Courses in prescribing for chiropractors? Is this the way to boil chiropractic frogs?

February 11, 2011

I tuned into to BBC news at 8 oclock to listen to the resignation of Hosni Mubarak and I was reminded how unpredictable politics is and of February 2008.  I made my way to the General Chiropractic Councils offices certain that by the end of the day the we would have won a no confidence vote in the chair of our regulator Peter Dixon by 10 votes to 8 and Chief executive Margaret Coats would be gone. A few weeks later it was me that was removed from office, three years later these two have managed to bring the  chiropractic profession to its knees but at least now the professional associations are trying to do something about it.

Everybody was certain Murbark was on his way out but he did not go, decided he could hang on, throw the protesters a few bones, set up a committee to oversee the transfer of power which may never happen unless the protesters keep the pressure on and ensure not just that Mubarak goes but that his cronies go with him. Funny how all these autocratic organisations behave in the same manner and are reluctant to give up power.

Its going to be interesting how this pans out and what the establishment come up with. The similarities with what the chiropractic associations and the regulators are going through at the moment are there for all to see.

Boiling-FrogsI suspect prescribing will be the banana skin that will split the chiropractic alliance and BCA, which will eventually get Dixon off the hook.

Having followed the skeptics now for a few weeks on twitter, I am convinced chiropractors will play into critics hands, by prescribing  “treating symptoms & diagnosing biomedical conditions”,  not forgetting the use of the doctor title. Lets make DC stand for the chiropractic doctor.

Many chiropractors all over the world crave recognition from the medical community and they are pushing ahead with their plan for chiropractors who are not ver good at adjusting spinal joints to use medications. With little consultation with the majority of the profession this small band are setting up prescribing courses for a minority of chiropractors who believe as former BCA president Mike Barber said in 2000 this is chiropractic comming of age.

I believe the World federation of chiropractic will announce a change of position on prescribing at the WFC congress on April 9th paving the way for prescribing in European associations. The vast majority of us will have watch as the chiropractic profession has the heat slowly turned up and is boiled by our medipractor colleagues.

This from the Foundation for Vertebral Subluxation

NBCE Developing Drug Exam for Chiropractors

The Master of Science in Advanced Clinical Practice (MSACP) Degree, developed at the National University of Health Sciences, purports to give chiropractors a broader immersion in clinical studies including pharmacology. National conferred diplomas on the first 14 graduates of its MSACP program in August 2009.  The program for chiropractic physicians consists of a two year, 36 credit hour program incorporating weekend and distance learning courses.  The Foundation, along with other concerned groups within the profession, has commented on the dangers of promoting so-called advanced practices within chiropractic which create a tiering of the profession giving the impression that the “advanced” chiropractors are somehow “better” chiropractors.

Just this January 2011, House Bill HB127 was proposed in the state of New Mexico to authorize “certified advanced practice chiropractic physician to prescribe and administer ANY dangerous drug or controlled substances subject to approval by the chiropractic board and within the physician’s clinical specialty.”  Additionally, “the existing statutory prohibition against chiropractors performing invasive procedures, operative surgery, and prescription or use of controlled or dangerous drugs is eliminated.”  It has been reported that this bill is being promoted by the American Chiropractic Association’s (ACA) New Mexico delegate.  Despite previous claims by proponents of tiering within our profession, this bill clearly demonstrates the goals of this faction for chiropractors to practice medicine.
In related events, the Council on Chiropractic Education has just changed their standards to allow for the accreditation of degree programs other than Doctor of Chiropractic. National’s accreditation was recently renewed by the CCE and specifically listed as Doctor of Chiropractic Medicine. The CCE has also removed subluxation and “without drugs and surgery” from their accreditation standards.
Further to these events, The American Chiropractic Association’s House of Delegates approved a resolution in 2009 “supporting the National Board of Chiropractic Examiners’ plan to create certification for an expanded practice chiropractic physician. New Mexico has added such an advanced practice designation to their statute and the American Chiropractic Association has voted to endorse such efforts.

Now, it has come to our attention that the development of such an examination by NBCE was discussed at the February 2011 meeting of the Washington State Chiropractic Quality Assurance Commision.  According to the meeting agenda, members of the commission planned to discuss the relevence of a proposed examination focused on competencies relating to the prescribing of drugs.
The Foundation for Vertebral Subluxation has serious concerns about the utilization of NBCE resources (i.e. students’ money)  to further advance the  development of designations to chiropractic credentials denoting a superiority to certain types of chiropractors which amounts to defacto tiering of the profession. Beyond the connotation of superiority and the tiering that arises out of such designations, the push to include drugs into the scope of chiropractic practice is the most serious issue facing the profession. Chiropractic is not the practice of medicine and is in fact a distinct and separate profession that enhances the ability of the body to heal without the use of drugs and surgery.
As this issue is not isolated to one or two states, the Foundation urges all chiropractors, chiropractic associations and organizations to join together and oppose these actions.

Contact the Foundation at

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18 Responses to Courses in prescribing for chiropractors? Is this the way to boil chiropractic frogs?

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  13. Richard Lanigan on November 3, 2011 at 22:25

    Alan, I dont think its just me or a lawyer who has this view. When I came into the profession that was the view. Five years ago the WFC identity statment has “drug free” as one of chiropractors UPS. Adusting is a skill that improves with experience, alternatively one can stop practicing the technique and pull out a prescribing pad like doctors do. As most chiropractors like to call themselves “doctor” you wont even have to explain the change to the public 

  14. Alan on November 3, 2011 at 05:17

    For all of you naysayers, Chiropractic is not a Drug and Surgery free profession, never was. As early as 1922, when California wrote their Chiropractic Initiative (written by Chiropractors), it allowed for over the counter drugs as well as vitamins. It mandated the inclusion of pharmacology and minor surgery into the curriculum. Oregon has had OTC medication and surgery in it’s law and yet the sky hasn’t fallen! The national average of 6 to 8% of the population being Chiropractic patients, the number is more like 22% in Oregon.

    The term “without drugs and surgery” was actually expounded by a lawyer. In trying to keep an early Chiropractor out of jail for “Practicing Medicine without a license”, he told the jury that Chiropractic was without drugs or surgery, so how could it be medicine? Do you really want to base your philosophy on a lawyer’s brief?

  15. Stefaan A.L.P. Vossen on February 11, 2011 at 17:28

    Fed up, fully agreed. There is one further discriminant I failed to add: “or the third episode with 2 week’s duration or longer within the space of 12 months”. I would also state to the surgeon that in my experience it takes a 3-5 year’s history of recurring low back pain before discal hernias would occur. This concurs with the experience of the neurosurgeon I regularly work with. The spinal dysfunction results in abnormal discal loading, which over time will result in physiological failure. In my opinion.

  16. Richard Lanigan on February 11, 2011 at 15:09

    Perhaps we should be focusing on the analysis rather than a time span.

    Pain or dysfunction becomes chronic because it was not dealt with adequetly in the early stages. So a major part of our art is the analysis and knowing where and when to do the adjustment. As chiropractors we know the body has an innate ability to heal and regulate itself and a subluxation may in fact be corrected if you were to go on a run or as BJ himself said if someone were to hit you with a shovel. The point is when people come into you you find spinal dysfunction/ subluxations and you clinical experience tells you how to correct them and when you need to check the spine again.

    Thats what we should be discussing as chiropractors sharing our experience learning from each other. The analysis and the correction is what makes chiropractic different from the biomedical model. The fact we dont use drugs to suppress symptoms and inhibit the healing process (Prosteglandin is part of the structure of new collagen) is central to the practice of chiropractic.

    Chiropractors must decide the kind of profession they want, as a profession there has to be certain principles which bring us all together. The GCC model or the US osteopathic model does not interest me, I decided two years ago the direction i was going to take and as yet few have followed me. I will continue to practice traditional chiropractic and for someone who has been stereotyped as someone who wanted to destroy chiropractic in the UK, I have presented a far more coherent and understandable model of chiropractic to the skeptics than any of the associations have.

  17. Fedup on February 11, 2011 at 13:45

    Hi Stefaan, your post reminds me of a lecture I attended by a neuro surgeon. He started by saying 90% of all back pain will resolve by itself in less than 6 weeks and he only sees people that have suffered with radicular symtoms for 6 weeks or longer. He then went on to show us a video of him at work performing a micro discectomy on a sequested disc. At the end of the lecture I tried to get his attention to ask him a question but he was ushered off. I did manage to catch him in the car park where I asked him “how many of your patients that you have operated on, had already had previous back pain that had self resoved in 6 weeks or less?” He thought and replied ” I expect all of them” ” so do you think an intervention that possibly may have dealt with the cause of the pain that had eased in the first 6 weeks may have prevented them from degenerating to a point where they need an operation?” He looked at me, smiled and said ” good point” got in his car and left.

  18. Stefaan A.L.P. Vossen on February 11, 2011 at 09:51

    Doesn’t prescribing medication strike you as odd for a chiropractor? I understood that as a chiropractor I am supposed to be looking for root-cause, correct the root-cause and let natural recovery take effect by virtue of a reduction of stress on the tissues secondary to having dealt with root-cause… Which means that the kind-hearted part of me is more than happy for a patient to take the necessary medication to see them through the rough patch of that process, but the reflective, “due-diligence” part of me as a chiropractor must beware of the serious possibility of me under-performing in my investigative and treatment duties courtousy of medication artificially reducing painlevels and inflammatory states… unless we are of course arguing that as a chiropractor we are not lead by subjective patient outcome measures… but I doubt any clinician can say that. Do I have anything against drugs? No, not at all, but then I am not interested in recent onset non-specific back pain with reasonable cause for onset. Why? Simply because it is not economical to entertain investigative and treatment protocols for something that had all reasonable chance to recover by itself. Is there a part to be played for the managment of such cases? Yes, but not by me because I choose to only get involved when there is clear indication that it is reasonable to assume that the pain and dysfunction won’t be going away by itself or where the cost of doing nothing outweighs the cost of doing something. Cost in what terms? Financial or human suffering? Many people have argued that it is cruel of me to let people who are in severe pain suffer. My argument is that there are plenty other people who have time and skills for that end of the spectrum and that I doubt that the speeding of recovery would be significantly greater than doing nothing, which is free. I also think that that is the bit where drugs can really be of benefit, but in order to be able to confidently identify those who need your care and those who don’t, there are two primary requesites: knowing what you’re doing and not having your judgment clouded by the bank breathing down your neck.
    As a final point on the latter: the clearer we are about what we do, the clearer the public will be. The clearer the public is about what we do, the more business we have. The more business we have the less the banks are breathing down our necks and the more we have a vested intrest in not entertaining work that doesn’t need to be entertained. Clinicians world-wide have entertained notions to expand their clinics and as Richard has said before, have sometimes done so in such distasteful manner that it has not only undermined their own reputation but that of their colleagues. The chiropractic profession is in my opinion vastly under-regulated and policed and we would in my opinion not even be having silly debates about prescription rights if we all were too busy dealing with the stuff we should be dealing with rather than entertaining cases that will get better by themselves.


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