Thursday
Jan142010
“Tiering” of the Chiropractic Profession: Guess Who’s Behind this…?
Thursday, January 14, 2010 at 7:01AM
Originator CBP Technique,President CBP NonProfit, Inc.
Almost as old as the profession itself is the position of a small faction within Chiropractic that adamantly argue that we would be better off if the profession were to be officially divided into different segments based upon scope, philosophy or some other principle that our profession cannot get beyond. This opinion is maintained by the extremists at each end of the spectrum. Now, after nearly 120 years, it appears that not only has this process started, but it is supported by the national groups who have been at the helm of the profession for years.
This process has taken new roots and in dangerous form in the state of New Mexico. New Mexico passed changes to its laws a year ago resulting in a “tiering” of the profession within that state. They defined, again in Statute, the designation of a “Certified advanced practice chiropractic physician”. The state law continues that this “means advanced practice chiropractor who shall have prescriptive authority for therapeutic and diagnostic purposes as authorized by statute and stated by the board.” The variety of substances that these “Advanced” chiropractors can inject into the human body, either intramuscular or intravenously, is to be determined by a panel of individuals comprised of chiropractors, medical doctors and pharmacists.
The statutory designation that these DC’s are somehow “Advanced” is presumptuous to say the least. It’s not as if this is merely some “certification” earned by a series of seminars, such as a “certified strength and conditioning specialist” or even a diplomate such as a DACBR. This is a legislated, implied superiority of certain DCs because of their right to inject “non-dangerous drugs” into patients. Whether Chiropractors wish to do this in their practice is up to them in my opinion, however the supposition that this makes them “Advanced” in any capacity over a “regular” Chiropractor is most disturbing. In no other state does this exist, for any group of Chiropractors; all Chiropractors are equal in each state. In fact I am not aware of any such “tiering” in the medical profession either. For example, while there are medical specialties and board certifications, there is no Statutory classification of MD’s into “Advanced” practitioners in any state of which I am aware. The General Practitioner MD can perform surgery should they desire.
More Than a Problem for Those in New Mexico
Right now, many of you are telling yourselves that this is New Mexico’s problem and asking… “how does it affect me?” As it turns out, the Statute in New Mexico requires a certification exam to be administered by a nationally recognized testing agency…enter the National Board of Chiropractic Examiners (NBCE). New Mexico contacted the NBCE and asked the NBCE to develop and administer a test for their state. NBCE agreed. While the NBCE explains that their purpose is merely to respond to requests for test development, in my opinion their acceptance to develop this test is a sign of support. How does an entity that has knowledge in testing Chiropractors, have the expertise to develop testing material on pharmacology, injectable delivery of substances, etc? NBCE has no expertise to develop a test on this subject matter that I’m aware of. It is my opinion that this is a farce that the NBCE has agreed to do this.
You’ll Never Guess Who Else Supports This…
To make matters worse, on October 07, 2009 the American Chiropractic Association (ACA) issued a press release titled “ACA House of Delegates Approves Policies, Elects New Leaders at Annual Meeting”. Within this press release was a short statement that the ACA House of Delegates declared that a resolution “supporting the National Board of Chiropractic Examiners’ (NBCE) plan to create certification for an expanded practice chiropractic physician…” was passed. So, the ACA has officially “supported” this process for the NBCE to develop a national certification test for these Chiropractors legislated to have an expanded scope of practice. It is logical that by declaring support for this NBCE testing process, the ACA supports “tiering” of the profession itself as well.
How Could This Affect the Profession?
At a minimum a standard is set that there are some DC’s by virtue of their practice style, are more “advanced” than other DC’s. This is contrary to most Statutes restricting DCs from implying that the manner in which they practice is in any way superior, advanced, etc. There are many scenarios that would have far greater implications for our profession. For example, would these “advanced” DC’s petition for greater insurance reimbursement to match their “expanded” practice rights? Would government run insurances be petitioned to expand the benefits allowed for these “advanced” practitioners only?
A line has been drawn in the sand. It was not drawn by a majority of the Chiropractic profession for the greater benefit of all Chiropractors…it is a line that indicates that some of our colleagues are better than the rest of us. It is a line that has been drawn not only in New Mexico, but also drawn by what are supposed to be impartial national organizations within Chiropractic…the ACA and the NBCE. This is the line that will divide our profession into segments. If you thought having two national associations resulted in underfunding and underrepresentation at the national level, wait until there are two (or in the future more) segments of the profession able to lobby for their own rights, and not the rights of all of the Chiropractic profession.
These primary care physician wannabe’s have drawn the line in the sand. The NBCE and ACA have joined with them through actions of support. Where we as a profession end with this chapter in Chiropractic history depends on the action of the average Chiropractor:
Go to www.chiropractic.org and sign up now. Your profession needs you!
Almost as old as the profession itself is the position of a small faction within Chiropractic that adamantly argue that we would be better off if the profession were to be officially divided into different segments based upon scope, philosophy or some other principle that our profession cannot get beyond. This opinion is maintained by the extremists at each end of the spectrum. Now, after nearly 120 years, it appears that not only has this process started, but it is supported by the national groups who have been at the helm of the profession for years.
This process has taken new roots and in dangerous form in the state of New Mexico. New Mexico passed changes to its laws a year ago resulting in a “tiering” of the profession within that state. They defined, again in Statute, the designation of a “Certified advanced practice chiropractic physician”. The state law continues that this “means advanced practice chiropractor who shall have prescriptive authority for therapeutic and diagnostic purposes as authorized by statute and stated by the board.” The variety of substances that these “Advanced” chiropractors can inject into the human body, either intramuscular or intravenously, is to be determined by a panel of individuals comprised of chiropractors, medical doctors and pharmacists.
The statutory designation that these DC’s are somehow “Advanced” is presumptuous to say the least. It’s not as if this is merely some “certification” earned by a series of seminars, such as a “certified strength and conditioning specialist” or even a diplomate such as a DACBR. This is a legislated, implied superiority of certain DCs because of their right to inject “non-dangerous drugs” into patients. Whether Chiropractors wish to do this in their practice is up to them in my opinion, however the supposition that this makes them “Advanced” in any capacity over a “regular” Chiropractor is most disturbing. In no other state does this exist, for any group of Chiropractors; all Chiropractors are equal in each state. In fact I am not aware of any such “tiering” in the medical profession either. For example, while there are medical specialties and board certifications, there is no Statutory classification of MD’s into “Advanced” practitioners in any state of which I am aware. The General Practitioner MD can perform surgery should they desire.
More Than a Problem for Those in New Mexico
Right now, many of you are telling yourselves that this is New Mexico’s problem and asking… “how does it affect me?” As it turns out, the Statute in New Mexico requires a certification exam to be administered by a nationally recognized testing agency…enter the National Board of Chiropractic Examiners (NBCE). New Mexico contacted the NBCE and asked the NBCE to develop and administer a test for their state. NBCE agreed. While the NBCE explains that their purpose is merely to respond to requests for test development, in my opinion their acceptance to develop this test is a sign of support. How does an entity that has knowledge in testing Chiropractors, have the expertise to develop testing material on pharmacology, injectable delivery of substances, etc? NBCE has no expertise to develop a test on this subject matter that I’m aware of. It is my opinion that this is a farce that the NBCE has agreed to do this.
You’ll Never Guess Who Else Supports This…
To make matters worse, on October 07, 2009 the American Chiropractic Association (ACA) issued a press release titled “ACA House of Delegates Approves Policies, Elects New Leaders at Annual Meeting”. Within this press release was a short statement that the ACA House of Delegates declared that a resolution “supporting the National Board of Chiropractic Examiners’ (NBCE) plan to create certification for an expanded practice chiropractic physician…” was passed. So, the ACA has officially “supported” this process for the NBCE to develop a national certification test for these Chiropractors legislated to have an expanded scope of practice. It is logical that by declaring support for this NBCE testing process, the ACA supports “tiering” of the profession itself as well.
How Could This Affect the Profession?
At a minimum a standard is set that there are some DC’s by virtue of their practice style, are more “advanced” than other DC’s. This is contrary to most Statutes restricting DCs from implying that the manner in which they practice is in any way superior, advanced, etc. There are many scenarios that would have far greater implications for our profession. For example, would these “advanced” DC’s petition for greater insurance reimbursement to match their “expanded” practice rights? Would government run insurances be petitioned to expand the benefits allowed for these “advanced” practitioners only?
A line has been drawn in the sand. It was not drawn by a majority of the Chiropractic profession for the greater benefit of all Chiropractors…it is a line that indicates that some of our colleagues are better than the rest of us. It is a line that has been drawn not only in New Mexico, but also drawn by what are supposed to be impartial national organizations within Chiropractic…the ACA and the NBCE. This is the line that will divide our profession into segments. If you thought having two national associations resulted in underfunding and underrepresentation at the national level, wait until there are two (or in the future more) segments of the profession able to lobby for their own rights, and not the rights of all of the Chiropractic profession.
These primary care physician wannabe’s have drawn the line in the sand. The NBCE and ACA have joined with them through actions of support. Where we as a profession end with this chapter in Chiropractic history depends on the action of the average Chiropractor:
- Will you join with them, promoting assimilation into the medical model of health care as the Osteopaths did years ago?
- Or will you fight to keep our profession a drugless model of health care?
Go to www.chiropractic.org and sign up now. Your profession needs you!