Case Overview

Case: Reynaldo “Rey” Gonzalez, Jr., M.D., J.D. v. Texas Medical Board (No. 24‑0340)

Court: Supreme Court of Texas

Opinion by: Justice Sullivan (Justice Hawkins not participating)

Opinion delivered: October 31, 2025

I. Introduction

This decision sits at the intersection of administrative law, constitutional litigation strategy, and professional-regulation impacts on political speech. The Texas Medical Board (TMB)—whose traditional mission is to regulate the practice of medicine and protect public health—attempted, for the first time, to discipline a congressional candidate for how he described his qualifications on the campaign trail.

Reynaldo “Rey” Gonzalez, Jr., who holds both an M.D. and a J.D. but has never been licensed to practice medicine, ran for Congress as “Dr. Gonzalez” and described himself as a “physician.” TMB treated these statements as unlicensed practice of medicine and violation of the Healing Art Identification Act, issued a cease‑and‑desist order, and threatened $5,000 civil penalties per violation if he persisted without clarifying that he was not licensed.

Gonzalez responded with a multi‑front challenge in district court, attacking:

• the evidentiary sufficiency supporting the cease‑and‑desist order (a substantial‑evidence challenge),
• the constitutionality of Texas Occupations Code § 104.004 as applied to him,
• the facial constitutionality of § 104.004, and
• the Board’s statutory authority to regulate his speech at all (an ultra vires claim).

The lower courts largely disposed of these claims on jurisdictional grounds—primarily via the “redundant‑remedies” doctrine and the Administrative Procedure Act (APA). The Supreme Court of Texas reverses in significant part, holding that Gonzalez’s ultra vires and as‑applied constitutional claims are not barred by redundant‑remedies principles and may proceed in the trial court alongside his facial challenge.

Although the Court does not resolve the underlying First Amendment issue, it sets an important precedent on:

• how the redundant‑remedies doctrine is properly applied to challenges to agency action,
• the availability of ultra vires and constitutional claims seeking prospective relief outside the APA’s narrow remedial scheme, and
• limits on an agency’s ability to “create” judicial review by rule where no statute provides it.

II. Summary of the Opinion

A. Holding

The Supreme Court of Texas:

1. Reverses the court of appeals in part, holding that:
   • The redundant‑remedies doctrine does not bar Gonzalez’s ultra vires claim.
   • The redundant‑remedies doctrine does not bar Gonzalez’s as‑applied constitutional claim.
2. Affirms the dismissal for want of jurisdiction of Gonzalez’s substantial‑evidence challenge to the cease‑and‑desist order, but on a different ground: he relied on an agency rule, not a statute, to support judicial review, which cannot confer jurisdiction.
3. Leaves undisturbed the court of appeals’ remand of Gonzalez’s facial constitutional challenge (because the Board did not file a cross‑petition).
4. Remands to the district court for further proceedings on:
   • the facial constitutional challenge to § 104.004;
   • the as‑applied constitutional challenge to § 104.004; and
   • the ultra vires claim alleging that TMB exceeded its statutory authority by proceeding against a non‑licensee for campaign speech.

B. Core Doctrinal Clarifications

The opinion makes three key doctrinal moves:

1. It reiterates that the redundant‑remedies doctrine is about remedies, not about whether the same claims could have been raised elsewhere. Where a plaintiff seeks prospective, non‑APA relief (such as declarations protecting future conduct), a UDJA/ultra vires suit is not necessarily “redundant” of APA review.
2. It confirms that as‑applied and ultra vires challenges that seek to restrain future enforcement go “beyond reversal” of a particular agency order, and thus may coexist with (or survive the loss of) APA remedies.
3. It underscores that agencies cannot create judicial‑review jurisdiction by rule. Judicial review of an agency order must rest on:
   • a statutory grant of review, or
   • a violation of a constitutional right that gives rise to an independent action.

III. Factual and Procedural Background

A. The Underlying Dispute

Gonzalez holds a medical degree (M.D.) from an accredited school and a law degree. He chose to practice law, teach as an adjunct at the University of Texas, and join the American Board of Legal Medicine, but he never obtained a Texas medical license. During a congressional campaign, he:

• used the moniker “Dr. Gonzalez,” and
• described himself as a “physician,” tying these credentials into a broader narrative of being “called to heal” in medicine, law, and politics.

A complaint alleged that Gonzalez was falsely holding himself out as a physician and improperly calling himself “Dr. Gonzalez.” TMB investigated, concluded that his campaign self‑description violated the Medical Practice Act and the Healing Art Identification Act, and issued a cease‑and‑desist order.

The order directed Gonzalez to stop using the titles “doctor,” “physician,” or “Dr.” (as in “Dr. Gonzalez”) unless he simultaneously disclosed the “authority giving rise to those titles”—which, in practice, would mean disclosing that he has an M.D. degree but is not licensed to practice medicine in Texas. The Board attached a threat of civil penalties of $5,000 per violation for continued noncompliance.

B. Administrative Proceedings and District Court Litigation

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

His “live petition” advanced several theories, which the Supreme Court reorganizes into four functional categories:

1. Substantial‑evidence claim: The cease‑and‑desist order allegedly lacked substantial evidence and should be set aside.
2. As‑applied constitutional challenge: Texas Occupations Code § 104.004 was unconstitutional as applied to his particular campaign speech.
3. Facial constitutional challenge: § 104.004 was facially unconstitutional because it purportedly prevented any holder of a medical or other doctoral degree from truthfully describing their education and training.
4. Ultra vires claim: TMB exceeded its statutory authority by regulating a non‑licensee who had not practiced or attempted to practice medicine, especially in the context of campaign speech.

Gonzalez sought a combination of:

• reversal of the cease‑and‑desist order,
• declarations that TMB lacked authority or that the statutes were unconstitutional,
• temporary injunctive relief against enforcement, and
• “such other and further equitable relief” as appropriate.

TMB moved to dismiss for want of jurisdiction, contending that:

• any challenge to the order had to proceed under the APA within 30 days; and
• the UDJA and ultra vires avenues were barred by the redundant‑remedies doctrine.

The district court agreed and dismissed all claims. The Third Court of Appeals:

• held that the APA applied, that the cease‑and‑desist proceedings were a “contested case,” and that Gonzalez’s putative APA challenge was untimely; and
• treated his ultra vires and as‑applied claims as “redundant” of an (untimely) APA remedy, but
• allowed his facial constitutional challenge to proceed, on the ground that a facial invalidation would go “beyond reversal” of the single order.

Gonzalez petitioned the Supreme Court of Texas. TMB did not file a cross‑petition, so the remand of the facial challenge was not before the Court.

IV. Detailed Analysis

A. Precedents and Authorities Cited

1. Patel v. Texas Department of Licensing & Regulation

Patel v. TDLR, 469 S.W.3d 69 (Tex. 2015), is the central precedent guiding the Court’s approach to the redundant‑remedies doctrine. In Patel, eyebrow threaders challenged onerous cosmetology licensing requirements as unconstitutional. A key issue there, as here, was whether they could sue under the Uniform Declaratory Judgments Act (UDJA) when APA review of agency orders was theoretically available.

Patel held that:

• APA remedies are limited to reversal of particular agency orders, and
• where plaintiffs seek prospective relief against future enforcement (e.g., injunctions against applying an unconstitutional statute to them again), a UDJA action provides non‑redundant relief.

The Gonzalez Court quotes and applies this reasoning: plaintiffs in an APA contested‑case appeal “wanted more than a reversal of the citations issued”; similarly, Gonzalez wants more than reversal of the cease‑and‑desist order—he wants protection for ongoing and future campaign speech.

2. Serafine v. Branaman (5th Cir. 2016)

The Court references Serafine v. Branaman, 810 F.3d 354 (5th Cir. 2016), not as binding authority but as context. In Serafine, the Fifth Circuit held that the Texas Board of Examiners of Psychologists violated a candidate’s First Amendment rights by forbidding her from using the title “psychologist” during a campaign.

The citation signals:

• that this case fits into an emerging line of disputes where professional‑licensing boards reach into the realm of political campaigning, and
• that serious First Amendment concerns are implicated when boards restrict how candidates truthfully describe their qualifications.

The Texas Supreme Court, however, expressly does not decide the First Amendment merits. Instead, it sets the stage for such a decision by clearing jurisdictional obstacles.

3. Jones v. Turner

In Jones v. Turner, 646 S.W.3d 319 (Tex. 2022), the Court reiterated that a declaratory judgment is improper when it would be truly redundant of other available relief—i.e., when a plaintiff “could be awarded relief that would render a declaratory judgment redundant and thus improper.”

Gonzalez uses Jones to reinforce that the touchstone is redundancy of remedy, not merely that some overlapping claims could be raised in another procedural vehicle.

4. APA and Constitutional Review Cases

Several cases are cited to confirm that constitutional challenges (both as‑applied and facial) can be raised in an APA petition for judicial review:

• Tex. Gov’t Code § 2001.174(2)(A) – authorizing reversal of agency actions that are “in violation of a constitutional or statutory provision.”
• City of Corpus Christi v. Public Utility Commission, 51 S.W.3d 231 (Tex. 2001) (per curiam) – a contested‑case APA appeal in which facial constitutional issues were considered.

These authorities are deployed to show that the mere availability of a forum (APA review) for constitutional issues does not, in itself, bar separate actions when those actions seek distinct and broader remedies.

5. Ultra Vires and Proper Defendants: City of El Paso v. Heinrich

City of El Paso v. Heinrich, 284 S.W.3d 366 (Tex. 2009), is cited on the procedural posture of ultra vires suits. Heinrich established that:

• sovereign immunity does not bar suits against state officials in their official capacity to require them to comply with statutory or constitutional limits (ultra vires suits), but
• the proper defendants are the state officials, not the agency as an entity.

The Court notes that on remand, Gonzalez will be free to amend his petition to name appropriate officials and request prospective relief consistent with Heinrich.

6. UDJA and Redundant Remedies: Patel and Related Doctrine

The opinion roots its summary of the redundant‑remedies doctrine in Patel and related precedent:

• The UDJA cannot be used to circumvent specific statutory review schemes where the relief is essentially the same.
• However, UDJA and ultra vires suits remain available where plaintiffs seek relief beyond the limited remedies afforded by an APA appeal.

7. Judicial Review Jurisdiction: Continental Casualty and Chemical Bank & Trust Co. v. Falkner

To dispose of the substantial‑evidence claim, the Court relies on:

• Continental Casualty Ins. Co. v. Functional Restoration Associates, 19 S.W.3d 393 (Tex. 2000) – reaffirming that judicial review of an administrative order exists only when:
  • a statute grants a right to review, or
  • a constitutional right is violated in a way that independently warrants judicial action.
• Chemical Bank & Trust Co. v. Falkner, 369 S.W.2d 427 (Tex. 1963) – recognizing the possibility of constitutionally grounded judicial review, though Gonzalez did not rely on such a theory for his substantial‑evidence claim.

Continental Casualty also furnishes the rule that an agency rule cannot expand district‑court jurisdiction beyond what the Legislature has granted. That principle is decisive here: Gonzalez’s reliance on a TMB rule, rather than a statute, to justify substantial‑evidence review is jurisdictionally fatal.

8. Contested Cases and the APA: Vazquez; Heat Energy; Hamilton & Jewett

The court of appeals treated the TMB proceeding as a “contested case” because TMB gave Gonzalez a hearing, citing:

• Vazquez v. Health & Human Services Commission, No. 03‑20‑00075‑CV, 2021 WL 3176031 (Tex. App.—Austin 2021, pet. denied)
• Heat Energy Advanced Technologies, Inc. v. West Dallas Coalition for Environmental Justice, 962 S.W.2d 288 (Tex. App.—Austin 1998, pet. denied)

Both interpret “contested case” broadly to include any proceeding in which an agency actually provides an adjudicative hearing, even if not statutorily required.

The Supreme Court notes scholarly criticism of this expansive reading, citing:

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),

which suggests that “contested case” should be limited to proceedings where the Legislature mandates a hearing. The Court, however, ultimately “need not resolve” this definitional issue because it disposes of the substantial‑evidence claim on other grounds (lack of statutory jurisdiction apart from the APA).

9. Facial vs As‑Applied Challenges: King Street Patriots and Board of Trustees v. Fox

The Court quotes the “usual judicial practice” that courts generally decide as‑applied challenges before facial ones:

• King Street Patriots v. Texas Democratic Party, 521 S.W.3d 729 (Tex. 2017)
• Board of Trustees v. Fox, 492 U.S. 469 (1989)

This reinforces why, as a practical and doctrinal matter, remanding only the facial challenge (as the court of appeals did) would have placed the district court in an awkward position. The Supreme Court corrects that by ensuring that both facial and as‑applied challenges proceed together.

B. The Court’s Legal Reasoning

1. Interpreting the Petition: What Relief Was Really Sought?

A key premise of the court of appeals’ decision was that, except for the facial challenge, Gonzalez’s claims “challenge only the cease‑and‑desist order” and thus seek nothing beyond what an APA appeal could provide.

The Supreme Court rejects this as an “unfairly cramped interpretation” of the live petition. Even though the pleadings are focused on the cease‑and‑desist order, the “plain thrust” of the as‑applied and ultra vires claims is:

• to obtain declarations that the Medical Practice Act and Healing Art Identification Act do not authorize TMB to regulate Gonzalez’s campaign speech as a non‑licensee, and/or
• that applying § 104.004 to penalize his campaign use of “doctor” or “physician” would violate his constitutional rights.

Such declarations are inherently forward‑looking. If successful, they would not merely undo one cease‑and‑desist order; they would prohibit TMB from imposing any adverse sanction on Gonzalez for future identical campaign speech. That dimension of prospective protection is precisely what an APA appeal cannot provide.

2. Remedy‑Based, Not Claim‑Based, Redundancy

The Court’s central doctrinal clarification is that:

“It doesn’t matter whether Gonzalez could’ve brought the same claims. What matters is whether the APA would’ve afforded him the same remedy—that’s why we call it the redundant‑remedies doctrine, not the redundant‑claims doctrine.”

Applying this approach:

• Yes, Gonzalez could have raised constitutional and ultra vires arguments in an APA appeal, including a facial challenge.
• No, the APA could not grant the full relief he seeks: lasting, prospective protection for future speech and a declaration limiting TMB’s authority with respect to non‑licensees in this context.

Thus, the redundant‑remedies doctrine does not apply, and the UDJA/ultra vires claims are not barred.

3. The Ultra Vires Claim

Gonzalez alleges that:

• he is not a licensee,
• he did not practice or attempt to practice medicine, and
• TMB’s statutory authority is limited to regulating licensees and those who actually practice or attempt to practice medicine in Texas.

On this theory, TMB lacked statutory authority to police his campaign speech at all. An ultra vires suit seeks to restrain state officials from acting outside their lawful authority; it is not an appeal of an agency order but a separate claim that the agency’s action is void for want of statutory power.

Because an APA appeal is confined to reviewing the specific order, and cannot grant broad prospective relief limiting TMB’s future regulatory reach, the ultra vires complaint is not rendered redundant by hypothetical APA review.

The Court also notes that, on remand, Gonzalez may refine this theory, name appropriate officials consistent with Heinrich, and seek purely prospective relief (e.g., injunctions against future enforcement).

4. As‑Applied Constitutional Claim

The as‑applied challenge asserts that § 104.004, as enforced against his truthful campaign statements, violates:

• the First Amendment to the U.S. Constitution, and
• Article I, Section 8 of the Texas Constitution.

Again, the key is not whether he could have raised this as an APA issue, but what he is asking the court to do. The claim is framed to secure protection for ongoing and future speech, not merely to set aside one order. Therefore, it is not redundant of the APA remedy and may proceed.

5. Facial Constitutional Claim

The court of appeals had already allowed the facial challenge to proceed, reasoning that facial invalidation would “go beyond reversal” of one order. The Supreme Court agrees with that logic and, because TMB did not seek review on that point, leaves the facial claim undisturbed.

Importantly, the Court invokes the general preference to consider as‑applied challenges before facial ones, which supports remanding both together so the trial court can follow ordinary constitutional‑litigation sequencing.

6. Dismissing the Substantial‑Evidence Claim for Want of Jurisdiction

Unlike the court of appeals, the Supreme Court does not engage in a detailed APA‑timeliness analysis. Instead, it takes Gonzalez at his word: he disclaimed reliance on the APA and argued that TMB had “created” a right to judicial review via an administrative rule (former 22 Tex. Admin. Code § 187.83(f)).

That rule, he claimed, allowed him to file a petition in Travis County district court challenging a cease‑and‑desist order without any deadline.

The Court applies Continental Casualty to hold that:

“An agency’s rulemaking power cannot validly expand or create district court jurisdiction beyond that given in the Legislature’s own enactments.”

Because Gonzalez pointed to no statute authorizing substantial‑evidence review of this cease‑and‑desist order outside (or beyond the deadlines of) the APA, the district court lacked jurisdiction over that particular claim. Thus, dismissal of the substantial‑evidence claim is affirmed—albeit on a different rationale.

7. Leaving the “Contested Case” Question Open

The Court acknowledges the disagreement over whether proceedings like this are “contested cases” under the APA. It notes case law suggesting a functional test (if the agency actually holds a hearing, it is a contested case) and academic commentary suggesting a more formal test (only proceedings where the Legislature mandates a hearing).

The Court explicitly declines to resolve this tension because the substantial‑evidence claim fails for lack of statutory jurisdiction even if the proceeding were not an APA contested case. In doing so, the Court signals that the definition of “contested case” remains an open and potentially significant question for future administrative‑law litigation.

V. Impact and Implications

A. Broader Access to Prospective Relief Against Agency Enforcement

Gonzalez materially strengthens the ability of regulated parties—and, crucially, would‑be regulated parties like non‑licensee candidates—to seek prospective relief against threatened or recurring agency enforcement, even when they have missed APA deadlines or are facing enforcement that does not easily fit into the APA’s contested‑case structure.

Key practical consequences:

• Plaintiffs can bring UDJA and ultra vires suits seeking to:
  • declare statutory provisions unconstitutional as applied,
  • declare that agencies lack authority over certain conduct or classes of persons, and
  • obtain prospective injunctive relief against future enforcement,
  without being automatically barred by the redundant‑remedies doctrine simply because an APA appeal could have been filed earlier.
• Agencies cannot rely on the existence of a theoretical APA avenue to shut down separate litigation when that separate litigation seeks broader, forward‑looking relief.

B. Reinforcing Limits on Agency Power to Regulate Political Speech

While the Court does not decide the First Amendment issue, the framing of the case is telling:

• TMB’s disciplinary action is described as an unprecedented effort “policing political campaigns.”
• The Court situates the case alongside Serafine, a prominent victory for a candidate’s right to describe professional qualifications in political speech.
• The closing line—“If the Texas Medical Board thinks it has the power to police campaign speech, it will have to defend that position on the merits”—underscores skepticism about expansive agency power in this domain.

On remand, the trial court must confront whether § 104.004, as used here, can constitutionally criminalize or otherwise penalize a candidate’s truthful statements about holding an M.D. degree (and possibly about being a “physician”) even if he lacks a license. Given the heightened protection for political speech and the trend in cases like Serafine, this case is poised to become an important test of the boundary between professional‑title regulation and political expression.

C. Litigation Strategy: Pleading for Non‑Redundant Relief

The opinion also offers a roadmap for practitioners:

• Plead prospective relief explicitly. The Court’s favorable reading of Gonzalez’s petition—emphasizing its implicit forward‑looking thrust—shows the importance of clearly asking for:
  • declarations about future conduct, and
  • injunctions against future enforcement.
• Include both as‑applied and facial challenges where appropriate. Having both allows the trial court to follow the normal sequence (deciding as‑applied first) and, if necessary, move to broader facial invalidation.
• Name correct ultra vires defendants. Relying on Heinrich, plaintiffs must sue state officials in their official capacity, not just the agency, and seek only prospective relief to avoid sovereign‑immunity problems.
• Do not rely on agency rules to create jurisdiction. Counsel should always identify a statutory basis for judicial review or ground the action in an independent constitutional claim.

D. Finality of Agency Orders and Institutional Concerns

From the agency perspective, there is a concern: does Gonzalez undermine the finality of administrative orders by allowing separate follow‑on litigation long after APA deadlines lapse?

The Court implicitly answers: no, but with qualifications. What is foreclosed is:

• belated “appeals” that seek only to overturn a particular order on evidentiary or procedural grounds, without a statutory basis for judicial review.

What remains available—and is constitutionally important—is:

• structural challenges (ultra vires, facial, as‑applied) that seek to determine the legality of future enforcement, not relitigate the correctness of a past order under the APA’s substantial‑evidence standard.

VI. Complex Concepts Simplified

A. Redundant‑Remedies Doctrine

The redundant‑remedies doctrine prevents plaintiffs from using the UDJA or similar vehicles to obtain relief that simply duplicates what is available under a specific statutory review scheme like the APA.

In simple terms:

• If you can get the same relief by filing a statutory appeal, you generally cannot file a separate UDJA suit for that same relief.
• But if your separate suit seeks different or broader relief—such as ongoing protection against future enforcement—then your suit is not “redundant.”

B. Ultra Vires Suits

“Ultra vires” means “beyond the powers.” An ultra vires suit alleges that government officials are acting outside the authority that the Legislature has granted them.

Key features:

• You sue the officials, not the agency itself, in their official capacities.
• You seek prospective relief (e.g., injunctions telling them to stop enforcing a statute beyond its scope), not damages for past wrongs.
• Sovereign immunity does not bar such suits, because the theory is that the State has not authorized the illegal action at issue.

C. Facial vs As‑Applied Constitutional Challenges

A facial challenge argues that a statute is unconstitutional in all or at least a substantial number of its applications, and therefore should be invalidated generally or narrowly construed.

An as‑applied challenge asserts that a statute is unconstitutional specifically as it was applied to the plaintiff in the particular circumstances of the case.

Courts usually prefer to decide as‑applied challenges first because they are more concrete and may allow the court to resolve the dispute without striking down the statute in all its applications.

D. The Texas Administrative Procedure Act (APA) and “Contested Cases”

The Texas APA provides a structured process by which persons affected by certain agency decisions can seek judicial review in district court. A central concept is the “contested case,” generally understood as an agency proceeding in which:

• the law entitles a party to a hearing before the agency, and
• that hearing determines the party’s legal rights, duties, or privileges.

In contested‑case appeals, courts:

• review the administrative record,
• apply standards like “substantial evidence,” and
• may affirm, reverse, or remand the agency’s decision.

Critically, the APA’s remedial scope is limited: it focuses on the specific order challenged and generally does not authorize broad prospective injunctions against future enforcement.

E. Substantial‑Evidence Review

Substantial‑evidence review asks whether an agency’s decision is reasonably supported by “more than a scintilla” of evidence in the record. The reviewing court does not substitute its judgment for the agency’s on fact questions; it only checks that:

• the agency followed the law, and
• there is enough evidence that a reasonable mind could reach the same conclusion.

In Gonzalez, the Court never reaches the substantial‑evidence merits because there is no jurisdictional basis for that type of review outside the APA.

F. Judicial Review of Agency Action: Statutory Versus Constitutional Bases

In Texas, you typically get judicial review of an agency order in one of two ways:

1. Statutory review: The Legislature has enacted a statute (like the APA or a specific provision in a regulatory statute) that expressly allows review.
2. Independent constitutional action: The agency’s action violates a constitutional right (e.g., free speech, due process) in a way that justifies a separate suit, such as an ultra vires claim or a declaratory‑judgment action challenging a statute as unconstitutional.

Agencies cannot, by rule, create an additional category of judicial review where the Legislature has not authorized it.

VII. Conclusion

Gonzalez v. Texas Medical Board is not yet the final word on whether professional‑licensing agencies may discipline political candidates for truthful references to their academic degrees or past professional status. Instead, it is a significant procedural and remedial decision that shapes how such constitutional clashes will be litigated in Texas.

The Court:

• clarifies that the redundant‑remedies doctrine focuses on remedies, not the mere possibility of overlapping claims,
• holds that ultra vires and as‑applied constitutional challenges seeking to restrain future enforcement are not barred simply because APA review was or could have been available,
• reaffirms that agency rules cannot enlarge judicial‑review jurisdiction beyond what statutes and the Constitution permit, and
• ensures that both facial and as‑applied challenges to § 104.004, along with the ultra vires claim, will be addressed substantively in the trial court.

Going forward, the opinion strengthens the tools available to individuals and entities who believe that administrative agencies are overstepping statutory limits or encroaching on constitutional rights, especially in contexts—like campaign speech—where constitutional protection is at its apex. The ultimate resolution of whether and how the Medical Practice Act and Healing Art Identification Act can constitutionally regulate political self‑presentation by individuals with medical degrees, but without licenses, remains to be decided on remand. But this decision ensures that those questions will be answered on the merits, not foreclosed by procedural barriers.