Every two weeks, if you choose to, you can read my thoughts on various issues relevant to chiropractic and the profession. You may not always agree, but it should give you some food for thought. With all of the current concern about what has been termed the "orthopractic movement," it is time to present my opinion on this issue in no uncertain words.
One of the most disturbing events to occur in recent chiropractic history is the question of portal of entry for chiropractic care. The history of chiropractic has been fraught with battles for the right of DCs to have direct access to treat the public. So far we have been successful, but the orthopractic movement seems to want to destroy that position.
According to the Patient Guidelines for Spinal Manipulative Practice, published by the Orthopractic Manipulation Society (OMS):
"By definition, an orthopractor is a 'self-limited specialist' whose discipline does not include general healthcare."While the orthopractic guidelines state that orthopractors have "direct access to patients," they state: "Any and all specialist treatment should be with the full knowledge and CONSENT of your family physician." (emphasis added).
But how does this really work?
When Consumer Reports presented their "investigation" on chiropractic, their recommendations were:
"If you are thinking about going to a chiropractor for back pain, proceed with caution and follow these guidelines.Just think, if the MD says your services are needed, the Orthopractic Manipulation Society may recommend you if: 1) you're a member; 2) if your phone conversation goes well; 3) and if you don't say you do any of the following:"See your physician first"
"Get a referral from a reliable source" (the National Association for Chiropractic Medicine or OMS).
"Have a chat on the phone."
"Watch for the warning signs."
Use x-rays to diagnose*
Manipulate children
Believe in the subluxation complex
Treat holistically
Use homeopathy
Use nutritional health care
Are against surgery
Use chiropractic for disease prevention
And many other "non-scientific" practices
If you pass the test, you could be allowed to see this patient!!
Interestingly enough, physical therapists can also becoming "orthopractors." The good news is that they will finally achieve equality with some chiropractors. The bad news is that they must sacrifice the possibility to have direct access to patients.
Looking at who is behind the "orthopractic" movement, you may recognize two of the names:
Charles DuVall, DC -- If you haven't had the pleasure of having Dr. DuVall review a reimbursement claim, you may have seen his very critical comments on "CBS Eye on America," the recent "20/20" hit piece, or his comments in an article in Pediatric Management.
Murray Katz, M.D. -- testified against chiropractic before the New Zealand Commission. He also made critical comments in Pediatric Management, and on "20/20."
Some believe that Dr. Katz worked as a consultant for the Consumer Reports article that endorses the Orthopractic Manipulation Society (please see "Consumer Reports Tackles Chiropractic" beginning on the front page of this issue). One of the reasons for this conjecture comes from the 23rd chapter of the report by the New Zealand Commission on chiropractic** which states:
"We would add this. Dr. Katz told us that he believed he had been instrumental in influencing the views of Mr. Joseph R. Botta, who is the executive director of the United States Consumers Union, and that the union's report on chiropractic (see Chapter 21) contained in the September and October 1975 issues of its magazine (Consumer Reports) had been materially influenced by Dr. Katz's views.Only a traitor would give up chiropractic to become an "orthopractor." Only an idiot would give up patient access.
Less than one year ago, many DCs were calling us, frightened out of their minds over the Clinton health reform bill. Most hadn't read it. Instead they became the chiropractic equivalent of Henny Penny. Chicken Little told them the profession was doomed, and they believed it.
Yes, the world is changing. Yes, you will have to adapt.
It is my belief that the "orthopractic movement" is preying on the fears of uncertainty. There is no magic in becoming subservient to the medical profession. There is only the tragedy of betraying your profession and yourself.
------------------------- * Taken from the orthopractic guidelines and other OMS literature
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
