Chiropractors down 1-9 in bottom of the ninth

Chiropractors down 1-9 in bottom of the ninth

The 2015 legislative sessions have ended in many states and others are drawing to a close in June. (Some legislative sessions are longer and a legislatures meet year-round, but we're not concerned about those here.) Chiropractors, as is usual, had a number of practice expansion and other favorable bills introduced across the country. So far, nine didn't pass and one remains pending, but only by the skin of its teeth. One bill unfavorable to practice expansion didn't pass, giving chiropractors their sole victory for this season. 

First, the win: In a rare pushback against chiropractic scope expansion, a bill was introduced in Idaho repealing a rule of the state Board of Chiropractic Examiners allowing chiropractors to prescribe, sell and compound vitamins, minerals, herbal medicines, homeopathic remedies and glandulars. In case you aren't familiar with glandulars, they are made from animal organs sourced in slaughterhouses and are prescribed by naturopaths and chiropractors for fake diseases, such a "adrenal fatigue," and other uses. In addition to the gigantic "ickiness" factor, they are unsafe and pose a risk of contracting "mad cow" disease. Unfortunately, the bill didn't pass.

Now for the losses. 

Chiropractors failed in other attempts to expand their pharmacological repertoire. New Mexico, where they already have limited drug prescription rights, refused to go further on their earlier ill-considered practice expansion.  At its extreme, under this bill a chiropractor, with some additional training that doesn't even begin to match an MD or DO family practitioner, could inject and dispense all dangerous drugs (as defined in by state law), except Schedule I and II controlled substances, used in standard primary care practice.  Arizona also rejected a bill which would have allowed chiropractors to prescribe, although with a much narrower formulary than New Mexico.  Although it didn't include prescription drugs, the Hawaii legislature rejected a bill allowing chiropractors to employ "clinical nutritional methods." Translated from this vague legislative language, this would mean chiropractors could use bogus nutritional testing and prescribe and sell dietary supplement to patients based on non-existent nutritional "deficiencies."

These attempts were sometimes coupled with an effort to expand the scope of practice in other ways -- ways that look suspiciously like the national effort to rebrand chiropractors as "primary care physicians." Both the New Mexico and Hawaii legislation included language which would have defaulted to the chiropractic colleges to determine the scope of practice. In New Mexico, a chiropractor could diagnose and treat any condition for which he has been "educated and trained." In Hawaii, a chiropractor would have been able to order diagnostic and lab testing, as well as any other method of diagnostic exam, as long as it was taught in chiropractic college and approved by the state chiropractic board.

Other means of boosting their efforts to refashion themselves as primary care providers are more subtle. In Wyoming, an attempt to allow the use of the term "chiropractic physician" didn't pass. Hawaii's more expansive bill also included the right to use the term "physician." In Virginia, a bill was introduced allowing chiropractors to perform physical exams for commercial drivers licenses, and in Nebraska, to perform physical and eye exams for school children. Neither of those passed.

In Texas, chiropractors are limited to diagnosing and treating "biomechanical conditions of the spine." An ingenious bill added "or the condition of another system of the human body that is affected by the musculoskeketal system" to both the scope of diagnosis and treatment. Since chiropractic "theory" teaches that "nerve interference" caused by the non-existent chiropractic "subluxation" is the source of many diseases and other conditions, and that adjustments of these subluxations will remove this "nerve interference," the bill would essentially allow chiropractors to "adjust" the spine for all manner of patient complaints. This failed as well. 

Mississippi currently allows chiropractors to use x-rays in detecting the mythical subluxation. Chiropractors wanted to expand the means of discovering this phantom condition with any "radiologic technologies" necessary for their services. Fortunately, they won't be able to subject patients to unnecessary radiation with PET scans, CT scans, MRIs and the like because the Mississippi legislature didn't pass their bill.

Arizona protected its animals as well as its humans this year. A bill was introduced permitting animal chiropractic, or, as we prefer to view it, wholly unnecessary torture of innocent beasts by their owners, who have been bamboozled into thinking that "adjusting" the spines of their dogs and cats (and maybe snakes and rabbits -- who knows?) will prove beneficial.  Perhaps the lack of sufficient education in anatomy and neurology can explain why chiropractors think this is possible. For veterinarians, who could also employ animal chiropractic with additional "training," it is unforgivable. Fortunately, Arizona pets are safe for another year. 

One final shot remains for the chiropractors, in Louisiana. The Senate passed a bill removing restrictions on performing and ordering diagnostic imaging and changing the definition of chiropractic practice from diagnosing and treating conditions "associated with the functional integrity of the spine" to diagnosing patients to determine "conditions related to the function of the neuromuscular or musculoskeletal system." It also allows chiropractors to counsel patients regarding "health, wellness, diet and nutrition," leading the way to bogus diagnostic tests used to sell dietary supplements. But they'd better hurry! Monday, June 8, is the last day to pass legislation, and the Senate bill is now before a House Committee. 




Points of Interest 06/08/2015
Points of Interest 06/05/2015

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