New Mexico Bomb Shelter and Pharmaceutical Rights for Chiropractors
March 15th, 2011 at 5:36 pm (Chiropractic Legislation, Chiropractors & Chiropractic, Current Events, Evidence Informed Chiropractic, ICA, Prescription Rights)
Remember those ethics scenerios about fallout shelters? You are trapped in a fallout shelter with ten different people and you know a little bit about each one: you’ve got the 19-year-old pregnant college student, the a 80-year-old priest, a 30-year-old man with mental disabilities, a policeman with a gun, etc. There are only enough supplies for four people to survive in the shelter. The individuals in the shelter are unable to decide who gets to stay, so they have turned to an outside committee to decide. The exercise is to weigh values and use problem-solving techniques to narrow down who has more worth.
You can learn a lot about someone by how they play this game and people can learn a great deal about themselves in the process. For example, if you’d kick out the old lady, you are utilitarian who values strength and youth over wisdom. Kicking out the pregnant girl? You probably value experience over promises and hope. But if you’d steal the policeman’s gun and shoot anyone in the ass who doesn’t look like you, you are probably a member of the International Chiropractic Association (ICA).
Let’s look at the bomb shelter that is New Mexico. Currently called House Bill 127 (HB 127) the New Mexico State Senate is considering legislation to permit prescription drug rights to a group of “Advanced Practice” Chiropractors. HB 127 passed the first of two NM Senate Committees last week. If it then passed the Senate Judiciary Committee it will go before the full Senate and eventually the New Mexico Governor Susana Martinez.
I received an email yesterday from someone outside of the New Mexico shelter trying to convince me to influence people’s decisions inside the shelter. The email basically said this:
“The sky is falling, the world is ending, run to your chiropractic shelter where we know the food is stale and the water is dusty but at least we know those four walls and they were built by our ancestors and it’s cozy in there and relatively dry. Now, go and shoot anyone who doesn’t look like you. Make sure nobody gets out of that shelter alive. Whew, that was close.”
The email is a call to action for chiropractors to call New Mexico state representatives. I suppose it doesn’t matter that these representatives represent New Mexicans, not the US at large. Writers are supposed to encourage the policy makers to go to hell with progress – chiropractors want to stay the same as they’ve been for over a hundred years. Screw improvement! Forget modernization! Down with public health measures and seeing a larger percentage of the population! Toss aside health care system efficiency! Repent! Regress. Grow irrelevant. Die.
Yeah, the end is near.
If these doctors stopped looking backwards so often they might realize that the direction they are actually shooting the shelter policeman’s gun is into their own foot.
If you happen to be a responsible person living in New Mexico, you should contact the folks on the list below and tell them that some people actually like progress, science and good clinical reasoning. And if you aren’t in New Mexico, you may want to drop them a note as a concerned person outside the fallout shelter and let them know that the people they are hearing, the ill-informed vocal minority, don’t represent you or your feelings. Or logic. Or sense.
Or you might say something like this:
Dear Honorable New Mexico Representative:
Please support HB-127. This bill would be of great benefit to patients who see chiropractic physicians as it would allow these physicians to provide better care for their patients. It would also lower costs in the health care system overall by reducing unnecessary trips to multiple providers for some pharmaceutical prescriptions. Chiropractic physicians would also be in a position to help patients decrease or eliminate certain medications which state law does not currently allow.
You most likely will be hearing from other chiropractors who do not feel medications should be a part of chiropractic practice. Rest assured that the passage of this bill does not require those chiropractors to exercise the privilege but will not prevent those doctors who feel it is appropriate. Please provide your support for this bill and those physicians who wish to improve quality care for New Mexico residents can do so.
And please do not assume that all chiropractors are a part of the small but vocal minority within our profession who oppose prescription rights for chiropractors.
Sincerely,
You
Click. Copy. Paste. Send.
Thanks.
Here are the people you should contact:
richard lanigan said,
March 15, 2011 at 7:30 pm
Hi Brett,
There must be something that the vast majority of chiropractors have in common I think it might be something like this:
We are spinal health care experts in the health care system, we are not alternative or complementary. We assess spinal joint function for its affect on well being we don’t use drugs as we attept to facilitate the bodies own healing ability.
I think all chiropractors could operate round that, in fact I would go as far as saying that is the chiropractors USP.This is something we could all live with as chiropractors, however prescriping drugs is far removed from what I or DD Palmer defined as chiropractic, its a different profession. If I feel a patient needs drugs I send them to a medical doctor, and if chiropractors start prescribing I would still send them to a medical doctor.
Drugs are not part of chiropractic, never have been and if put to the profession I am certain the majority would vote against includiung it, however those with other agendas will push it through starting at the WFC in Rio and the will be the point of no return for two chiropractic approaches.
If you ask to see a patient three times a week for a year it makes me look bad, if you prescribe Vioxx it makes me look bad. You may see the benefits for you in your practice however chiropractors need to have a consensus on what it is to be a chiropractor if we are to continue describing ourselves as a profession.
I am lost as to why you see prescribing as a progressive move for chiropractic?
Brett L. Kinsler, DC said,
March 15, 2011 at 8:35 pm
I am curious why you see restriction of scope of practice as progressive? Don’t want to be a chiropractor who uses therapies? Don’t be one. Don’t want to do rehab? Fine, don’t. Want to stick to the spine and not address extremities? Okidokie. But because you don’t want to prescribe an occasional medication when you know it will help your patient and save them a trip to another practitioner, you are going to make damn sure the entire profession is prevented from doing it? That’s the logic I fail to grasp.
Michalene Elliott DC said,
March 15, 2011 at 10:28 pm
There is a shortage of PCPs here in NY, and I would guess that is true elsewhere. My patients often have to wait a day or two to get in to see their primary care doctor. In some cases, there would be a measurable benefit to the patient in terms of pain management. Healthcare is changing rapidly and sticking to the “old way of doing things” doesn’t help the profession or our patients. Refusing to evolve is not responsible.
William Doggett DC FACO said,
March 16, 2011 at 9:29 am
Brett
Thanks for the blog. I do think that you have a good and reasonable grasp of what we are attempting to do in New Mexico. We have a 25% uninsured population with another large group of under insured. Some areas of the state are 2-3 hours away from the nearest medical facility or health center and the DC is the most easily accessible provider. The program designed and started at National (NUHS) has been well thought out and is in fact more extensive than programs for PA’s and Cnp’s that give them full prescription rights. The DC wanting to complete the program will have to go through a Master’s in Clinical Chiropractic followed by 400 hours of clinical rotations in a medical facility. Only then can they ask for a specific formulary that has to be approved by the medical board, pharmacy board AND chiropractic board. With that formulary they will then have a two year supervision where a MD or DO will have to review their prescribing activities. But, the program will be able to add qualified practitioners to the pool of primary care providers within a 3 year period as opposed to hoping that in 10 years more MD/DO students will choose primary care specialties. We hope to succeed in getting the bill passed and signed this year, but if we fail in this first attempt the torch will not be dropped. Chiropractors who prescribe still have the understanding that the primary goal is to get the patient well and then get them off of medications that can be eliminated and teach/encourage healthy life style changes to reduce the recurrences and pass that understanding on to succeeding generations. Diet, exercise, optimum mechanical functionality and injury prevention has always been the only way to reduce health care costs over the long term.
Eugene Pearce said,
March 16, 2011 at 10:15 am
I am sick and tired of being dictated to by a vocal minority of chiropractors. In the UK the prescribing issue has been politised to split a profession, see Richard Lanigans comment “however those with other agendas will push it through starting at the WFC in Rio and the will be the point of no return for two chiropractic approaches”. It smacks of paranoia.
I wonder how many Chiropractors in the US have informally suggested Melatonin for their patients with Jetlag or a blind patient who has sleeping difficulties. Its a supplement right from the health food store. Now another chiropractor does the same thing in the UK, its a presciption med, does that make the a bad chiropractor.
The us and them thing between general medicine and chiropractic is a joke, prescription and non-prescription designation of drugs is arbritary, we should strive to offer the best service in the field of non surgical neuro-musculoskeltal care we can, not strive to make others practice according to a 120 year old theory.
James J. Lehman, DC, MBA said,
March 16, 2011 at 10:20 am
Where would dentistry be today if dentists determined not to use anesthetics and modern technologies to advance their profession? I can only imagine a dentist advising everyone to take a swig of booze and hold on while the infected tooth was yanked out because that is how it was done 100 years ago.
The osteopathic profession has given up antiquated and unscientific concepts in order to integrate the health care system. Fortunately for the chiropractic profession and unfortunately for patients, many of them are not using spinal manipulation.
The chiropractic profession need not be separate and distinct. That was an old legal strategy to keep chiropractors out of jail for practicing medicine without a license. Now is the time to evolve with many different specialties and advanced training, which should include primary care training.
This confused profession continues to act as its own worst enemy. While the AMA plans to limit/control/eliminate chiropractics by restricting our practice acts (http://www.camlawblog.com/articles/health-trends/ama-scope-of-practice-partnership/), The ICA also promotes the limiting of New Mexico’s practice act. (http://www.thechiropracticchoice.com/TCC_Sept2010/Sept_2010_Choice_9.pdf)
Is it possible that the ICA and the AMA are collaborating in order to prevent progressive legislation that expands the scope of chiropractic practice and training?
Do you think that chiropractors are prospering with antiquated practice acts? Is it reasonable to restrict a chiropractic orthopedist from examining and treating a patient with an ankle sprain because there is no presenting subluxation of the spine?
Does it make sense that in New York a chiropractor may not be referred to as a chiropractic physician or treat a patient with the common cold? http://www.op.nysed.gov/prof/chiro/article132.htm
How can the chiropractic profession tolerate antiquated practice acts that limit chiropractic physicians to the treatment of subluxations?
If a chiropractor has completed four years of chiropractic training, which prepares him/her to be a primary care provider and suggested by CCE, why does the profession permit antiquated and risible laws to prevent chiropractors from continuing their training in any health care specialty that they choose to pursue?
A wise profession will unify and develop contemporary practice acts that permit chiropractors that same training opportunities as other providers and an expanded scope of practice. Chiropractic patients prefer chiropractic physicians with a broader scope of practice and advanced training. http://www.journalchiromed.com/article/S1556-3707(10)00148-3/abstract
It is time for the chiropractic profession to become patient-centered and evidence-based with broad scope practice acts that permit the use of pharmaceuticals.
kirowyf said,
March 16, 2011 at 10:40 am
Here is the deal…it’s our science, art and philosophy that sets us apart from the licensed killers, aka medical profession. Yes, I said it and I mean it. And here is why: the medical profession killed my dad. They misread the Rx and gave him TEN TIMES THE AMOUNT OF MORPHINE…know what happened next? The nurse said whoops and my mom stood by, watching my dad’s body shut down…the whole time the nurse was injecting him, my mom told her it was way too much but guess what? That nurse with her education knew more than the housewife. And then what happened? We took my dad’s lifeless body to the morgue and the nurse and doctors went on their merry way. No charges filed. No remorse shown to the family. Nothing changed for them! our lives were forever changed.
This bill is a travesty to chiropractic. There is no place for drugs with the realm of what chiropractic stands for. Any of you that believe otherwise need to leave this profession. Become the medical doctor your heart truly desires to be. How did you end up in chiropractic in the first place? Couldn’t pass the MCAT? Couldn’t get through the interviews? So you copped to being a chiropractor? Chiropractic does not NEED you. Please excuse yourself and find a more suiting profession.
And to be so small minded as to think that what happens in New Mexico does not affect the rest of chiropractic world wide…I don’t want this to even be a subject within the state I live so whatever I can do to stop the first state to consider such an ideology I will do.
This atrocity must be stopped!
Cory Atchley said,
March 16, 2011 at 11:34 am
Let me first say, that I am not a Chiropractor, while there are almost a dozen in my family. So I do know about Chiropractic and its core believes. I do not see how allowing Chiropractors to prescribe drugs is progress. It is not what Chiropractic is about, its about allowing and helping the body to be in its best to heal itself. Its also not a scope of practice restriction. In that sense, not allowing a Chiropractor to perform surgery is a scope of practice restriction. Chiropractic is a specialty, much like Dentistry. You don’t see dentist wanting to be able to perform plastic surgery, its just not what they are about. What I don’t understand is why did you or any other Chiropractor become a Chiropractor if you wanted to prescribe drugs? Looking on your resume on your web page, it appears to me that you have a stronger background and interest in Medicine then you do in Chiropractic. So then why didn’t you become a Medical Doctor? What is it that you truly believe in?
Ian Groves said,
March 16, 2011 at 12:52 pm
That is one of the arguments being used to push this legislation through here in NM (lack of PCPs)…and is about the WORST argument that can be made for extending Rx abilities to Dc’s. Lack of PCP’s has nothing to do with Dc’s, and should not be “solved” by Dc’s. That is the first, and most obvious of many problems with this legislation, not mention that, as I understand it, “drug-free” is one of the premises of chiropractic care.
I am simply a patient, but I can go to my PCP and get drugs, or I can go to my chiropractor and get healed. If my chiropractor started pushing drugs on me I would leave their practice immediately.
Richard Lanigan said,
March 16, 2011 at 2:03 pm
I think it is unfortunate to describe the medical profession as “Licensed killers” on the basis of someones error. Thats what skeptics do to chiropractic, scrape the barrel to get examples of the worst of chiropractic practice and make generalisations. I understand your personal anger but as a profession, I would hope we are better than that.
“restriction of scope of practice” There is no restriction, anybody with a spine can benefit from spinal care. While there are contraindications for spinal manipulation there are none for people who need my help. Prescribing drugs is restricted to ill people.
I teach core stability exercise classes, I do video gait analysis, we sell orthotics and ice packs and Tempur Pillows. I had a patient who asked me to do a breast exam because she was unsure if it was a lump. I unblocked an elderly patients sink the other day. There are lots of things we do all I am asking is what are the ones that are chiropractic. What is chiropractic that we can all agree about as a profession. If we can not agree them we are not part of the same profession by virtue of the title chiropractor. I can not use the title in the UK, I define my profession by what we do.
It may be that I am such a good adjuster but I have never had the need to advise someone to take NSAIDs. After I see someone with low back problem the advice is always the same, stay active, ice, avoid sitting. I have had 8 knee operations (3 ACL re constructions football). I am 54, I play tennis regularly and always Ice afterwards. The only thing I take anything for is Gout.
If Eugen or anyone else wants to prescribe thats fine with me, what not fine is when the next Vioxxs scandle breaks and it is chiropractors who were doing the prescribing and it reflects bad on me. So if Eugene or anyone else does a medical course to learn prescribing fine they are providing a product, medicine.
If that is something the majority of chiropractors want to call chiropractic, then I will call what I do something else. Eugene is “sick and tired of being dictated to by a vocal minority of chiropractors”, while being regulated by a body made up of 7 chiropractors, who have charged 700 chiropractors for using the doctors title and misleading the public by saying things like “Chiropractic care could help colic, otis media, headaches. In the UK we have a lot of Turkeys funding the thanksgiving celebrations of seven chiropractors.
The reason I gave Eugene the link to this site is because its the first place I have come across where the pro side has been given an airing. I am not convinced but I think Brett has presented the argument well for those interested.
What I find odd is it is not clear who are the politicians who are promoting this fundamental change in a “principal” of chiropractic. Who is going to show up in Rio with a mandate from 60,000 saying this is progress this is where we want to go. I fight this because I have seen no evidence that it is something the majority want, and like eveyrthing else those with an agenda triumph over apathy.
If you were going to change the constitution of the US you would need a bit more that Dick Cheny and Donald Rumsfeld to show up at the senate because it seemed like a good idea at the time.
Nancy said,
March 16, 2011 at 2:10 pm
I simply cannot understand why a chiropractor would want prescription rights without going through the training an MD goes through. We (yes I am a chiropractor too), even with a dozen weekend seminars, could never understand all the interactions of prescription drugs the way MD’s do. Besides their educational training, they get years of internships and residencies to hone their skills. With all that training, they still make a lot of very deadly and costly mistakes.
Chiropractic is about allowing the body to heal itself and getting to the root cause of the problem. Is the problem, in most cases, a lack of a drug? Probably not. So, if you treat the problem with a drug (or herb) and the problem has been caused by an injury or even toxic trauma as in vaccinations, you are causing the patient more harm. If you don’t think that DC’s with RX rights won’t at some point take the easy route and prescribe drugs rather than getting to the source of the problem, then you are not living in reality. Just like pharma which is greedy, it is human nature for the rest of us to be seduced.
Robert said,
March 16, 2011 at 4:51 pm
If chiropractic is a profession, we have to assess what it is that we profess. If we fail to do this, THEN chiropractic will become irrelevant and die. It is very simple. When a person asks a chiropractor, or the patient of a chiropractor what it is that we do, what will the answer be?
It is not backward to know what you do and to be able to clearly communicate it to others. It is backward to throw everything into a bucket and call it a profession. Tailors don’t make wagon wheels, and if you hire a jack-of-all-trades to make you a wheel or a shirt, you aren’t getting the best of either. Chiropractors, at their best, remove a source of spinal nerve interference (subluxation) that inhibits the normal function of the body and its ability to adapt successfully in its environment. Nowhere in that statement, is there room for the application or administration of drugs.
If the people with chiropractic degrees and licences wish to prescribe medications in opposition to the very clearly defined parameters long established within the chiropractic profession, and the state legislators feel that a need exists, then allowances can be made to allow those practitioners to transfer their educational credits toward a physician’s assistant or RN credential. Those 400 hours can then be used to fill in the gaps more appropriately. There is no need to involve chiropractic in it at all.
I hope for the sake of the people of New Mexico that the legislators have the vision to see that passing this bill will have the effect of confusing the public, diluting the profession of chiropractic, and creating a second-class dealer of drugs. None of which serve the public interest or the people of New Mexico.
Dr. Shawn Thistle said,
March 16, 2011 at 5:21 pm
Hi Brett,
Nicely written – I posted it to the RRS Facebook page.
Cheers,
Shawn
Kyle said,
March 16, 2011 at 6:50 pm
We already have DO’s in the world, no need for watering down another profession into a system that admits 106,000 deaths due to prescriptions.
kirowyf said,
March 16, 2011 at 8:53 pm
I’m guessing RIchard has never had a family member murdered by license. How can it be called “someone’s error”? Don’t we teach our children to “Say no to drugs”? and now chiropractors want the ability to prescribe drugs? Debilitating and killing drugs. I will not apologize for my comment. Have this happen to your family member and then try to fight their red tape BS to get someone to admit their wrong doing. It’s impossible. The MD’s will do whatever necessary to protect one another…even to the detriment of a patient’s care. But I will tell you this…no one’s mal-practice insurance went up over this ordeal. No one lost their job. No one was convicted of a crime. No one even admitted the mistake. No one even offered an apology because that would be an admission of guilt on their part. Face it…more people die from being in the care of a medical doctor than any other disease known to man at this time.
There are other ways for these “chiropractors” to prescribe drugs. They need to leave this profession and go to the “dark side”. Plain and simple.
Aaron said,
March 16, 2011 at 9:15 pm
Brett, Thanks for the well-written post. I am reading the posts above of a few “traditional” chiros asking: “What makes us Chiropractors?” presumably wanting to hear “we dont use drugs or surgery”. I feel these people have missed the boat…I think what makes us chiropractors is our unified desire to help people heal. I am excited by the future possibility of adding new tools to my toolbelt that I can use as a chiropractor to help my patients heal. It is too bad that such a small but vocal minority are so bogged down with dogma and tradition that they are afraid to see the profession progress with the rest of health care.
Dr Joe said,
March 16, 2011 at 10:10 pm
Great post Brett Kinsler DC. Why is this small vocal group of chiros so content with the status quo and continue to waste their time attacking and restricting progression of their own profession. Why not put your time and effort into something productive. Allow the portion of the profession that is willing to advance this profession into the new century. If you do not wish to utilize pharmaceuticals, hen don’t. I see this as an opportunity for the profession to gain knowledge via experience and in return we will be able to understand our patients better by being familiar with their condition as well as their medication that they are on. Just like PT portion of our education, because it is part of the chiro curriculum, we are more familiar with exercise and rehab to enhance patient care. At the end of the day it is all about patient centered care and being able to deliver it to them effectively while keeping cost down. And let’s be honest I’m sure even the straightest chiro out there has used pharmaceuticals or will use it in their lifetime.
Pha Kiu said,
March 16, 2011 at 11:05 pm
Baseball is a nice sport. Its good, but not everybody watches it. Let’s put swimming lanes between the bases so the swimmers will like us. And lets have cheerleaders in the outfield because that is a waste of precious real estate where some people would come just for the girls. And then, if a batter didn’t want to use a bat, why, he could use a tennis racket instead – some folks would really like that! I bet they would come to watch. Oh, and when the pitcher throws the ball, he could rush the plate and tackle the batter. Sweet! More entertainment; more revenue. Hey, we can change the rules right? I mean, this is PROGRESS. Baseball has been around a long time virtually unchanged in its present form and not everybody follow the game. Wait, this is great – every third guy up at bat has to wear swim fins. Its all about entertainment right? Baseball is just entertainment for the public so why not?
BUT we’ll STILL CALL IT BASEBALL! Screw those old farts who want to cling to those ancient ways- WE’RE “MODERN BASEBALL-ERS”
We’re not saying you shouldn’t prescribe drugs. Personally I think your fucked in the head if you want to ape a failed, unscientific cult like the religion of medicine. But here’s where I will shoot first and ask questions later – when you do it in the name of the Chiropractic Profession. It is clear that even if you didn’t prescribe toxic substances in the name of “health”, your splinter group is unsuccessful at practicing chiropractic, so you are forced to add “tools”. As if Mother Nature needs YOUR help. With your educated, 4 years plus of book reading. What arrogance!
I’ll help you with a step by step process:
Step 1: Go to Medical School
Step 2: Graduate from Medical School
Step 3: Practice Medicine
Never mind that you’ll be joining a profession that is the third leading cause of death in the United States! Oh, yes! We need more people on more drugs. Its been a smashing success so far! You’re so f’ing brilliant. You’re SO brilliant that you’ll be able to do the job better than the “real” doctors who actually have a degree in it, right? Laughable, but pathetic and feeble really. Because you think chiropractic is a modality; a “tool”; a treatment for a disease, you misguided ignoramus. If you REALLY want to help out the public like you say, put a bullet in your skull.
Progressive DC said,
March 17, 2011 at 1:30 am
Great article Brett. Always nice to see someone raising some eyebrows within the profession. My questions is this: what do you call something that has stood unchanged (relatively) for 115 years? A relic, that’s what. Good for New Mexico, and I hope this bill goes through!
James J. Lehman, DC, MBA said,
March 17, 2011 at 9:32 am
James J. Lehman, DC, MBA, DABCO
Associate Professor of Clinical Sciences
University of Bridgeport College of Chiropractic
The passion for healing and love of the chiropractic profession has enabled it to weather the storms over the past 100 years plus of our existence. This same passion causes emotions to run wild as many of the respondents proclaim their chiropractic beliefs. Certain chiropractors suggest that chiropractors should hate medicine and drugs because “drugs kill.” Conventional wisdom dictates that all chiropractors should save their patients by practicing as pure chiropractors without the use of drugs or surgery.
I pose this question to the chiropractic profession, “Is this type of behavior patient-centered or doctor-centered?”
Is the position that chiropractors are drug-free providers an honest position?
Codex considers the use of vitamins and neutraceuticals to be the use of pharmaceuticals.
Does the claim of purity from dangerous drugs satisfy the patients’ desires and needs of their chiropractors? Research in New Mexico indicates that chiropractic patients want their chiropractors to pursue additional training and gain the right to prescribe drugs for their pain.
The AMA has attempted to eliminate our profession in the past. Once again, this medical trade organization is attempting to control and eliminate the chiropractic profession by attacking our practice acts (http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=52017).
The AMA wants to narrow our scope of practice and reduce patient access to chiropractic services. Interestingly, the attitude of the ICA regarding the expansion of the scope of practice in New Mexico is similar to that of the AMA.
Change is very difficult for some chiropractic professionals and their family members due to their belief systems. A paradigm shift is taking place with this progressive legislation in New Mexico and this type of change will be difficult for some within the profession due to their belief systems and the fear of change.
Conventional wisdom and belief systems are oftentimes misleading. As an example, Corey Atchley commented that “You don’t see dentist wanting to be able to perform plastic surgery, its just not what they are about.” That is Corey’s belief and he/she is entitled to that belief but it is not the truth. As a former member of the medical faculty at the University of New Mexico School of Medicine and a personal friend of the Chief of Surgery and a former plastic surgery resident, I can assure you that dentists became oral surgeons and then specialized in plastic surgery.
Can you imagine if dentistry did not change?
“We have always extracted infected teeth without the use of modern technology or the use of drugs. So, take a swig of this booze and hang on while I yank this bad tooth.”
It is time for the chiropractic profession to change and catch up with the times. Patients want access to chiropractic primary care and they deserve it. We must make sacrifices to avail our services within the health care system.
Brett L. Kinsler, DC said,
March 17, 2011 at 9:51 am
Actually, baseball has progressed quite a lot since it’s original inception. And, professional sports borrow from each other’s ideas to increase their fan base all the time. As far as calling it something other than chiropractic, part of the bill in New Mexico includes the designation of “Chiropractic Medicine.”
Mike said,
March 17, 2011 at 10:35 am
Go to medical school? Do dentists, optometrists, NP’s, PA’s and now naturopaths? Will PT’s go to medical school when they get the authority to prescribe a limited # of rx items? National’s new program seems to go well beyond the pharmaceutical education of any of these fields. Yes, go to medical school if you want to rx everything and do surgery. But please stop using this argument–it just doesn’t hold water. Also, stop telling me I can’t get more education and be able to do more–as long as my state feels my education is adequate to protect the public safety. We are the only profession who has a minority of members who treat it as a religion. This thinking is killing us, keeping us at treating 7% of the population and makes us a laughing stock at home shows, garden shows and city fairs. For you straights out there you should be encouraging all us “non believers” to rx our hearts out. Wouldn’t that make your piece of the flawed vertebral subluxation based pie that much larger? You could tier yourselves as the true chiropractic believers and go crazy signing your patients up for 100 visits at $6K. My patience is wearing thin for the “keepers of the faith”.
Brett L. Kinsler, DC said,
March 17, 2011 at 10:44 am
Very well stated, Dr. Lehman. Thanks for your input here.
Brett L. Kinsler, DC said,
March 17, 2011 at 11:05 am
FWIW Dynamic Chiropractic has an unscientific poll going to see if chiros would support prescription rights in their own state.
Andrea(chiropractic student) said,
March 17, 2011 at 11:29 am
I cannot tell how much reading your blog has upset me as a current chiropractic student. To see a chiropractor so obviously disallusioned with his chosen profession that he feels the only advancment possible is being able to perscribe drugs is just so incredibly disturbing. If you want to right to be able to perscribe dangerous and possibly deadly medications then maybe you should have obtained your MD or DO and left the chiropractic profession to people who believe in practicing principled Chiropactic. Advancement in chiropractic can happen without backsliding into the dangerous world of perscription drugs. I hope and pray that you will find your way back to the chiropractic philosophy you once learned in school and now seem to have abandoned.
Joanne Eash, DC said,
March 17, 2011 at 11:47 am
Excellent blog, Brett.
I have to reiterate what others have said regarding this bill and our profession.
If you don’t like this idea, DON’T move to New Mexico. If you don’t want to get a Master’s Degree or Diplomat in something relevant to patient care, then DON’T. But DON’T tell ME what is good or bad for ME, as I am a member of this profession too.
This profession has been marginalized from the inside for decades; from antiquated “philosophy” courses that should really be “historical” courses, to instilling this mindset that medicine is the Devil. It is not. I would love to be able to prescribe my patient a Medrol pack or administer a B12 shot, or intelligently discuss the pros and cons of other pharmaceutical issues. This does not make me the anti-Christ of Chiropractic. It makes me a physician. A physician who can care for her patients with skill and cultural authority.
I will not go down with the philosophical sinking ship when there is SO much more we can do for our patients.
If there are those of you who don’t want to progress individually, then DON’T.But don’t take the rest of us down with you.
Good job, Brett. This is an excellent topic.
Brett L. Kinsler, DC said,
March 17, 2011 at 12:02 pm
@Andrea: you are mistaken. I love practicing chiropractic and want to see our profession survive and thrive. If we do not adapt and change, we will suffer the fate of other dinosaurs and become extinct. Once there was a time if a chiropractor used a stethoscope or reflex hammer, they were being disloyal to chiropractic. Nonsense!
The way the laws are in my state, I cannot advise a patient to take or discontinue an aspirin without practicing medicine without a license. Is that right? I have administration rights as an EMT that trump what I can do as a chiropractor. Ridiculous!
I learned philosophy as an undergraduate. Kant, Hume, Descartes. Good stuff. I think about it a lot. What you refer to as philosophy in chiro school is actually antiquated dogma and I wear that about as often as I wear my old graduation gown.
Will you use an electric chiropractic table? Will you address trigger points? Check deep tendon reflexes? Use an MRI? Is that chiropractic? Of course it is. We are a profession, not a technique. And the least common denominator is not being drugless. It is spine care.
Brett L. Kinsler, DC said,
March 17, 2011 at 12:05 pm
Thanks, Dr. Eash. That really is the key, isn’t it? If someone wants to limit their own practice, that’s fine. Just don’t step on my rights or progress in the process.
Richard Lanigan said,
March 17, 2011 at 3:21 pm
“Is this type of behavior patient-centered or doctor-centered?”
Of course it is, because if a patient needed meds or surgery i would send them to a medical doctor not a quack and when chiropractors prescribe one could argue that title may apply.
Its outrageous to suggest I am not patient centred because I do not wish to be a jack of all trades. I know what I am good at, I set a price on that service and if members of the public value it they pay for it. If I need an electrician, I dont expect him to do a bit of plumbing on the side to save me money, I want an expert and the experts at prescribing are medical doctors and I want my patients to have the best and when I need something for my Gout, I go to a medical doctor.
We are supposed to be colleagues yet you call me a “dinosaur”, I took the time to do a Masters in Health Promotion and the medicaliseation of health is a concern in many fields outside chiropractic. In fact in medicine they view broadening presribing rights as part of “deskilling” medicine, as a way for government to save money. The skilled workers go on strike and the bosses bring in bring in non unionised cheap labor to do the job and save money.
I dont see chiropractors who want to subscribe as the “antichrist”. I just am sorry you have not been able to get the satisfaction from developing the skill as I have. When I played football I practiced to be as skilled as I possible could be and I have approached chiropractic the same way.
Obviously we see this very differently and the “modernist” view of chiropractic is very different from my traditional view. You want to provide a different service than what has been traditionally know as chiropractic a service which was “identified” by the WFC as recently as 2005 as drug free. So can someone please tell me tell how the damascene conversion came about. What has happened to convince the majority of chiropractors that this is “progress”. Can someone can show me the evidence that this is what the majority of the profession want. Can someone show me the evidence that prescribing makes me a better chiropractor. They cant but as always in chiropractic some clown knows best and they spend the next 20 year arguing about it.
If prescribing is what the majority want fair enough, I can call myself something else.
But please dont insult my intelligence telling me I dont have to prescribe if I dont want to. Prescribing is going to effect the image of chiropractic one way or another. The medicalisation of chiropractic is why I am no longer on the register in the UK and why 700 chiropractors have been charged with unprofessional conduct. Does not bother my patients that I am not on the register or cant call myself a chiropractor in the UK, I even employ an osteopath and acupuncturist.
Allowing chiropractors in New Mexico to prescribe will be nothing more than using chiropractic as cheap labour in a state short of Medical Doctors said,
March 17, 2011 at 5:57 pm
[...] discussion going on Brett Kinsler DCs blog about prescribing. Can someone please give me some figures that would suggest a majority of chiropractors or patients [...]
Mike said,
March 17, 2011 at 7:14 pm
Richard you just don’t get it. What business is it of yours if I get education from a federally accredited institution required by my state–that protects the public safety–and practice an expanded scope of practice? Your arguments were the same ones I heard when DC’s started expanding into acupuncture–remember your cohorts were saying we would be committing heresy if we injected needles into people? How about the fight over utilizing PT modalities? Every time the profession weathered the “chicken little” prophesies and they will with expanding into rx items. Oregon didn’t fall into the Pacific when they allowed properly trained DC’s to do minor surgery. People haven’t died. DC’s weren’t called quacks. Oklahoma DC’s (properly trained) have been doing IV’s (makes your spine shiver doesn’t it Richard?) for over 30 years. Oklahoma is still there and the profession is the better for it. The health care world is changing. Don’t change if you don’t want. Promote your straight practice–even denigrate those DC’s who have expanded their scope if you wish if that makes you feel better. But stop trying to influence those of us who want to do more for our patients. I don’t tell you how to treat your patients and show me the respect to treat mine the way I want if I have the proper training.
gregg said,
March 17, 2011 at 7:31 pm
I can’t believe we’re still having this discussion, it makes no sense. If you want to prescribe medicine go to school and be a medical doctor and then you will have the proper training and proper credentials to do more harm than good and you won’t tarnish our profession. If you want to do physical therapy go to school and be a physical therapist. There is no good reason for you to be in the profession and you made a poor choice from the get go. why did you choose to be a chiropractor, you could have been a DO. Chiropractic is a natural drugless healing profession period!
Richard Lanigan said,
March 17, 2011 at 8:57 pm
“Make my spine shiver” Guantanamo makes my spine shiver, not prescribing.
Mike, I could care less if you learn to prescribe, I could care less if you use acupuncture, or paint houses, or indulge in S&M in the privacy of your home. The point is none of that is chiropractic. I was trained at one of the more Bio-medical chiropractic schools in the world AECC, we were trained to do many things interferential, ultrasound, but I was always told by all chiropractors until recently, chiropractic is drug free, I believe the WFC called it a USP for chiropractic in their identity document of 2005.
If you wanted prescribing as part of your intervention why on earth did you study chiropractic. How is masking pain making you a better chiropractor? How does inhibiting prosaglandin production going to help collagen formation and the healing process of a dysfunctional joint.
Why can you not work together with medical doctors, integrated patient centered health care its called. I could throw in Cultural Authority if you like those sound bites. You assume I have a “straight practice” and you would be wrong. I recently performed a breast exam on a patient who wanted my opinion on a lump, I had my CA present during the exam.
You are colleague of mine, if you want to go and do something that might make me look bad, that makes it my business. Dont you care if a chiropractor signs someone up for 100 visits for a bit of back pain relief. Dont you mind a chiropractor giving botox injections (and someone died I think a few years ago.)
If you live in New Mexico you will have to go and study medicine if you want to prescribe because its just been announced that the legislature realized, that this was an effort to provide medical care on the cheap. If you want prescribing you will need to do a lot better to convince chiropractors, because after this you will need a majority and this has woken up a lot of those sleeping dinosaurs you were worried about.
Forgive me for crowing on behalf of the “noisy minority”; http://youtu.be/x4jSrkwiWE0
Adam Morrell said,
March 17, 2011 at 11:20 pm
The chiropractor’s restricted license in most states has proven a bane to me personally and it has nothing to do with me wanting to prescribe or not. It has everything to do with integration and coordination of care. Many medical doctors are open these days to working with chiropractors who put forth reasonable treatment plans and communicate with them about their patients. It is a fact that we see a small percentage of the population that we should be seeing for even simple back pain.
The best way to see more patients and get chiropractic out there as a forefront and respectable profession is to work together with our medical brethren, gain their trust and earn their referrals. The easiest way to integrate is to free up our licensing laws and put forth an evidence driven and patient centered image. Imagine seeing 90% of the population instead of 10%!
That said, I don’t wish to prescribe often because I would rather manage things conservatively as best as possible. I believe through evidence and experience that healthy living is the best medicine. But if a patient needs a med, then I’d like to be able to prescribe a short course. I treat herniated disc cases and some of them truly need a med to get them over the hump so that my treatment and their active participation can get help them really heal.
Thus, scope expansion is crucial. There is no need to fear chiropractic being diluted by being able to prescribe or discontinue a patient’s nsaids or muscle relaxer. A small minority of individual chiros may overutilize meds, but they are probably the same to overutilize adjustments or defraud insurance companies they are contracted with. Please, to those who are against scope expansion, do not let this type of fear rule you. We are really on the same team and that is to increase chiropractic’s standing.
Brett L. Kinsler, DC said,
March 18, 2011 at 6:22 am
Exactly, Dr. Morrell. Given the opportunity, I would probably very rarely prescribe anything. Isn’t it better that our scope be as broad as possible and we limit it ourselves instead of having legal restraints put upon us?
Mike said,
March 18, 2011 at 11:45 am
Richard, I was as straight as just about every other chiropractor when I graduated chiropractic school. Over the years that changed as I saw the abuse of MD’s prescribing drugs, keeping patients away from DC’s, referring them to PT’s, etc. I saw that with the education required a NP, PA, dentist, and/or optometrist I could safely rx those few times a year when I felt I needed to to take care of my patients. Why would you assume I want to mask pain? The primary need I’ve seen over the years for a very limited use of prescription medication is to get the patient over the hump for a few days and after that, hopefully, an adjustment is indicated. My doing that is going to make you look bad? That’s your main argument? My goodness Richard, subluxation based chiropractors make us all look much worse day in and day out. Spend this weekend at your local city festival, garden show, look in the YP and/or newspaper ads.
Richard Lanigan said,
March 18, 2011 at 4:01 pm
I do not see anything unreasonable in what you guys are suggesting. I went to college with Eugene. Mine is not a “fundamentslist” position, I am trying to look at it from the eyes of 100,000 chiropractors and I am certain it would be wrong to push a head with prescribing without 70% of the profession.
Every day some skeptic digs up some dirt about chiropractic colleagues that is indefensible, much of it related to being motavated by $$ rather than patient care. Now were these same people seduced by the pharma reps I would despair.
I went to one of the best schools in Ireland, you would not believe how many medical doctors I went to school with, the new Irish Secretary of State for Health Dr James Reilly was at Gormanston with me. I can confidently say the reason chiropractors see only 10% of the population is the profession has not figured out a consensus view of what chiropractic is or what chiropractors do, ask people, What is chiropractic? What do the do? Would you trust a chiropractor? The ACC Paradigm might have worked, the WFC identity statement 2005 is acceptable.
Until chiropractors stop fighting among themselves and eating their young, we do not deserve to see more than 10% of the population
Adam Toulon, MS, DC, FACFN said,
March 18, 2011 at 4:59 pm
What an exciting time in our profession, a crossroads of undeniable and palpable change…creating dysfunction of the whole to survive the reduced (and often misinformed) culture of yesterday under the guise of integrity or principal. I can see that many just want to better serve their patients, because they can make short term mild prescriptions that they can control the usage, dosage, and duration of to help patients through the crisis. I can also see the fear in trusting our profession with the easy option to prescribe and get paid, and then next! Human nature is lazy and seeks the path of least resistance…our profession would have never developed if it wasn’t for the integrity of the giants whose shoulders we stand on today!!
*When emotions run high, they cloud logic and reason, be careful we don’t destroy ourselves from within.
*Change is inevitable, it either happens to us or from us!!!
I personally have no need to prescribe meds, if a pt will benefit from crisis intervention meds then I refer to the professionals that everyday for a living prescribe meds…that’s a no brainer. I agree that Chiropractic is a drug-less profession, and I want it to stay that way, I also appreciate scope expansion so we can better serve mankind, that being said, I would enjoy the freedoms that come with the scope and ability to reduce or remove drugs as necessary so that we can restore appropriate function, kind of like having reverse prescription rights!! That would make us a real drug-less profession, “Want to reduce or get off your drugs, well then get to your Chiropractor today!!” I’m sure we all have many many many patients that come to our office on 2 to 5 to 12 different Rx meds, how great would it be to be able to appropriately, and that means getting the appropriate education (such as proposed for the NM crew, MS degree and 400 hrs clinical rotation in Hospital), reduce or eliminate the Rx meds, a shift from mechanistic management to vitalistic corrective care. I know none of this would be necessary if Medical Doctors would shift their focus from prescription management of symptoms to a more corrective model that leads to Rx drugs becoming less and less necessary or if as proposed a more integrated model where the patients safe and efficient return to good health is the priority and a team approach from crisis to health development is employed.
Another hot topic hidden in this discussion is the CODEX, will we continue to have the rights to prescribe nutritionals for health development and therapeutic support of our patients??? We cannot deny the benefit of appropriate nutritional support, especially for our chronic condition patients.
Once again, I have no need for prescription rights, although if I had them (and I’m OK if we go that route, provided with the appropriate education) I trust myself to continue to do what’s best for my patients, and we all know that more drugs has never and will never equal better health or function!!
OK that is all for now….thank you for the opportunity to participate in this engaging collective
Nick Karapasas, D.C. said,
March 19, 2011 at 12:06 pm
Engaging conversation all… one of the benefits of this medium is the ability to share thoughts and be able to sift through the muddy waters, so to speak.
One point I wanted to make before it slips my mind:
HB 127 was tabled in the legislative committee by a 5/3 vote.
The reason it was tabled was that some of the senators were convinced that a DC with an additional clinical MS degree, 400 hours of clinical rotations, and two years of supervised practice were a risk to public health do to “lack of training” and “the inability to diagnose.”
This came not from the AMA, or some anti-chiropractic group… but from out of state chiropractors (and some from canada) calling the offices of those senators and telling them that this degree would put the public in danger.
It came from two former presidents of straight chiropractic colleges going to lobby and testify to those senators. It came from a lobbyist paid for by one of the minority national organizations.
So, if an MS + 400 hours (more direct patient contact hours than what is needed for a PA, NP, or even a DC to perform spinal manipulation) + 2 years of clinical supervision is a risk to public health….
What do you think those senators think about the safety and training of a DC who does NOT have those additional hours or degree?
(Ever hear the phrase “cut off your nose to spite your face”?)
Richard Lanigan said,
March 19, 2011 at 6:11 pm
Hopefully they explained that spinal care is safer than prescribing meds for patients with musculoskeletal pain syndromes
Nick Karapasas. D.C. said,
March 19, 2011 at 7:16 pm
The New Mexico Chiropractic Association had done that for years leading up to this bill.
We all know that chronic NSAID use is detrimental to healing… Having a body of providers in the state who could triage and adjust as necessary was a big part of the equation.
However, the calls from out of state focused on “a drug free choice” from a “drug free profession”… The risks of overmedication etc didn’t seem to factor in.
That is more of an internal chiropractic version of the “cars kill thousands a year, why would you want a drivers license” argument that you hear from green commuting evangelists.
Richard Lanigan said,
March 20, 2011 at 5:46 pm
Another point which has been raised on my blog, is that people in parts of New Mexico are poor and they have no health care in many remote areas.
This is not only a problem in New Mexico is a problem with the health care system in the US. If you dont have money its unlikely there will be a doctor working in your neighborhood.
I met with American students when I was last in Havana, who had scholarships to study medicine in Cuba. Otherwise they would not have been able to become doctors and provide health care in their inner city communities. http://www.henryreevebrigade.org/?p=234
If the Cubans are able to provide health care in poor communities all over the world, why is the US failing in its own back yard. I have worked with doctors in a hospital in Cuba and they have a very enlightened attitude to what they call “natural medicine”. Acupuncture is available in all hospitals and only one chiropractic clinic.
Chiropractors are not the answer, to the lack of health care in New Mexico.
John M Ventura, DC said,
March 20, 2011 at 8:24 pm
save for the vulgarities, obvious lunacy and ad hominem attacks on Dr Kinsler, there is some good dialog. To those opposed to expansion of the scope of practice for chiropractors, you need to understand that this would only be done in the context of expansion of training, ultimately perhaps leading to an expanded degree. And you have to face facts: DCs have the highest default rate of all health professions on student loans, over the past decade the percentage of the population utilizing chiropractors has dropped to below 8% and the trend for insurance companies is to constrain reimbursement for spinal adjustments aka manipulative therapy. By expanding their scope the DOs have been able to fulfill their mission – train primary care providers. While some DOs do go into specialty practice, the majority are primary care physicians with full privileges in all states. And they are growing larger every year, with cultural authority and all the privileges that go with that.
keep up the great work Brett.
Brett L. Kinsler, DC said,
March 30, 2011 at 11:06 pm
I contacted Dr. James Winterstein, president of National University of Health Sciences and Dr. Gerry Clum, recently retired president of Life College of Chiropractic West to hear what they had to say. Both doctors had testified at the New Mexico hearings and agreed to speak with me.
Listen to this episode on iTunes or over at the On The Other Hand podcast website: http://www.kinslerpress.com/podcast
Ryan R Wood, DC said,
April 3, 2011 at 10:34 pm
Broader scopes of practice promotes further education. Further education creates a stronger healing art. Do not limit yourselves when presented with opportunity to create more depth. I would love to see this happen and Bret, I must say, Well Done!
I wish we could create similar legislation in Montana.
Recent Grad said,
April 5, 2011 at 9:32 am
Dr. Kinsler,
I absolutely love your blog and podcast. Feeling down about our dogmatic profession (after terrible interviews with insane crooks), a friend recommended your podcast. This was a great interview! I wont say that I would like to prescribe but I see the need to not paint ourselves into a small corner of the room. I want our profession to be around long enough for me to start working
I havent listen to all your podcast (YET!), but a suggestion for one is the education we are receiving and the need for reform. We literally had two quarters of toggle?!?! and not one on low back pain. Doesn’t make sense.
New Podcast Interview: Two College Presidents Discuss Prescription Rights for Chiropractors said,
April 5, 2011 at 9:38 pm
[...] blog article on this topic on the RochesterChiro blog attracted some heated debate and strong opinion. For more depth on this issue, podcast host [...]
Frustrated said,
April 14, 2011 at 4:22 pm
Just read the latest Chiropractic Journal. Incredible to believe that the ICA (my group) would severely limit our scope they way that it was proposed. As usual, the ICA’s response was WORSE than the bill itself.
The medical board was PR0-CHIROPRACTIC, and the ICA AGAINST? WTH. Guys making 100K – and happy with it – are trying to stop someone else from making 400K. It’s absolute BS. If you don’t want to prescribe….then don’t.
Incredible. The first piece of legislation that could be passed that is worth anything in my 27 years of practice. And we dumped on OURSELVES. Vomited on our shirt like a drunk in an alley.
Alan Dinehart, DC said,
May 26, 2011 at 3:20 pm
In the beginning of the Allegory of the Cave Plato represents man’s condition as being “chained in a cave,” with only a fire behind him. He perceives the world by watching the shadows on the wall. He sits in darkness with the false light of the fire and does not realize that this existence is wrong or lacking. It merely is his existence — he knows no other nor offers any complaint.
Plato next imagines in the Allegory of the Cave what would occur if the chained man were suddenly released from his bondage and let out into the world. Plato describes how some people would immediately be frightened and want to return to the cave and the familiar dark existence. Others would look at the sun and finally see the world as it truly is.
They would know their previous existence was farce, a shadow of truth, and they would come to understand that their lives had been one of deception. A few would embrace the sun, and the true life and have a far better understanding of “truth.” They would also want to return to the cave to free the others in bondage, and would be puzzled by people still in the cave who would not believe the now “enlightened” truth bearer. Many would refuse to acknowledge any truth beyond their current existence in the cave.
The cave dwellers are the Chiropractors in today’s health care system. Many Chiropractors practicing in the country today attended schools that focused on Chiropractic Philosophy rather than scientific knowledge. Relying on the Chiropractic philosophy, It became more comfortable to remain in the cave than to venture to and see the light of reality. Today’s health care relies on evidence based forms of treatment, rather than philosophy. If you can’t prove it works, you can’t expect a third party payer to accept responsibility for paying a claim. National health is a reality and we all can expect some drastic changes.
With the advent of a National Health Care Plan, emphasis is being placed on the primary care sector rather than on the medical specialists. The idea is not unique as other countries that have a national health system have always relied on the primary care to address the majority of the health care needs of the population. However, in the United States, the number of primary care practitioners is severely lacking. Currently, the American College of Family Practitioners estimates that there is a shortage of 6000 family practitioners to fill the current needs. With the increasing age and numbers of the ‘Baby Boomers”, this shortage increases to 20,000 by the year 2020.
As most new medical school graduates feel that primary care is not how they want to spend their careers, the gap is being filled by foreign trained physicians, Nurse Practitioners and Physician’s Assistants. In and of itself, this is not a bad situation if you are not in the cave. The reality is that Chiropractic has failed to practice primary care and therefore will be left by the wayside when it comes to inclusion in any future reimbursement plans. Are you starting to see the light at the opening of the cave?
With the passage of a national healthcare law, we must realize that there are finite dollars in the system and the payers must divvy the pie up in the most effective manner. If you have been in the Chiropractic profession for any length of time, you realize that the more powerful lobbies have the most say. I have heard the analogy that healthcare is like the basic automobile. And, Chiropractic is an expensive option. Sure, it works but the car runs perfectly well without it! This is the excuse that will be used when coverage is to be determined. Unfortunately, we, as a profession, have turned ourselves into a One Trick Pony. We spend most of our resources defending ourselves rather than expanding our service base.
Recently, the State of New Mexico adopted a new program called Advanced Chiropractic Physician. This designation comes after a set educational course and allows those Chiropractors who have completed the requisite hours of training to utilize a formulary of medications and the injection of vitamins. Although this sounds good to some, it really does not come close to being adequate to fill the role of a primary care practitioner. To be an independent primary care practitioner, there can be no restraints on which medications can be used or prescribed.
Currently, in the United States, there are fourteen states and the District of Columbia that have licensing laws pertaining to Naturopathic Medicine. However, out of the fourteen, Utah and the District of Columbia have not issued any licenses.
Arizona and Oregon are the only two states that have Naturopathic laws that would qualify the practitioner as a true primary care physician. As the scope of practice is slightly less restrictive, Arizona’s law should be used as a model for future legislation. For reference, this website will take you to the Arizona Naturopathic Medical Board http://www.npbomex.az.gov/. Naturopathy is also licensed in Canada and the province of British Columbia has recently adopted laws allowing prescriptive rights to Naturopathic Doctors, licensed in the province.
This was done to fill their increasing need for primary care doctors.
Now, in order for our profession to survive in the national healthcare arena, we must offer more medical services and expand our scope of practice. A decision will have to be made weather the advancement comes through a program in Naturopathic Medicine taught in our schools, leading to a DC/ND degree or expanding the scope from within by establishing an Advanced Chiropractic Practice certificate, taught at Chiropractic Colleges on the post graduate level. To date, there are two Chiropractic Colleges that have started Naturopathic Schools under their university umbrella. These are University of Bridgeport and National University of Health Sciences.
Most Chiropractors don’t understand that scope of practice is determined from within the profession, not from without. If the demand is there, the state associations lobby the legislature and laws are passed. Chiropractic Boards do not determine the scope of practice. Their job is to determine what the current laws say and enforce them. When they determine that a practice is within the law or outside the law, they can be wrong. And, if so, can be challenged in court. We all know that two people can read a rule and interpret it differently.
For those of you who exist in an all cash practice or those who are close to retirement, this article is of little use. However, if you are among the vast majority, especially the new graduates who carry massive debt in student loans, this should be a wake-up call to action.
What can be done? Well, the profession needs to decide which way it wants to go. Currently, there are three options:
One, interact with the Naturopathic profession and have the schools begin opening Naturopathic schools on their campuses. This would allow students to graduate with a duel degree. The schools could also develop programs for practicing Chiropractors to get their ND degree and practice accordingly.
Second, develop an advanced chiropractic practitioner program and attempt to get state and national Chiropractic organizations to promote the idea.
Third, do nothing and ultimately dissolve from the health care industry and be a footnote in history. Without moving forward, you move backward.
The future of your profession is up to the current practitioners and the current students. I urge you to take a few minutes and write a letter to your school or to your state or national organization and express your concern. Give them the direction you feel your profession should be going. The urgency of this matter cannot be over emphasized as the camps are already staking out their position in the national healthcare arena. You can make a difference by doing something or by doing nothing.
phoenix chiropractor said,
August 4, 2011 at 9:36 am
I don’t want to see the chiropractic field trend towards a drug-oriented approach. It has always been about helping the body to heal itself.
Terry W. Todd, D.C. said,
August 16, 2011 at 3:59 pm
I think adding Rx rights to Chiropractic is a beautiful thing. I spent almost 3 decades in mainstream healthcare, but became a chiroprctor because of the drug free stance they held. Now after 10 years my eyes are opened to the prejudice that insurance comp., MD’s, PA’s, PT’s and nurse practitioners have toward Chiropractors. The aforementioned professions are protected by law. Who protects the right of the chiropractor to deliver spinal manipulation. I have witnessed massage therapists, PT’s and MD’s (trained at a weekend seminar) manipulate spines. In my city we have an appliance salesman who will adjust you in his back room, he had a whole year of Schooling. Who is jailing and fining these people for practicing Chiropractic without a license? I heard a patient refer to his PA as a doctor one day and its obvious that to be called a doctor one only need write prescriptions. I only know that my butt is in the seat at every class learning and collecting new tools to treat my patients. Who better to start patient care with, than someone with the knowledge and expertise to try other means FIRST.before drugs and surgery. I don’t see Chiropractic offices becoming pill mills. I do however want to be a REAL DOCTOR and if it takes more education and work to ensure that my profession advances. I will take the challenge and change my perspective. God bless America and the freedom to choose!
Mark Momano said,
September 25, 2011 at 9:33 am
We not only need drugs we need surgery! I can’t wait to dig into the field of surgery. I could not get into medical school, due to my mental condition, but I am with the “Advanced” DCs in New Mexico! We NEED drugs!!!! Great page for those of us with like minds to band together for the drugs we need!