POSTED: 7:28 pm CDT June 12, 2007

MADISON, Wis. -- Health professionals on Tuesday debated a bill that would keep it so only physicians could practice a potentially painful needle exam to diagnose nerve or muscle disease.

Health professionals of all kinds weighed in on a bill that would keep needle electromyography, or EMG, in a physician's office, as opposed to the offices of chiropractors or physical therapists.

Assembly Bill 325 broaches a touchy topic for health care professionals who aren't doctors because it aims to make sure the testing doesn't become part of their scope of practice.

A retired neurologist who authored the bill told a state committee that he is a member of that the bill is a "preemptive strike" to keep chiropractors and physical therapists from doing the test. But many doctors said the test is much too important to leave to a broader group of health professionals.

During testimony on AB 325, doctors talked about the expensive and important nerve and muscle test. EMG is used in conjunction with nerve conduction studies in diagnosing diseases, some of them severe and potentially life-threatening, WISC-TV reported.

"It involves placing a sharp needle, which is sterile, into a muscle and recording the electrical potentials from several spots in that muscle," said Rep. Chuck Benedict, the bill's author.

How many muscles and which ones get tested are based on "real time" monitoring during the test by the doctor, WISC-TV reported.

EMGs can cost around $1,000, and doctors use them to help diagnose everything from muscle strains and carpal tunnel syndrome, to disease like ALS or Lou Gehrig's Disease and Muscular Dystrophy.

Doctors with special training in neurology and neuromuscular diseases said that only they should continue to give the tests because they're complicated.

They contend their medical degree and training are necessary to properly administer the test so patient pain is limited and a correct diagnosis can be reached. They said that simply training to physically conduct the test isn't enough.

"I believe if any patient has to undergo an EMG examination, they should have it performed by a highly qualified medical professional trained to do that and that is licensed physician," Benedict said.

"I strongly believe that needle EMG and nerve conduction should be performed by physicians who are sufficiently trained in this technique," Dr. Andrew Waclawik, president of the Wisconsin Neurology Society, told a committee.

But Jeff Wilder, a Madison chiropractor opposed to AB 325, said the bill once again divides chiropractors and doctors.

"It was not that long ago that our professions didn't get along well at all," Wilder said.

Some chiropractors said the bill that limits EMGs to physicians amounts to "discrimination." They and physical therapist associations said their peers, if trained in it, can do the test, too.

And at least one neurologist from a state where that's legal said he agrees. Dr. Edward Milstler shares a clinic with a physical therapist who conducts EMG tests for him.

"Doing EMGs requires specialized training. Unfortunately, most physicians who do this test do not have specialized training and most of the physical therapists who do them are better trained than most physicians," Milstler said.

But state neurologists, the medical society and other doctor groups vehemently disagree. While chiropractors get 300 hours of neurology training to do the test, medical doctors said they have years of specialized training.

Chiropractors argued that the bill limits competition, while doctors said it will drive up health care costs.
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