Tiering Can Be Healthy for the Chiropractic Profession

A s chiropractors, most of us know, the chi­ropractic profession has been split between what some of us think we arc and what some of us think we should be. This isn't new. but the divi­sion has reached a point where unscientific old time chiropractic philosophy lias prevented us entry into new healthcare programs that arc being developed. According to The History of Chiropractic Education in Xorth America by Joe Keating. Jr. PhD (1998) The following is the first advertisement fora chiropractic education(1896) "$500.00 will get you an education in 3 months which will better fit you for a healer of disease than any medical education in the world. The above docs not include medical surgery or Obstetrics." As we can sec. the earh chiropractic training was brief and not very thorough. By 1908 D.D. Palmer started the DD College of Chiropractic in Portland. Oregon and the curriculum was increased to two (2) years and nine (9) months. This college later went on to become the "Peerless College of chiropractic & Neuropathy. In 1920. the first mention of tiering of the profession comes from, none other, than D.D. Palmer himself! The curriculum offered consisted of three years but. you could graduate in two (2) years with a DC degree, however you had to return within five years to finish the final ycar(3rd). Once the third year was completed, you were granted a PhC degree! In the ensuing years the profession wanted recognition and licensing, so the educational curriculum was increased. Ap­parently successful, in 1974 the last state (Louisiana) filially granted licensurc to chiropractors, thus making it eligible to participate in the federal Medicare program. However, mam of the leaders thought we needed to further expand our education so the prerequisites and curriculum hours were expanded to where they are today. Unfortunately, after all these efforts, we arc still under the old laws, and arc still restricted to the same scope we had in the 1920s. The majority of chiropractic schools teach pharmacology as part of their core curriculum, yet only a few states allow limited pharmaceutical privileges for chiropractors. Recent changes to the healthcare system have presented an opportunity for the chiropractic profession to either llourish or finish. With the advent of the Affordable Care Act (Obamacare) thirty million previously uninsured people will become insured and w ill be seeking healthcare. On the surface, it sounds good but in reality, the current healthcare system will be overwhelmed and there wont be enough physicians to care for these people. Current statistics predict a shortfall of 90.000 physicians to care for these newly uninsured citizens. The 90.000 figure is representative of a lack of primary care practitioners! Enter the redheaded stepchild of medicine, chiropractic! Cur­rently there arc approximately 60.000 licensed chiropractors in the United States. These individuals arc trained in almost even aspect of general medicine and are primed to fill the void created by this legislation. I know there seems to be a giant leap here but let me ex­plain. As I already noted, the educational requirements have increased through the years and today, our education is on a par with medicine. Yes. medical doctors are more trained in some fields but so are we in others. No profession knows more about musculoskclctal conditions than chiropractors! We also excel in nutrition as well as wcllncss practice. All of these arc neces­sary to combat the ever increasing introduction of unhealthy lifestyles and poor diet decisions on the burgeoning population, and tis effect on the healthcare svstcm. In the last few years, some monumental changes have occurred in the upper ech­elons of the chiropractic profession. The American Chiropractic Association has come out in favor of self destiny. This means that the practitioners should be free to practice what they arc taught, and what they believe is best for their patients. Almost simultaneously, the Council on Chiropractic Education changed its" definition of chiropractic medicine by dropping the old worn out phrase of "... without the use of dnigs or surgery." Their reasoning is that it is simply not tnic any­more. There are states that allow the use of dnigs and there are some sates that allow chiropractors to perform surgery. In good conscious, they couldn't perpetuate the fallacy that we are a druglcss profession. As all these changes are occurring and the state organization are doing nothing to expand our scope. Along comes the Florida Chiropractic Physicians Association! In August 2011. a small group in Florida started a campaign expressly to expand the scope of chiropractic medicine in Florida. Thus, the FCPA was formed. It seems incongrucnt that the law demanded over four thousand hours of training, yet it still restricts us from practicing anything more than physical medicine In the October issue of the Canadian Chiropractor Magazine, is an article featuring the FCPAA ( First Chiropractic Physician Association of America) and the question on prescriptive authority. They cite two surveys with the following results: "In 2008. 55.5 percent said they were in favor. 8.9 percent were neutral and 35. 7 per cent were not in favor. In 2011. the number of those in favor of chiropractors prescribing anti-inflammatory medications or analgesics increased to 61 per cent, while those who were not in favor went down to 27 per cent. Some 13 percent took a neutral position." It is apparent to anyone that lias been following this internal politics of the chiroprac­tic profession, that expansion of scope and fundamental changes to the profession are moving at a monumental pace. The classically "fundamental" schools arc losing favor and some arc closing altogether. New student enrollments have decreased steadily for the past ten years yet the anti-expansion faction refuses to admit that the answer is expansion or extinction! ► Come and meet like minded chiropractors regarding prescription rights bv attending one of the CE Seminars as an FCPAA guest, for free if you live outside of Florida and only pay $75 in Florida. Credits applied for in 34 states through the Health Sciences Postgraduate Education Department of the University of Bridgeport (UB).