Redundant Remedies, Not Redundant Claims:
Gonzalez v. Texas Medical Board and the Scope of Judicial Review of Texas Agencies

I. Introduction

In Reynaldo “Rey” Gonzalez, Jr., M.D., J.D. v. Texas Medical Board, No. 24‑0340 (Tex. Oct. 31, 2025), the Supreme Court of Texas confronted an unusual intersection of professional regulation, administrative law, and campaign speech. The Texas Medical Board (TMB), historically responsible for ensuring that individuals who practice medicine are licensed and competent, turned its attention to a congressional campaign. Gonzalez, a lawyer who also holds a medical degree but has never been licensed to practice medicine, campaigned as “Dr. Gonzalez” and described himself as a “physician.” TMB treated this as the unlicensed practice of medicine and issued a cease‑and‑desist order.

The legal dispute now before the Supreme Court did not decide whether TMB may constitutionally police that kind of campaign speech. Instead, it concerned something more foundational: which kinds of claims and remedies a litigant may pursue in Texas courts when challenging agency action—and, crucially, whether the redundant‑remedies doctrine closes the courthouse doors when the litigant did not timely pursue review under the Texas Administrative Procedure Act (APA).

The Court’s opinion, authored by Justice Sullivan, clarifies and sharpens Texas law in two principal ways:

It holds that the redundant‑remedies doctrine focuses on remedies, not on the mere availability of similar claims under the APA. Where a plaintiff seeks prospective, non‑APA relief that goes beyond reversal of an agency order—particularly ultra vires and constitutional relief—the UDJA suit is not barred as “redundant,” even if the same legal theories could have been raised in a timely APA proceeding.
It re‑affirms that only statutes, not agency rules, can confer subject‑matter jurisdiction for judicial review. An agency rule purporting to authorize judicial review of an agency order cannot create jurisdiction where the Legislature has not done so.

As a result, Gonzalez’s facial constitutional challenge, as‑applied constitutional challenge, and ultra vires claim may proceed in the district court, while his substantial‑evidence challenge to the specific cease‑and‑desist order remains dismissed for lack of jurisdiction.

Beyond its procedural posture, the case matters because it sets the stage for an eventual confrontation between the TMB’s authority and robust protections for political speech under the First Amendment and Article I, § 8 of the Texas Constitution, particularly where a candidate uses truthful professional titles in a campaign.

II. Factual and Procedural Background

A. Gonzalez’s background and campaign speech

Gonzalez holds both a medical degree (M.D.) and a law degree (J.D.). He elected to pursue a career in law, became a licensed attorney in Texas, taught as an adjunct at the University of Texas, and joined the American Board of Legal Medicine. He never obtained a Texas medical license and does not practice medicine.

While running for a seat in the U.S. House of Representatives, Gonzalez described himself in campaign materials as a “physician” and campaigned as “Dr. Gonzalez.” His candidate profile captured his self‑presentation:

By God's grace I am a physician and an attorney. I adopted a motto years ago which appears on my office's logo. It says in Latin, "Vocatus ad Sanandum," which means, "Called to Heal." My calling to serve in medicine was to heal the sick. My calling to serve in law is to heal my fellow man who is wronged by a third party. My most recent calling, to serve in the United States House of Representatives, is to contribute to the healing and a return to civility to our nation.

A complaint was filed with TMB asserting that these statements constituted unlawfully “holding himself out as a physician” and improperly using the title “Dr.” under the Medical Practice Act and the Healing Art Identification Act.

B. TMB’s cease‑and‑desist order

TMB initiated an investigation and provided Gonzalez a hearing. It ultimately concluded that he had violated the relevant statutes and issued a cease‑and‑desist order. The order required Gonzalez to:

stop using the titles “doctor,” “physician,” and “Dr.” (as in “Dr. Gonzalez”) without specifying the authority for those titles, and
either refrain from those titles or disclose, in campaign materials and possibly during speech, that he held an M.D. but was not licensed to practice medicine.

TMB warned he could face civil penalties of $5,000 per violation for non‑compliance.

Gonzalez sought rehearing, which was denied by operation of law. Eighty‑one days later, he filed suit in Travis County district court.

C. Gonzalez’s claims in the district court

Gonzalez’s live petition advanced several theories, which the Supreme Court grouped into four main claims:

Substantial‑evidence challenge: the cease‑and‑desist order lacked substantial evidentiary support.
As‑applied constitutional challenge: Texas Occupations Code § 104.004 (Healing Art Identification Act) was unconstitutional as applied to his campaign speech.
Facial constitutional challenge: § 104.004 was facially unconstitutional because it broadly prohibits persons with medical or other doctoral degrees from truthfully describing their education and training.
Ultra vires claim: TMB exceeded its statutory authority because Gonzalez was not licensed to practice medicine and had not practiced or attempted to practice medicine in Texas.

He requested:

reversal of the cease‑and‑desist order,
declarations that TMB exceeded its authority and that § 104.004 is unconstitutional (facially and as applied),
temporary injunctive relief barring enforcement of the order, and
“such other and further equitable relief” to which he was entitled.

D. Lower‑court rulings

The district court dismissed all claims for want of jurisdiction.

The Third Court of Appeals (Austin) largely affirmed. It applied the redundant‑remedies doctrine to hold that the ultra vires claim, the as‑applied constitutional claim, and the substantial‑evidence claim were all barred because Gonzalez could have sought timely judicial review under the APA. It saw those claims as doing nothing more than attacking the particular cease‑and‑desist order.

However, the court of appeals distinguished Gonzalez’s facial constitutional challenge. A ruling that § 104.004 is facially unconstitutional would “go beyond reversal” of the order and thus was not redundant of APA review. Accordingly, it remanded only the facial challenge to the district court for further proceedings. See Gonzalez v. Tex. Med. Bd., 716 S.W.3d 664 (Tex. App.—Austin 2023).

Gonzalez petitioned for review; TMB did not file a cross‑petition. Thus, the remand of the facial challenge was not at issue in the Supreme Court.

E. Questions before the Supreme Court of Texas

The Supreme Court addressed:

Whether the redundant‑remedies doctrine barred Gonzalez’s ultra vires and as‑applied constitutional claims;
Whether the district court had jurisdiction to hear his substantial‑evidence challenge, given the timing of his suit and his disavowal of the APA; and
The proper scope of remand to the district court.

Importantly, the Court did not decide whether TMB’s actions violated the First Amendment or exceeded its statutory powers. Those issues remain for the trial court on remand.

III. Summary of the Opinion

A. Holdings

The Supreme Court’s core holdings can be summarized as follows:

Redundant‑remedies doctrine does not bar Gonzalez’s ultra vires and as‑applied constitutional claims.
Even if Gonzalez could have brought those same theories in a timely APA judicial‑review proceeding, the APA would only have allowed reversal of the particular cease‑and‑desist order, not the prospective declaratory and injunctive relief he now seeks. Because the remedies differ, the UDJA/ultra vires claims are not redundant.

As the Court underscores: it is the remedy, not the mere availability of a similar claim under another procedural vehicle, that matters. “That’s why we call it the redundant‑remedies doctrine, not the redundant‑claims doctrine.”
The district court lacked jurisdiction over Gonzalez’s substantial‑evidence claim.
Gonzalez deliberately disclaimed reliance on the APA and instead argued that a now‑repealed TMB rule (22 Tex. Admin. Code § 187.83(f)) gave him a right to judicial review of the cease‑and‑desist order in district court. The Court held that an agency rule cannot create subject‑matter jurisdiction for judicial review. Only a statute (or a constitutional violation) can do that. Because Gonzalez neither relied on the APA nor pointed to an alternative statutory grant of jurisdiction, the substantial‑evidence claim was properly dismissed.
Remand for three claims.
The Court:
- Reversed the dismissal of:
  - the facial constitutional challenge to § 104.004 (already ordered remanded by the court of appeals),
  - the as‑applied constitutional challenge, and
  - the ultra vires claim.
- Affirmed the dismissal of the substantial‑evidence claim for lack of jurisdiction.
The case goes back to the district court for consideration of the facial and as‑applied constitutional claims and the ultra vires claim on the merits.

B. What the Court did not decide

The Court carefully avoided resolving:

Whether § 104.004 is unconstitutional on its face or as applied;
Whether TMB has statutory authority to regulate campaign uses of “doctor” or “physician” by individuals who hold medical degrees but are unlicensed;
Whether TMB’s enforcement action violates the First Amendment or Article I, § 8 of the Texas Constitution.

Those questions will be determined, in the first instance, by the district court on remand. The Supreme Court’s opinion is therefore procedural and jurisdictional, but it decisively opens the door to robust judicial review of the Board’s claimed power to police political speech.

IV. Key Concepts and Doctrines (Simplified)

A. The Texas Administrative Procedure Act (APA) and “contested cases”

The Texas APA (Tex. Gov’t Code ch. 2001) provides a framework for:

agency rulemaking, and
“contested cases”—adjudicative proceedings where legal rights or privileges are determined after an opportunity for a hearing (Tex. Gov’t Code § 2001.003(1)).

When an agency decision qualifies as a contested‑case “order,” the APA usually provides a method for judicial review. Typically, a party must file suit in district court within 30 days after the agency’s decision becomes final. See Tex. Gov’t Code § 2001.176(a).

In this case, the court of appeals treated the TMB cease‑and‑desist order as a “contested case” because TMB voluntarily gave Gonzalez a hearing. The Supreme Court noted that there is scholarly and textual support for limiting “contested case” to hearings that the Legislature requires, but it ultimately found it unnecessary to settle that interpretive dispute because of how Gonzalez framed his jurisdictional arguments.

B. Substantial‑evidence review

When a court conducts APA review of an agency order, one standard often applied is substantial‑evidence review. The court asks whether the agency’s decision is supported by “more than a scintilla” of evidence in the record—not whether the court would have reached the same decision. It is a deferential standard focusing on the reasonableness of the agency’s fact‑finding, not a de novo re‑trial.

Gonzalez attacked the TMB order under this standard, arguing that it was not supported by substantial evidence. But because he disclaimed the APA as a jurisdictional basis and pointed only to an agency rule, the Supreme Court held that the district court lacked subject‑matter jurisdiction over this claim at all.

C. Ultra vires suits

An ultra vires suit alleges that a government official or agency has acted beyond the scope of lawful authority given by statute or constitution. In Texas:

Such suits are generally brought against state actors in their official capacities. See City of El Paso v. Heinrich, 284 S.W.3d 366, 373 (Tex. 2009).
They are a key vehicle for challenging unlawful agency actions while avoiding sovereign immunity, because the State has no legitimate interest in illegal acts.

Gonzalez’s ultra vires claim asserts that TMB exceeded its statutory authority by regulating a non‑licensee who did not practice or attempt to practice medicine in Texas, based solely on campaign speech.

D. The Uniform Declaratory Judgments Act (UDJA) and the redundant‑remedies doctrine

The Texas UDJA (Tex. Civ. Prac. & Rem. Code ch. 37) allows a person whose rights are affected by a statute or governmental action to seek a declaration of rights and status. Litigants often invoke it to obtain:

declarations that statutes are unconstitutional,
clarifications of the meaning of statutes, or
determinations that an agency has exceeded its authority.

However, under the redundant‑remedies doctrine, courts will not entertain a UDJA action when another statutory scheme (like the APA) already affords a “complete and adequate” remedy. As the Court put it in Patel v. Texas Department of Licensing & Regulation, 469 S.W.3d 69, 79 (Tex. 2015), courts “will not entertain an action brought under the UDJA when the same claim could be pursued through different channels.”

In Gonzalez, the Supreme Court clarifies that “same claim” must be read in a remedy‑focused way: what matters is whether the existing statutory review process permits the same scope of relief, especially with respect to prospective, systemic, or constitutional relief. If the APA only allows reversal of a specific order, but the plaintiff seeks broader injunctive or declaratory relief that would prevent future enforcement, then the UDJA suit is not redundant even if the legal theory overlaps.

E. Facial vs. as‑applied constitutional challenges

A facial challenge asserts that a statute is unconstitutional in all or most of its applications. A successful facial challenge often results in the statute being declared invalid altogether, or at least significantly narrowed.

An as‑applied challenge contends that a statute is unconstitutional as enforced against a particular person or set of facts, even if it could be lawfully applied in other situations.

The Supreme Court notes the “usual judicial practice” of deciding as‑applied challenges before facial challenges, citing King Street Patriots v. Texas Democratic Party, 521 S.W.3d 729, 732 (Tex. 2017) (quoting Board of Trustees v. Fox, 492 U.S. 469, 484–85 (1989)). This underscores why remanding only the facial challenge (as the court of appeals did) was problematic.

F. Subject‑matter jurisdiction and statutory authorization for judicial review

“Subject‑matter jurisdiction” refers to a court’s power to hear a type of case. In Texas:

There is no right to judicial review of an administrative order absent a statute or a constitutional violation. See Continental Casualty Ins. Co. v. Functional Restoration Assocs., 19 S.W.3d 393, 397 (Tex. 2000).
An agency rule cannot itself create jurisdiction in district court; only the Legislature can. See Continental Casualty, 19 S.W.3d at 397 n.5.

Thus, although TMB once had a rule (§ 187.83(f)) suggesting that aggrieved parties could seek judicial review of cease‑and‑desist orders in Travis County, Gonzalez could not rely on that rule as a stand‑alone jurisdictional grant. Without invoking the APA or identifying another statute authorizing review, his substantial‑evidence claim fell outside the district court’s competence.

V. Detailed Analysis of the Court’s Reasoning

A. Re‑centering the redundant‑remedies doctrine on remedies, not theories

1. The court of appeals’ narrow reading of the petition

The court of appeals treated Gonzalez’s as‑applied constitutional and ultra vires claims as “challeng[ing] only the cease‑and‑desist order”. On this reading, APA review was an adequate substitute because he could have attacked that order under the APA (on constitutional and statutory grounds) if he had acted within 30 days.

The Supreme Court rejected this “unfairly cramped” interpretation. It noted that Gonzalez did more than simply ask for reversal of the existing order. He alleged:

That TMB lacked statutory authority to regulate him at all (as an unlicensed non‑practitioner) for his campaign speech, and
That, even if the statutes were read to authorize such regulation, applying them to his political speech would violate his state and federal free‑speech rights.

On the Court’s reading, the “plain thrust” of these claims was to obtain prospective protection: declaratory and injunctive relief that would prevent TMB from taking any future action against him for describing himself as a “doctor” or “physician” in his political campaign.

That type of relief is conceptually distinct from reversing a past order. It addresses ongoing and future enforcement, not simply nullifying the agency’s prior decision on this particular complaint.

2. Challenging an order vs. challenging authority and ongoing enforcement

The Supreme Court draws a critical distinction:

APA review is typically retrospective and record‑bound: it asks whether a particular agency order was lawful and supported by the record.
UDJA and ultra vires suits can be more prospective and systemic: they can determine whether the agency ever had authority to act in a certain way and whether enforcing a statute or order in the future would be unconstitutional.

Gonzalez’s claims, as the Court reads them, are of the latter type. He seeks a declaration that it is legally impermissible—for statutory or constitutional reasons—for TMB to penalize his use of “doctor” or “physician” in campaign contexts going forward.

Such relief is not confined to the existing cease‑and‑desist order. Even if a court were to reverse that order on APA review, TMB could perceive itself as free to initiate a new proceeding based on new or continued campaign speech. Only a broader declaratory or injunctive ruling can give Gonzalez complete protection.

3. Application of Patel and Jones v. Turner

The Court explicitly roots its analysis in Patel v. Texas Department of Licensing & Regulation, 469 S.W.3d 69 (Tex. 2015), a landmark case in which eyebrow‑threading practitioners challenged onerous licensing requirements.

In Patel, the agency similarly argued that the plaintiffs could have raised their constitutional objections in APA proceedings after being cited. The Court rejected that as a basis for invoking the redundant‑remedies doctrine, emphasizing that:

The remedies available through APA review are limited to reversing the particular orders at issue.
The plaintiffs there sought prospective injunctive relief against future enforcement based on the same statutes and regulations. The APA could not supply that broader remedy.

Gonzalez explicitly parallels that scenario. Drawing on Patel, the Court underscores that what matters is whether the APA could provide the same level of relief, not whether the same legal arguments (e.g., constitutional challenges) could be raised.

The Court also cites Jones v. Turner, 646 S.W.3d 319, 328 (Tex. 2022), which observed that the key inquiry is whether a plaintiff “could be awarded relief that would render a declaratory judgment redundant and thus improper” (emphasis added). Again, the focus is on the actual scope of potential relief, not merely whether some vehicle exists to litigate similar issues.

On this logic, even though Gonzalez could have raised constitutional and ultra vires arguments under the APA, that route could not have definitively settled whether:

TMB may ever regulate his campaign use of “doctor” and “physician,” or
§ 104.004 may constitutionally be enforced against his political speech in the future.

Therefore, his UDJA and ultra vires claims are not redundant.

B. Availability vs. adequacy of APA review

The court of appeals emphasized that Gonzalez could have sought APA review within 30 days and raised his constitutional and statutory challenges there. The Supreme Court labels this observation “True but irrelevant.”

The reason: Under Tex. Gov’t Code § 2001.174(2)(A), APA review permits reversal or modification of an agency decision if it violates a “constitutional or statutory provision.” That means all three of Gonzalez’s constitutional theories—facial, as‑applied, and ultra vires—could in theory have been raised in an APA petition.

If the mere availability of those theories under the APA were dispositive, then even the facial challenge (which the court of appeals allowed to proceed) would be barred as redundant. But the Supreme Court refuses that conclusion because:

A facial ruling under the APA would still only reverse the specific order; it would not in and of itself bar future enforcement against similar conduct.
Declaratory and injunctive relief under the UDJA can give prospective, general protection beyond the single order reviewed under the APA.

This reinforces the core principle: what matters is whether APA review provides the same remedy, not whether it allows the same legal question to be raised.

C. Subject‑matter jurisdiction over the substantial‑evidence challenge

1. Gonzalez’s reliance on the TMB rule

On the substantial‑evidence claim, the Supreme Court departs from the court of appeals’ reasoning and takes a simpler route. The court of appeals had held that Gonzalez’s APA petition was untimely: he filed suit more than 30 days after his motion for rehearing was overruled by operation of law.

But in the Supreme Court, Gonzalez disclaimed any reliance on the APA. Instead, he argued that TMB had created a right to judicial review by promulgating 22 Tex. Admin. Code § 187.83(f) (since repealed), which supposedly:

authorized an aggrieved party to file a petition in Travis County district court, and
imposed no deadline for seeking review.

2. Only statutes can create jurisdiction

The Supreme Court rejected this argument emphatically. Citing Continental Casualty Ins. Co. v. Functional Restoration Assocs., 19 S.W.3d 393, 397 (Tex. 2000), the Court reiterates:

“[T]here is no right to judicial review of an administrative order unless a statute provides a right or unless the order . . . violates a constitutional right.”

And further:

“[A]n agency’s rulemaking power cannot validly expand or create district court jurisdiction beyond that given in the Legislature’s own enactments.” Id. at 397 n.5.

Thus, even if an agency purports by rule to authorize judicial review, that rule cannot enlarge the jurisdiction of the courts. Only the Legislature—through statutes—can do that, or the Constitution itself if a constitutional right to review is implicated.

Because Gonzalez chose not to rely on the APA and identified no alternate statutory basis for judicial review of the cease‑and‑desist order, the district court had no subject‑matter jurisdiction over his substantial‑evidence challenge. The Supreme Court therefore affirms the dismissal of that claim on jurisdictional grounds, without needing to address timeliness or the definition of “contested case.”

3. The unresolved “contested case” question

The Court notes, without resolving, an important interpretive question: does “contested case” under the APA include any proceeding in which an agency voluntarily affords a hearing, or only those for which the Legislature has mandated a hearing?

The Third Court of Appeals has suggested the former, broader reading, citing Vazquez v. Health & Human Servs. Comm’n and Heat Energy Advanced Tech., Inc. v. West Dallas Coalition for Environmental Justice. The Supreme Court points to historical analysis suggesting that “contested case” was originally intended to refer to legislatively required hearings. See Robert W. Hamilton & J. J. Jewett III, The Administrative Procedure and Texas Register Act: Contested Cases and Judicial Review, 54 Tex. L. Rev. 285 (1976).

By choosing not to resolve this conflict, the Court leaves open a significant future question about the scope of APA judicial review—but makes clear that, in this case, the jurisdictional defect is Gonzalez’s reliance on an agency rule rather than on any statute.

D. Pleading posture and remedial flexibility on remand

TMB argued that Gonzalez’s petition did not clearly request constitutional declaratory or injunctive relief. The Supreme Court notes that it need not resolve this issue because:

TMB did not file a cross‑petition for review; the court of appeals had already ordered a remand on the facial challenge, which stands.
On remand, Gonzalez will be free to amend his petition, including to add explicit claims for prospective relief and to name appropriate state officials as defendants.

The Court references City of El Paso v. Heinrich, 284 S.W.3d 366, 373 (Tex. 2009), to remind litigants that ultra vires suits must be brought against state actors in their official capacity, not against the agency as such. It also notes the general rule that under a prayer for “general relief,” a plaintiff may be awarded any relief to which the pleadings and evidence entitle him, citing Starr v. Ferguson, 166 S.W.2d 130, 133 (Tex. 1942).

Practically, this means that:

On remand, the district court will likely see an amended petition with clearer requests for:
- declarations that § 104.004 is unconstitutional (facially and as applied), and
- injunctions preventing future TMB enforcement against Gonzalez’s political speech.
The defendants may shift from “Texas Medical Board” as an entity to TMB members or officials in their official capacities.

VI. Precedents Cited and Their Influence

A. Patel v. Texas Department of Licensing & Regulation, 469 S.W.3d 69 (Tex. 2015)

Patel is the cornerstone of modern Texas administrative‑law jurisprudence on economic liberty and constitutional review of occupational licensing schemes. The plaintiffs, eyebrow threaders, challenged cosmetology licensing requirements that, in their view, were irrationally burdensome.

Its relevance in Gonzalez is twofold:

Redundant‑remedies doctrine. Patel held that the redundant‑remedies doctrine does not bar UDJA actions where plaintiffs seek relief—such as prospective injunctions against future enforcement—beyond reversal of particular citations.
Substantive constitutional standard. Though not reached in Gonzalez, Patel developed a stronger “real and substantial” relationship test under Article I, § 19 for economic regulations. That substantive reasoning may influence any future decision on the constitutionality of § 104.004, particularly if Gonzalez argues that the statute irrationally restricts truthful professional self‑description.

B. Jones v. Turner, 646 S.W.3d 319 (Tex. 2022)

Jones reinforced that UDJA claims are improper only when another avenue would provide relief that renders the declaratory judgment redundant. Gonzalez cites Jones to confirm that courts must compare the scope of relief, not merely the overlap in issues.

C. King Street Patriots v. Texas Democratic Party, 521 S.W.3d 729 (Tex. 2017)

King Street Patriots involved non‑profit advocacy and campaign‑finance regulations. The Supreme Court there noted that courts usually decide as‑applied challenges before facial challenges. Gonzalez cites this “usual judicial practice” to illustrate the awkwardness of remanding only a facial challenge while barring as‑applied claims.

D. City of Corpus Christi v. Public Utility Commission, 51 S.W.3d 231 (Tex. 2001) (per curiam)

In City of Corpus Christi, the Court considered a facial constitutional challenge within the framework of APA review of a contested‑case proceeding. Gonzalez invokes this to show that nothing prevented Gonzalez from raising a facial challenge under the APA—but, again, the existence of that possibility does not bar a separate UDJA action seeking broader, prospective relief.

E. City of El Paso v. Heinrich, 284 S.W.3d 366 (Tex. 2009)

Heinrich is foundational for Texas ultra vires jurisprudence. It holds:

Ultra vires suits are not truly against the State; rather, they are against officials acting outside lawful authority.
They must be brought against state actors in their official capacity, not against the agency or the State as such.

In Gonzalez, the Court cites Heinrich to signal that, on remand, Gonzalez should align his suit with that framework—by naming appropriate TMB officials in their official capacities if he wishes to pursue ultra vires relief.

F. Continental Casualty Ins. Co. v. Functional Restoration Assocs., 19 S.W.3d 393 (Tex. 2000)

Continental Casualty established the principle that no right to judicial review of an administrative order exists absent a statute or constitutional requirement. It also clearly states that an agency cannot, via rulemaking, expand judicial jurisdiction beyond what the Legislature has authorized.

Gonzalez relies on these propositions to dispose of Gonzalez’s attempt to ground subject‑matter jurisdiction in TMB’s former rule § 187.83(f).

G. Chemical Bank & Trust Co. v. Falkner, 369 S.W.2d 427 (Tex. 1963)

Chemical Bank recognized that there can be circumstances in which a constitutional right to judicial review might exist even absent a statute. In Gonzalez, the Court notes this but emphasizes that Gonzalez has not argued for such an inherent constitutional right to review the TMB order. Thus, it does not explore that avenue further.

H. Serafine v. Branaman, 810 F.3d 354 (5th Cir. 2016)

Although not binding precedent on questions of Texas law, Serafine is a key federal case interpreting the First Amendment in a strikingly similar factual context:

A political candidate, a licensed attorney with a Ph.D. in psychology but not a licensed psychologist, called herself a “psychologist” on the campaign trail.
The Texas State Board of Examiners of Psychologists attempted to restrict this usage.
The Fifth Circuit held that such restrictions violated the First Amendment; using the title “psychologist” in political speech about qualifications is core political speech entitled to strong constitutional protection.

The Supreme Court in Gonzalez cites Serafine as contextual background, underscoring the novelty of TMB’s attempt to regulate campaign speech and hinting at the significant constitutional questions lurking beneath the jurisdictional wrangling. While the Court does not resolve the First Amendment issues, Serafine strongly suggests that licensing boards face serious constitutional limits when they try to police how candidates truthfully describe their academic and professional credentials in campaigns.

VII. Merits Issues Foreshadowed but Not Decided

While Gonzalez is strictly about jurisdiction and remedies, its factual context and citations point toward substantial substantive questions that will likely be litigated on remand.

A. Statutory authority of the Texas Medical Board

Gonzalez’s ultra vires claim contends that TMB’s enabling statutes do not authorize it to:

discipline or regulate non‑licensees for campaign‑trail speech, or
treat truthful use of “doctor” or “physician” in a political context as the “practice of medicine” or the unlicensed holding out as such.

On remand, the district court will likely need to examine:

The precise text and structure of the Medical Practice Act and the Healing Art Identification Act;
Whether they clearly extend to campaign speech by non‑licensees holding medical degrees;
Whether any ambiguity must be resolved narrowly to avoid constitutional problems (the canon of constitutional avoidance).

B. First Amendment and Texas free‑speech protections

The case implicates core questions about political speech and professional titles:

Is using “doctor” or “physician” in a campaign profile by someone with a medical degree but no license inherently misleading or truthful speech?
Does requiring a disclaimer (e.g., “M.D., not licensed to practice medicine in Texas”) amount to an unconstitutional condition on political speech?
What level of scrutiny applies when a licensing board restricts the language candidates use to describe themselves?

The Supreme Court cites Serafine to highlight that:

Campaign use of professional titles is typically core political speech, subject to the highest First Amendment protection, and
Occupational licensing rules, which may be permissible in purely professional‑client contexts, are much more suspect when applied to political messaging to voters.

Article I, § 8 of the Texas Constitution often affords protection at least as robust as, and sometimes greater than, the First Amendment. Thus, on remand, the district court may have to address whether the restrictions on Gonzalez’s speech can survive strict scrutiny or some other demanding standard under state and federal free‑speech provisions.

C. Regulation of truthful professional titles by unlicensed degree‑holders

Gonzalez’s facial challenge attacks § 104.004 on the ground that it broadly prohibits individuals who possess doctoral degrees (including M.D.s) from truthfully describing their education and training, unless they comply with restrictive disclosures or licensing requirements.

Key issues likely to arise include:

Whether the statute is overbroad in the First Amendment sense, chilling a substantial amount of protected speech relative to its legitimate sweep;
Whether the statute is narrowly tailored to prevent genuinely misleading or fraudulent claims, as opposed to merely restricting accurate self‑description;
How Texas courts draw lines between commercial or professional speech (where more regulation is tolerated) and political speech (where regulation is highly disfavored).

VIII. Practical and Doctrinal Impact

A. For Texas agencies and licensing boards

Gonzalez sends a clear message to agencies:

They cannot rely on the redundant‑remedies doctrine to shield themselves from UDJA and ultra vires suits seeking prospective, systemic relief, even when the plaintiff could have pursued APA review earlier.
They must assume that their claimed powers can be tested directly in court, including through constitutional challenges and statutory interpretation, especially where future enforcement is threatened.
They cannot create judicial‑review rights or timelines by rule that expand or displace statutory jurisdictional requirements.

For occupational licensing boards in particular, the opinion highlights that:

Venturing into political‑speech regulation (e.g., controlling candidates’ use of professional titles) is legally risky and likely to provoke full‑scale judicial scrutiny.
Courts will look skeptically at attempts to stretch professional‑regulation statutes to cover campaign communications, especially where speech is truthful and relates to candidate qualifications.

B. For regulated professionals and political candidates

Professionals (or degree‑holders) who run for office and face threats from licensing boards gain several strategic advantages from Gonzalez:

Even if they miss the narrow APA deadline to challenge a specific order, they may still:
- file UDJA actions asserting facial and as‑applied constitutional challenges, and
- bring ultra vires suits to test the agency’s authority to regulate them.
They can seek forward‑looking declaratory and injunctive relief to prevent future enforcement, rather than being limited to undoing past orders.

This enhances access to judicial review for individuals who may not realize, within 30 days, the full scope of the constitutional or statutory issues raised by administrative enforcement.

C. For litigation strategy in challenging agency action

Gonzalez is likely to shape how Texas lawyers plead and structure challenges to agency action:

Expect more complaints that combine:
- timely APA claims (if possible),
- UDJA requests for facial and as‑applied relief, and
- ultra vires claims against officials in their official capacities.
Plaintiffs will frame their UDJA and ultra vires claims to emphasize prospective and systemic relief, carefully distinguishing these remedies from what APA review could supply.
Agencies, in turn, will need to refine their redundant‑remedies arguments to:
- identify precisely what remedies the APA provides in a given context, and
- show that those remedies truly make additional declaratory or injunctive relief unnecessary.

D. For district courts on remand and in future cases

Trial courts are given clear guidance that:

They must carefully parse the type of relief sought when applying the redundant‑remedies doctrine.
They should not dismiss UDJA or ultra vires claims merely because similar issues could have been raised under the APA; they must ask whether the full scope of relief would have been identical.
They may need to allow amendment of pleadings to ensure that constitutional and ultra vires claims are properly directed at the correct officials and framed as prospective relief, consistent with Heinrich.

IX. Conclusion: The Significance of Gonzalez v. Texas Medical Board

Gonzalez v. Texas Medical Board does not yet decide whether a professional licensing board in Texas may constitutionally punish a congressional candidate for calling himself “Dr.” or a “physician” when he has an M.D. but no medical license. That controversy—sitting at the crossroads of professional regulation and political speech—remains to be resolved on remand.

What the Supreme Court does decide, however, is of considerable systemic importance:

The redundant‑remedies doctrine is about remedies, not merely claims. UDJA and ultra vires suits that seek broad, prospective, or systemic relief are not barred simply because the plaintiff might once have raised similar theories in an APA proceeding aimed only at reversing a specific order.
Agency rules cannot confer judicial‑review jurisdiction. Only statutes (or constitutionally compelled review) can open the courthouse doors to review of administrative decisions.
Courts will not force plaintiffs to fit all challenges into the narrow confines of APA review when the true controversy concerns an agency’s ongoing authority and future enforcement power.

In short, Gonzalez fortifies the role of Texas courts as guardians against administrative overreach—especially when constitutional rights and the limits of agency authority are at stake—and ensures that litigants retain meaningful avenues to challenge not just what an agency has done, but also what it claims the power to do in the future.

Redundant Remedies, Not Redundant Claims: Gonzalez v. Texas Medical Board and the Scope of Judicial Review of Texas Agencies