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ISSUE 2 March 31, 2012
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| Greetings! |
 Welcome to the second edition of the "ICA In Action" newsletter. The last issue focused on the need for reform at CCE. This issue will begin the process of addressing the prescription drug debate and the many tangential issues involved (primary care, nutrition, functional medicine, formularies, injectables, scope of practice statutes, chiropractic medicine, primary care physician and the stay order in New Mexico). Also included is an update on the CCE stakeholders meeting as well as a response to an inquiry regarding "spin" in the recent reporting on CCE. Check it out in the E-mails to the Editor column. Last week the Supreme Court heard oral arguments related to constitutional challenges to the implementation of the PPACA legislation ("Obamacare"). The ICA is sponsoring Life University's 2012 Octagon Conference on Health Reform on April 12-14, 2012. Consider joining me in Marietta, Ga., for a complete and thorough review of the elements of reform including the potential impact of the future Supreme Court ruling. Click here for additional information. Every two to three weeks I will attempt to inform, educate and assure you that the ICA is working on your behalf to "Advance chiropractic throughout the world as a distinct health care profession predicated upon its unique philosophy, science and art."
As the ICA continues to increase its involvement in state, national and international events I hope to keep you informed as to the "what, where and whys" behind the ICA actions. I look forward to your feedback. Dr. Steve Welsh Secretary/Treasurer ICA |
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 Chiropractic Board Defies New Mexico Appeals Court
|  I recently paid a visit to the "Land of Enchantment" and the site of a political battle the likes of which the Chiropractic profession has not seen for decades. On one side, a stubborn Board of Chiropractic Examiners continues to insist that they have sole jurisdiction within the chiropractic profession over a series of injectables including IV therapies. On the other side, the ICA, the New Mexico Medical Board, the New Mexico Pharmacy Board, the General Counsel for the New Mexico Regulation and Licensing Department and most recently a 3 judge panel of the New Mexico Court of Appeals have indicated otherwise ( click here to review the court order). If you really think that the issue is "Primary Care", I would like to offer the following observations: During the last public hearing the NMBCE added the "Grossman Wellness Center" as an authorized provider of continuing education. (Training for IV Therapies.) Here is what that Grossman Center says about some of the proposed injectable procedures for which the ICA requested a stay: "Most complementary intravenous therapies remain outside of mainstream medical practice. Pharmaceutical companies are not interested in these therapies since most utilize unpatentable drugs, so there have not been adequate studies done to prove their effectiveness. Due to the controversial nature of the therapy, we do not actively advertise or pursue business in this area." ( Click here for more information regarding these IV procedures) I have a simple question ... Is the incorporation of controversial medical procedures, that do not have "adequate studies" (not evidenced based), to be performed by "advance practice" chiropractic primary care providers in New Mexico, without appropriate training and certification from the medical profession, really in the best interests of either the patient or the profession? "Nuf Said" |
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The Drug Issue ... Is It All About Nutrition?
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I recently came across an anonymous blog written in 2011 by a relatively new graduate of a chiropractic program. After reading many of the entries I had to ask myself: What are they teaching in some of our schools? After reading the excerpts provided below please ask yourself the following question: Is this the future of our profession as envisioned by CCE? It would certainly explain some of the recent changes in the standards.
Excerpts From A New Graduate's Blog:
I despise the word "subluxation".
Yes, I'm a DC (Doctor of Chiropractic) myself. Do I have a vested interest in promoting chiropractic? Not exactly, simply because I don't do spinal adjusting (all of my work revolves around Functional Medicine ... Yes, it's true: not every DC touches the spine. No, we're not being sacrilegious or wasting our chiropractic degree; we're just choosing to utilize different parts of our education and develop a different skillset.
The fact that I don't diagnose and treat nonmusculoskeletal conditions, for all practical purposes, probably hangs in nothing more than pure vocabulary technicality.
Repeat after me: Thou Salt Not Use Thy Words "Treat", "Treatment", or "Cure" (at least until we have taken some clues from the DOs and merged with the accepted medical profession).
A Word to the Wise
(From the Editor)
Many of the elements of the practice of Functional Medicine have tremendous potential for both the doctors who employ the principles in their practice, and the patients who follow a path towards natural health. There is, however, a big difference between applying those principles to good eating habits, proper exercise, and nutritional supplementation in order to promote health and applying those principles to diagnose and treat disease. Make sure you understand the scope of practice in your state.
There are very few states that allow a DC to practice medicine in any form. |
New Mexico Court Grants ICA Stay |  Acting on behalf of concerned members in New Mexico and out of concern for the integrity and credibility of the chiropractic profession at large, on November 14, 2011, the International Chiropractors Association (ICA) filed a notice of appeal with the New Mexico State Court of Appeals directed at specific questionable actions of the New Mexico Board of Chiropractic Examiners. On December 21, 2011 the ICA next filed an extensive memorandum in support of a motion to stay (click here to read the ICA filing ) what is being held to be illegal actions on the part of that state's Board of Chiropractic Examiners. On February 15, 2012 the Court of Appeals granted the Stay requested by the ICA. The legal effect of the Stay of the proceedings means that the disputed 2011 Chiropractic regulations are not in effect or to be utilized by any New Mexico Licensed Chiropractor subject to a final Court Order.
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CCE Meets With Stakeholders ... To Tell Them How It Is |
On Friday March 16, 2012 the CCE held the much anticipated Stakeholders Meeting in Las Vegas in conjunction with the Annual ACC-RAC Conference. The ICA was represented by Dr. Gerry Clum. It has been reported that members of the Chiropractic media were ejected from the meeting before it started on the basis that they didn't qualify as stakeholders per CCE's definition. After initial introductions and a review of the status of the 42 citations of non-compliance, the CCE announced that the provision added by NACIQI at the December 14, 2011 hearing had been removed. Click here for a full report from Dr. Clum on the meeting. |
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E-mails to the Editor
"What is the truth...no spin please"
This is a follow up letter...from the ACA...is this accurate - or close? | |
A Concerned Chiropractor wrote:
"When I circulated your (news)letter among my colleagues I received this back from a high ranking NY state rep... "As I understand it, the ICA and cohorts were the primary parties who took issue with most if not all of CCE complaints. The ACA was one of the CCE supporters realizing what would happen to chiropractic if CCE was disbanded. In a ruling this weekend, the Secretary overruled the panels decision and gave no credibility to a small and concentrated voice of objection. The ACA will have additional postings explaining the decision and what it means."
"What is the truth...no spin please." and then e-mailed again with ..."this is a follow up letter...from the ACA...is this accurate - or close?
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Dear Concerned Chiropractor:
Some of it is accurate ... some of it is not... . The statement that "...there were several speakers opposing CCE's federal recognition... " is very misleading. Attached is a copy of the 350 plus page transcript. The CCE hearing begins at about page 107 and ends around 300. 3rd party comments start at about page 120 and end at about page 243. You are hereby challenged to find a single commenter that said they were opposed to CCE retaining federal recognition.
Click here to read the official report of the meeting. It, in summary, stated that: "Commenters expressed concern with the agency's most recent review of its standards and their disagreement as to what terminology should be included in the chiropractic standards. They also alleged a lack of inclusiveness and unwillingness by the agency to address the concerns of the commenters... positive comments supported the agency's medically-based approach." The most fundamental issue is whether the apparent move into a "medical model" approach to chiropractic and the deletion of chiropractic specific language ( i.e. "without drugs and surgery", "subluxation") "has wide acceptance" in the chiropractic community. It is the ICA's concern that it does not.
Spin statements included in your referenced letter are highlighted in red and numbers are placed where comments will be provided.
The follow-up letter from the ACA that you asked for comment on is:
"Lastly, I wanted to tell you about the CCE stakeholders meeting held in conjunction with ACC-RAC. There were 37 attendees in a closed meeting that included representatives from most of the profession's organizations and colleges. The meeting was chaired by Dr. Craig Little, CCE chairman. (1) The meeting began with a review of a letter dated March 15, 2012, from Eduardo M. Ochoa, assistant secretary for postsecondary education. (2) The letter reminded CCE that it needed to comply with a number of issues as determined by Department of Education (DOE) staff and following a public hearing during the process of gaining federal recognition. (3) While most were simple procedural issues, there was the one that got all the press. (4) Item 602.13 stated that CCE must improve its communications with stakeholders as it develops its standards and policies. If you recall, in the December hearings there were several speakers opposing CCE's federal recognition. However, (5) Mr. Ochoa determined last week that those opposed were from the same organizations but speaking individually and representing a "minority of the profession". As a result of his findings, Mr. Ochoa reversed the decision made following the December hearing. A letter to CCE from Mr. Ochoa stated that: "I disagree with NACIQI's concern about lack of wide acceptance of the agency's standards in the field. The dissenting voices in my judgment are a small minority within the profession. Generally, I agree with the arguments presented by the agency in this regard. Accordingly, I am not requiring that CCE address 34 C.F.R. 602.13, or how the agency's standards advance quality in chiropractic education, in its compliance report." (6) The tone among those who want significant change in CCE changed after they saw the letter from Mr. Ochoa during the meeting. While CCE could have ended discussions at that point they chose not to. In fact, to Chairman Little's credit he encouraged conversation on all topics on the agenda (7) as if he still had to comply legally. In addition, he has agreed to set up multiple stakeholder meetings per year to keep communication with the profession as open as possible. The topics on the meeting's agenda were across the board. They included the election process of CCE's leadership, CCE's governance, subluxation, drugs and surgery, transparency, primary care, etc. CCE was well prepared, and in my view showed that (8) the legitimate issues that were present in the past were not nearly as pressing now. There appeared to be genuine agreement throughout the room to leave the past behind and move forward with ALL segments of the profession as active participants. (9) While we may see different organizations file reports on the meeting in a different light, I firmly believe (10) CCE is doing everything it can to be the best they can be. As I've stated before, (11) CCE is a vital organization to our profession and (12) ACA will do everything it can to help the council when improvement is needed and acknowledge their good work when that is appropriate as well. If you would like a copy of the March 15 letter from DOE to CCE, please let me know."
Response from the Editor:
While most of the communication is accurate there are a number of statements that seem to have varying degrees of "spin". Please research those areas and draw your own conclusion.
(1) SPIN: It was reported by one of the attendees that Dr. Little opened the meeting by asking the attendees to introduce themselves and to relate their affiliation. Dr. Little then discussed requests for the meeting to be recorded. He advised the group that the Executive Committee of the CCE had rejected the request. The rationale was that recording the event would interfere with the desire for a frank, open and honest discussion. Following the recording discussion Dr. Little provided an update on the concerns expressed by the NACIQI staff. A description of the 42 issues already addressed was presented: 18 of the 42 concerns had been addressed by five policy changes; 8 were related to policy manual revisions; 7 were related to minor administrative revisions; 3 would be addressed by Standards revisions; 2 by additional training; 2 with committee work and the final 2 with revisions of the program characteristics report. This seems to be a repeat of the information presented at the CCE Public meeting in January. After a discussion relating to the nature and complexity of dealing with the remaining concerns Dr. Little then presented the letter dated March 15, 2012.
(2) TRUE: Except that a "number of issues" as stated seems to imply a few ... the number, as previously stated was 42.
(3) SPIN: Although it is true that many of the issues were "procedural" and related to new regulations, there were a number of issues that were significant. Click here to read a copy of the staff report. It is suggested that you read it and come to your own conclusion.
(4) SPIN: The requirement deleted by the Assistant Secretary did not say "... that CCE must improve its communications with stakeholders as it develops its standards and policies." It actually stated that "In addition to the numerous issues identified in the staff report, NACIQI asks the agency to demonstrate compliance with Section 602.13 dealing with the wide acceptance of its standards, policies, procedures, and decisions, and to address how its standards advance quality in chiropractic education." The statement included NO reference to improving communications.
(6) TRUE: Concerned organizations considered the requirement that was deleted to be a key to obtaining requested reforms.
(7) SPIN: The CCE is still expected to comply with regulation 34 C.F.R. 602.13. The letter only removed the requirement to submit a report demonstrating compliance. Unfortunately the letter also removed the requirement to submit a report demonstrating that the new standards will improve chiropractic education.
(9) TRUE: As already indicated
(10) SPIN: This does reflect the CCE's opinion of itself ... and of course that of the ACA.
(11) TRUE: All concerned organizations agree.
(12) SPIN: I have yet to see a single public acknowledgement by the ACA of the need for reform and/or improvement at CCE ... if you find one please send it to me ... ALL public statements from the ACA have stated that CCE was in essence doing a superb job. Click here to read the letter that the ACA will "provide on request". Please read it and come to your own conclusion.
I hope this addresses your questions adequately.
Dr. Steve
Please contact me with your comments or questions at icainaction@mindspring.com . |
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The ICA continues to strive to advance chiropractic throughout the world as a distinct health care profession predicated on its unique philosophy, art and science on a daily basis. I sincerely hope that the "ICA In Action" newsletter will assist you in combating the mis-information campaigns that have begun to proliferate as the ICA continues to increase its efforts to defend chiropractic.
Sincerely,
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Stephen P. Welsh, DC, FICAInternational Chiropractors Association
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