Wisconsin bills allowing chiropractors to perform sports physicals puts student athletes at risk

Wisconsin bills allowing chiropractors to perform sports physicals puts student athletes at risk

Across the U.S., chiropractors are seeking to expand their scope of practice well beyond "spine care," up to and including promoting themselves as primary care physicians. Getting bills passed in state legislatures allowing them to perform sports physicals for student athletes is part and parcel of this effort. Two bills (Assembly Bill 260 and Senate Bill 232) pending in Wisconsin would force schools to accept sports physicals performed by chiropractors and would prevent schools from contracting with interscholastic associations that did not accept physicals done by chiropractors. The bills apply to both K-12 students and students at technical schools and two-year colleges. It is a testament to the importance of college athletics in Wisconsin that four-year colleges and universities are not included in the bills.

Chiropractors wanting to perform sports physicals would need a certificate from the state chiropractic board, but it would be solely up to the board to determine what "postgraduate study in performing health or physical examinations" would be required. Given the fact that courses in hotel conference rooms qualify chiropractors for "board certification" in pseudo-medical "specialties" like "chiropractic pediatrics" and "chiropractic internist," one has little confidence that these certificates would ensure a competent examination.

Fortunately, a broad-based coalition of medical and allied health professional organizations, as well as insurers and athletic organizations, joined forces to oppose AB 260 and SB 232. These include:

  • Wisconsin Medical Society
  • Wisconsin Nurses Association
  • Wisconsin Academy of Physician Assistants
  • Wisconsin Athletic Trainers Association
  • Wisconsin Interscholastic Athletics Association
  • Wisconsin Academy of Family Physicians
  • Wisconsin Chapter of the American Academy of Pediatrics
  • Children's Hospital of Wisconsin
  • Wisconsin Insurance Alliance
  • Wisconsin Primary Health Care Association

As these groups pointed out in a committee hearing on AB 260, a complete pre-participation physical includes a comprehensive evaluation of:

  • Cardiovascular conditions
  • Appropriate immunizations
  • Growth and development
  • Mental and behavioral health
  • Laboratory testing
  • Hearing and vision screening
  • Anticipatory guidance related to adolescent risk-taking behaviors
  • Health education

While annual exams are recommended for all children from birth to age 21, the groups says, the rate drops off dramatically as children age. This means the sports physical may be the only opportunity for a thorough physical exam the child gets .Of special concern is the risk of sudden cardiac death and the recognition and treatment of concussions. Chiropractors, they point out, simply do not have the education and training to competently perform thorough physicals, a subject SFSBM's own Harriet Hall, MD, herself a retired family practice physician, thoroughly covered in her Science-Based Medicine post: Sports Physicals, Sudden Death, and Chiropractors.

These are certainly legitimate concerns, but there are more reasons to oppose these bills. Not only is chiropractic education and training woefully inadequate to the task, their practice is filled with subluxation-based pseudoscience. Chiropractors "specializing" in pediatrics are among the worst offenders. They tell parents that "birth trauma" can cause the mythical chiropractic "subluxation" and that children must be periodically "adjusted" for good health. There is no evidence that chiropractic manipulation is effective for any pediatric disease or condition, yet chiropractors regularly advertise it as effective for colic, ADHD, asthma and bedwetting, among others.

Chiropractors are also notoriously anti-vaccination. A study published in Pediatrics just last year adds to the growing body of evidence that this ideology is being imposed on pediatric patients, in the form of lower vaccination rates for influenza. Authors of the study, Complementary and Alternative Medicine and Influenza Vaccine Uptake in US Children, analyzed the data from around 9,000 children from the 2012 National Health Interview Survey (NHIS), looking at influenza vaccination uptake among those children who had ever used, among other forms of CAM, alternative medical systems ("AMS;" e.g. naturopathy) and manipulative and body-based therapies ("MBBT;" e.g. chiropractic manipulation).

The authors found that children who had ever used AMS or MBBT had lower odds of influenza vaccination. They reasoned that, since the second most prevalent type of AMS is naturopathy and the most prevalent type of MBBT was chiropractic or osteopathic manipulation, use of these specific types of CAM

"may require contact with CAM practitioners shown to have vaccine-critical viewpoints, advise against vaccine, or advise vaccine schedules different from those recommended by the federal government."

SB 232 has been referred to the Committee on Health and Human Services. AB 260 is already before the Assembly. Fortunately, amendments (here and herehave been introduced eliminating that portion of the bill allowing chiropractors to perform sports physicals. The amendments are sponsored by Rep. Debra Kolste, who holds a B.S. in medical technology and formerly practiced as a medical technologist.

Chiropractors are not competent to perform sports physicals, but this is not the only reason to oppose these bills. Chiropractic treatment in general, and chiropractic pediatrics in particular, is filled with anti-vaccination ideology and bogus diagnoses and treatments. In putting the state's imprimatur on chiropractic treatment of children, the Wisconsin Legislature simply making them and their parents easy marks for bogus chiropractic healthcare. 

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