By James Edwards, DC

After several organizations [1] testified in favor of the Council on Chiropractic Education (CCE) being renewed as the accrediting agency for chiropractic colleges, some of those organizations issued less-than-accurate communications implying that the CCE was victorious in its effort. The fact is that nothing could be further from the truth.

It is not my intention to identify the organizations that misinterpreted and/or misrepresented what occurred. For those organizations that attempted to “spin” the facts in order to place the CCE in the most favorable light, I will leave it to them to correct the record. Instead, I will rely solely on transcripts and the reporting of the objective and highly prestigious Chronicle of Higher Education, and let you make your own judgments. After your review, I think it will become obvious that in a word, the CCE got publicly “spanked” for blatantly and steadfastly ignoring the wishes of the majority of the chiropractic profession.

While using the word cartel might seem harsh, it is important to stress that the description of the CCE as being a “virtual cartel” did not originate from me or even from within the chiropractic profession itself. It actually arose during a previous hearing by a member of the United States Department of Education (DOE) National Advisory Committee on Institutional Quality and Integrity (NACIQI). For your reading pleasure, the committee member’s harsh comments are below [with emphasis added]:

“Madam Chair, we’ve heard charges and countercharges from I trust a wide, fairly wide spectrum of the chiropractic profession. At least that’s the way it seems to me. Battles over turf, battles over philosophy, maybe battles over personal ambition, but divisions of every kind.

And some of this, maybe most of it, is a consequence of, at least as I see it, a monopoly control of a profession which has led to the establishment of a virtual cartel, not unusual. There are several other professions that we deal with that have a virtual cartel control of the profession. We can’t change that, but we can consider measures that will try to send a message to the prevailing control group that they should try to be more inclusive rather than less inclusive and I suggest that we try to figure out what is within our range of alternatives to do that.

Because I believe if we simply hear it, discuss it, anguish over it, and then give them five years of recognition, that we haven’t been the impetus for any corrective action for the profession and I worry about the profession.” [2]

Harsh Words

And now to the objective reporting of the highly prestigious Chronicle of Higher Education. Sit down, fasten your seatbelts and read what this impeccable, trusted source reported [again with emphasis added]:

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Acting on behalf of concerned members in New Mexico and out of concern for the integrity and credibility of the chiropractic profession at large, on December 21, 2011 the International Chiropractors Association (ICA) filed an extensive memorandum in support of a motion to stay what is being held to be illegal actions on the part of that state’s Board of Chiropractic Examiners. In its memorandum of explanation, ICA’s attorneys argued that it was important for the court to carefully consider the urgent issues of the letter of the law and the protection of both the public and chiropractic practitioners and prevent the “New Mexico Board of Chiropractic Examiners from implementing its new rule establishing an advanced practice formulary to include dangerous drugs and drugs to be administered by injection…and implementing its new rules establishing a certain course of training to certify advanced practice chiropractic physicians to administer and prescribe dangerous drugs and drugs to be administered by injection” because such actions were outside their authority under the law.

On August 30, 2011, at an official rulemaking hearing and meeting, the New Mexico Chiropractic Board adopted new rules to greatly expand the chiropractic formulary to include certain dangerous drugs and drugs to be administered by injection that had not been approved by either the New Mexico Medical or Pharmacy Boards as specifically required by state law. At that same hearing, lawyers representing the State of New Mexico were very clear in their advice that the Board was acting outside their authority and should not proceed. The Chiropractic Board ignored those admonitions and acted to adopt a new formulary anyway.

ICA representatives were present at both the August and December Board meetings and, in concert with New Mexico DCs, urged the Board to act only within the rules established by statute but to no avail. At their meeting of December 13, 2011, the New Mexico Chiropractic Board denied all requests to stay the implementation of the new rules pending appeal. ICA received official documentation of the New Mexico Chiropractic Board’s official denial of a request to stay the controversial rules on January 5, 2012. Having exhausted all administrative remedies, ICA is seeking the protection of the courts in the face of the Board’s questionable actions.

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There has been a lot of recent traffic to our postings about Alabama [1] and New Mexico’s attempts to gain prescription rights. For that reason, we are featuring 2 articles, both pro and con on the topic of expanding chiropractic practice into the realm of medicine. We hope you will find the following 2 articles of interest.

A Prescription for Professional Disaster

By Gerard Clum, DC, President Emeritus, Life Chiropractic College West

The expansion of the scope of practice of chiropractors to prescribe drugs is an absolute non-starter for me. In recent weeks, this conversation has moved to center stage, as evidenced by activities in the states of New Mexico, South Carolina and Alabama, as well as at the biennial gathering of the World Federation of Chiropractic (WFC).

Legislation proposed to expand the authority of chiropractors in New Mexico to prescribe broadly failed; the South Carolina measure appears to be mired in committee; and the Alabama State Chiropractic Association voted down a proposal to seek such an expansion. The WFC, while presenting a forum on this issue, has not changed its policy that the practice of chiropractic is without drugs and surgery.

The battle lines are rather well-drawn and clear. One element within the profession seeks to alter the history, tradition, conceptualization, culture, laws and regulations under which we have existed throughout our entire existence to include prescription authority of various extents. This view is being opposed by members of the profession who object and perceive the very heart of our clinical approach being hijacked and transformed into the practice of medicine.

“Conflicts Clarify!”

A recent legislative hearing in New Mexico did just that: it clarified the intent and extent of the drug lobby in chiropractic. In the past, whenever the question of prescription authority in chiropractic came up, it was always related to injected vitamins and nutritional support, as opposed to the common understanding of prescription medications associated with the practice of medicine.

In Santa Fe, N.M. on March 17, 2011, the veil was pulled back on that charade as representatives of the National University of Health Sciences and University of Western States joined members of the executive committee of the New Mexico Board of Chiropractic Examiners in seeking legislation that would allow the use of “primary care drugs.” Further, these representatives indicated that they were part of the solution for New Mexico’s primary care shortage with their willingness and self-perceived ability to treat patients with hypertension and diabetes, among other maladies. It is now clear and on the record that this is not about nutrition in any shape or form; this is about the practice of primary care medicine under the auspices of a chiropractic license.

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This is the second in a series of articles about expanding chiropractic practice into the realm of medicine. [1] We hope you will find these 2 articles of interest.

By James Winterstein, DC, President, National University of Health Sciences

Recently, I had the privilege of testifying for the chiropractic physicians in New Mexico who currently have some prescriptive rights and wished to expand that scope to improve their ability to provide stronger, more complete primary care.

It should be clear that I was asked to appear in behalf of the chiropractic physicians there or I would not have been there. It is not my purpose, as president of National University of Health Sciences, to dictate the direction of the chiropractic profession, but to provide the education that is required by the profession.

In this instance, the request to provide advanced education in pharmacology came to the university several years ago, just as requests to provide education in acupuncture came to the university 41 years ago and requests to provide education in “over-the-counter” medications came from Florida some 20 years ago. Our institutional charter says that we will “provide education,” which is what we have done in New Mexico, and which we intend to continue to do in New Mexico and elsewhere when asked.

Some members of the profession appeared before the New Mexico Senate Judiciary Committee and testified against the wishes of the New Mexico chiropractors – not as invited guests, but as intruders into state concerns. Some of the senators even received calls from out of the United States urging action against the wishes of the New Mexico DCs. I consider this kind of activity to be completely inappropriate and negative toward the profession. New Mexico DCs see a need that can be met with additional education and an expanded scope of practice. They, it appears, have a concern for the public, while their detractors have a fiercely held belief that the chiropractic profession must always remain what it was when formed by its originators.

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Treat the Patient, Not the CT Scan

By ABRAHAM VERGHESE
Published: February 26, 2011

THE other day as I walked through a wing of my hospital, it occurred to me that Watson, I.B.M.’s supercomputer, would be more at home here than he was on “Jeopardy!” Perhaps it’s good, I thought, that his next challenge, with the aid of the Columbia University Medical Center and the University of Maryland School of Medicine, will be to learn to diagnose illnesses and treat patients.

On our rounds of the wards, Watson would see lots of other computers with humans glued to them like piglets at a sow’s teats. We might visit a patient with a complex illness — one whose second liver transplant has failed, who has a fungal meningitis and now also has kidney failure and bleeding and is on a score of medications.

Watson might help me digest the sheer volume of data that is in the electronic medical record and might see trends in the data that speak of an impending disaster. And since Watson is constantly trolling the Web, he would perhaps bring to my attention a case report published the previous night in a Swedish journal describing a new interaction between two of the drugs my patient is taking.

Better still, if Watson could harness data from all the patients in our hospital and in every other hospital in America, we might be alerted to mini-epidemics taking shape. For example, Watson might recognize that the kidney failure in our patient is linked to kidney failure in a patient in Buffalo and another in San Antonio; all three patients, he might inform me, were taking a “natural” weight loss supplement that contained a Chinese herb, aristolochia, that has been associated with more than 100 cases of kidney failure.

In short, Watson would be a potent and clever companion as we made our rounds.

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I have no experience to guide me. I have never met a patient whose muscle spasm (or spinal “fixation”) was so great that I was not able to adjust them. Of course, that doesn’t mean that they might not be out there somewhere. I can only assume that’s why someone came up with the idea of MUA in the first place. Until now this never seemed relevant to me, and I didn’t pay attention to the evolution of this practice.

What I do know is that organized medicine is in a huge uproar about MUA.

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