upon by this Court and the Supreme Court that its soundness is above question. “The omission of any reference to
The dissent argues that
While the dissent correctly cites
A review of prior chiropractic cases supports our conclusion that massages are not statutorily authorized chiropractic treatment. Foremost among these is Foster v. Ga. Bd. of Chiropractic Examiners,
The Supreme Court rejected this reasoning, and found that “[t]he regulation of health professions, for the preservation and protection of public health, is universally regarded as a duty of the State in the exercise of inherent police power.” (Punctuation omitted.) Id. at 419 (14). It noted that the chiropractor did not merely sell vitamins, he “[represented] to a patient who [had] come to him that such vitamins [would] cure a disease or ailment. . . . [T]he chiropractor in a professional capacity advises the patient to take the vitamins for the ailment or disease, charges compensation for such advice, and may cause the patient to think his ailment or disease will thereby be cured. This is the vice condemned.” (Punctuation
The same reasoning applies here. The legislature has chosen to regulate chiropractic closely, and has clearly delineated the bounds over which chiropractors may not cross. Unlike a chiropractor, one who gives massages for relaxation or similar purposes does not represent to a patient, for a fee, that massage will cure a disease or ailment. Although anyone may give massages, when a chiropractor gives a massage as part of his rehabilitation or maintenance of a patient’s health, he is representing, based upon his professional judgment, that the massage has mediсal, rehabilitative benefits. The character of the massage is therefore transformed when it is administered by a chiropractor — from an act anybody can perform to a professionally diagnosed and administered chiropractic procedure which the patient believes will alleviate his pain or cure his disease.
As was the case in Foster, which is binding authority upon us, herein lies the difference between simply providing massаges and in providing them as part of a patient’s chiropractic treatment. Although, unlike Foster, Siegrist’s giving of massages does not amount to the unlicensed practice of medicine, the vice condemned is the same. In the same way that Foster unlawfully represented that certain vitamins would assist or cure various conditions in his patients, Siegrist — unlawfully under the statute — represented that massage had chiropractic benеfits and administered massages as part of chiropractic treatment to heal and cure. Although massage may indeed have some benefit, that issue is not before us, and only the legislature has the authority to address this issue.
History shows us that this pattern is a common one in Georgia jurisprudence where the scope of the chiropractic statutes is at issue. For example, after the Supreme Court held in Foster that the Cоde did not authorize Foster to “prescribe or dispense vitamins, minerals, or nutritional substances,” Foster, supra at 417 (10), the Georgia legislature amended
To claim, as Siegrist does, that because anyone can perform massages with little more than a business license, his ability to give massages should not be proscribed, misses the point of the reasoning behind regulating the profession of chiropractic. If chiropractors could perform all services any other person, medical or otherwise, could perform, there would be no need for a statute setting forth those specific treatment modalities which chiropractors are authorized to use to treat or rehabilitate a patient. Siegrist is not barred from giving massages, he is simply not authorized to provide them as сhiropractic treatment and then charge for them. The reason for this rule is basic. Chiropractors are limited to providing, and charging for, certain services which are within the scope of their profession. A chiropractor cannot, pursuant to an agreement to pay for services like the one Iwuagwa was required to sign here, perform services which are not authorized as chiropractic treatment and then force a patient to pay for those services by virtue of the agreement to pay.
A chiropractor may provide massage services if he chooses, so long as such massages are not provided in his capacity as a chiropractor rendering chiropractic treatment to a chiropractic patient. In no event could a patient’s guarantеe to pay for chiropractic services include the guarantee to pay for any type of non-chiropractic service, including massage. The absence of massage from the current statutory scheme evinces the legislature’s determination that massage is not a proper form of chiropractic treatment at this time. Accordingly, the trial
2. Siеgrist claims the trial court should have enforced the executed contract for which Iwuagwa received full benefit. As held in Division 1, however, the massages were not authorized by law as chiropractic treatment. Pursuant to
3. Siegrist raises several constitutional arguments, and claims the trial court erred in failing to address them. He contends that his due process and equal protection rights will be violated if chiropractors are prohibited from practicing massage. He also claims that barring chiropractors from offering massages unconstitutionally impairs his contract with Iwuagwa. While the trial court’s order does not specifically address these arguments, it implicitly finds them to be without merit. Also, Siegrist’s “contract” with Iwuagwa was nothing more than a general guarantee to pay for chiropractic services. Massages not being chiropractic services, there was no guarantee to pay for such services.
(a) Siegrist argues that chiropractors have a fundamental right to practice massage, and that denial of that right is a violation of equal protection. However, the right to practice massage is not a fundamental right.
The state’s classification of chiropractors, including its classifications regarding what procedures chiroрractors are and are not authorized to use, bears a reasonable relationship to the government’s legitimate purpose of protecting the public’s health. See generally Foster, supra at 419 (14). Preventing chiropractors from prescribing, administering, and charging for massages, in the course of chiropractic treatment, reasonably furthers the state’s purpose in protecting public health and welfare from an activity it has determined is beyond the scope of the practice of chiropractic. The same is true of preventing chiropractors from directly or implicitly representing to the public that massage is an authorized chiropractic treatment. For this reason, Siegrist has failed to show that the state’s legislation “was undertaken with an unreasonable purpose or was arbitrary and сapricious,” and he has therefore not shown the existence of an equal protection violation. Watson, supra at 187.
(b) Siegrist contends the taking of his ability to perform massages in connection with his profession amounts to a deprivation of property without due process of law. He correctly asserts that a license to engage in a profession is a property right. See Wills v. Composite State Bd. of Med. Examiners,
Nothing in the statutes governing chiropractic practice precludes a chiropractor, who is otherwise qualified, from providing separate massage services. Siegrist is simply prohibited from doing so and representing massage as chiropractic services and charging his chiropractic patients for such unauthorized procedure.
(c) Siegrist claims the trial court’s ruling impairs his right to contract. “The test is whether there was a vested right. If so, no subsequent legislative Act could impair it; but if not, there is no bar to a change or abolition of it at any time before it becomes fixed by a judgment.” (Punctuation omitted.) Goolsby v. Regents of the Univ. System of Ga.,
Although Siegrist argues that he should be allowed to perform chiropractic massages and charge for them, he does not argue that he had a vested right to do so. Nor does anything contained in the record so indicate. See generally S. J. T., Inc. v. Richmond County,
4. We need not reach Siegrist’s enumeration that summary judgment should have been granted for him.
Judgment affirmed.
Notes
Siegrist also suggests that he is entitled to equitable relief so that Iwuagwa will not be unjustly enriched. Though we need not address this argument for Siegrist’s failure to separately enumerate it, “where a contract is illegal only in part, recovery is allowed on a quantum meruit basis for the part of the services which was legal.” (Emphasis supplied.) Remediation Svcs. v. Ga. Pacific Corp.,
Fundamental rights include “the guarantees of the Bill of Rights, the right to fairness in the criminal process, the right to privacy, the right to travel, the right to vote, freedom of association, and procedural due process rights.” Ambles v. State,
Dissenting Opinion
dissenting.