Hello ICA~I Members and Chiropractors at Large,
Did you ever hear about the Wilks lawsuit where Chiropractic won against the powerful American Medical association's attack to "get rid" of the Chiropractic Profession? It went all the way to the Supreme Court! Did you think that was the end of it? Do you think Chiropractic is "safe"?
Right now with the American Chiropractic Association's "Choose Wisely" program which has been positively viewed by the CCE, NBCE, COSCA, the WFC, and several others (which is linked as are others) resulting in a restriction delegated for the acceptance of Chiropractic by the mainstream medical system. No, Wilksdidn't beat us, but if we submit to medically suggested parameters when we very well know already aren't working for them, all for the "inclusion" due to medical acceptability, we are doomed as a profession.
Let's review our perspective as a Chiropractor against what the "Choose Wisely" protocols suggest:
1. The Practicing Chiropractor's Committee on Radiology Protocols (PCCRP) to which both International Chiropractors Association (ICA) and the separate and distinct group of the International Chiropractors Association of Indiana (the Indiana State Association known as the ICAI) adopted these protocols as a guide for appropriate use of Chiropractic Radiographs in patient care. Whereas we as a Profession of Licensed Doctors in all 50 States for the purposes of detecting and correcting the subluxation (vertebral and extremity in Indiana per State Law) are within our Professional Scope of Practice to take x-rays beyond the medical oriented parameters suggested in #1 of the "Choose Wisely" document. We as Chiropractors do not dictate to the medical profession the number of MRI's, CT scans, Ultrasounds on fetuses, etc. regardless of their potential harmful effects to the patient and so therefore feel that any deviation from the PCCRP guidelines to "fit in" creates a problematic stance. National "statutes, rules, and regulations concerning the practice of Chiropractic DO NOT explicitly limit the use of x-ray examinations to cases where "RED FLAGS" are present." Furthermore "some courts have explicitly upheld the use of Chiropractic x-rays to detect or determine the presence of spinal subluxations". [These two quoted statements are from the PCCRP guidlines.] The nature of our craft entitles us to have the diagnostic ability to aid in the health, wellness, and structure of our patients in order to offer them a vast expression of their vitality for life.
2. Although in premise we can agree that radiographic analysis is necessary for assessment of scoliosis and its progression, other areas also in fact necessitate the use of routine radiographs. Postural distortions that persist, tissue remodeling, degenerative spinal conditions, osteophytic anomalies, etc. are diagnosed and evaluated frequently based upon deterioration or reduction of positive progress with the Chiropractic applications when referencing the PCCRP guidelines. As only roughly 70% of bone is viewed on x-rays at any given time, progression of issues such as osteophytic bridging may be vital information for the practicing Chiropractor. Persistent pain may be a sign of premature Ankylosing spondylitis as seen with HLB27 in teens and in fact can be a reason for follow-up radiographs for non-responding long term low back pain. According to these so-called guidelines of the "Choose Wisely" program; " There is currently no data available to support a relationship between changes in alignment or other structural characteristics and patient improvement." I will submit my own study that has never been done in over 100+ years of Chiropractic related to outcomes assessed by a Roche scientist of 30 seconds of active gait pre and post Chiropractic adjustments. There IS a relationship and our office proved it (CLICK HERE)!
3. This section suggests as follows: Passive physical therapeutic modalities are defined as those interventions applied to a patient with no active participation on the part of the patient. These include heat, cold, electrical stimulation and ultrasound." Your practice parameters that YOU choose as a treating Doctor of Chiropractic are being dictated on how to practice AND eliminated per "Choose Wisely". The Physical Therapists have not been happy about D.C.s usage of their tools in our arena for years. Many are not aware that it is now illegal for Indiana Chiropractors to advertise that they do Physical or Physio-therapeutic procedures in their office by website or other means! It is no coincidence that as of 2019 this is the case and that the "Choose Wisely" program echoes the message! Do we honestly think that this will strengthen Chiropractic as a Profession by submitting to the will of those who want to feel included in the medical model? There is a concerted cohesive force that is in process of taking your right to practice as if a frog on slow boil in a pot! You may also NOT be aware that the ICAI was who stopped the mandate of HB 1384 which became law that could've removed your right to dictate legislation of your own profession in the State of Indiana! The "other State Association" was totally on board to give your rights away! This Internationally organized plot to take over your right to legislate has become successful in several States across the US! It almost happened in Indiana too but for the ICA and the ICA-Indiana (your Indiana State Association)!
4. Further reading of this document also suggests: "There is a high probability that any person with a chronic pain syndrome has a concomitant psychological disorder, most notably depression and/or anxiety." Think about how many of your patients are "chronic"? Most of them, right? Why you may ask? Well, how about the over prescription of opiods for one? By the time many of our new patients come in, they ARE chronic and already hooked on prescriptions! Yes, Medicine historically failed mankind. So, the "Choose Wisely" response is rather than correct your patients subluxation to restore their vitality as a human being and potential reduction of drug usage, we are relegating them to a psych profiler! What typically is THEIR solution; more drugs for their pain, right? If we as a profession "ChooseWisely", how exactly are we "helping" people? Ask yourself how many people you have restored their light after a solid adjustment!
5. "The prolonged use of lumbar supports is not supported by the literature for the treatment or prevention of low-back pain." and " the patient must engage in an active rehabilitative regimen to achieve the best outcomes." Okay, scoliosis braces for chronic issues are used all of the time by the medical establishment. And, doesn't it look like they want us to either BE or REFER to a Physical Therapist? I guess that this could be considered "playing nice". Nonetheless, the end result is the same, weaken the Chiropractic Profession from within to "fit in"!
Here's the deal my fellow Chiropractors; we need you to become involved! Whether it be State or International ,Chiropractic is at risk for falling into traps made by our own people! In the rollout of the last Indiana Chiropractic legislation regarding scope of practice, do you know that it was the ICA-I that added to Law that WE Chiropractors now legally have the right to affect neuro-immunity? THIS IS HISTORIC! We may be the ONLY State Nationwide to have this in our Law! How do we do that? We detect and correct the Subluxation my friends. The very thing that is being suggested to be REMOVED is the term SUBLUXATION from Medicare Law as you read this letter! There IS more!
In Australia the right to treat Children is at risk! In Canada the right to express your opinion about Vaccines IS Illegal which strips you of your license to practice! In Spain, Chiropractic is NOT recognized, and is being hijacked by non-chiropractors and may be subservient to the Physical Therapists as it may be placed under the guidance of the PT Board! Chiropractic is again under attack! Will you help one, the other, or both associations today? Or, will you wait until it's too late? Become a member of the ICA-I TODAY!
Dr. Todd McDougle, D.C., F.I.C.A.,