National University Vows Support of Drug Expansion Efforts in Wisconsin

In a letter dated October 21, 2014 to Rod Lefler DC, President of the Wisconsin Chiropractic Association (WCA), Dr. Joseph Stiefel President of the National University of Health Sciences (NUHS) states that NUHS “fully supports your efforts to include the use of prescription drugs” in efforts to expand the scope of practice in the State of Wisconsin.

The release of the letter from NUHS follows closely on the heels of a similar letter sent to the WCA by Dr. Joseph Brimhall, President of the University of Western States.

The Wisconsin Chiropractic Association recently announced that it would seek scope expansion in the state to include drugs in a similar fashion as New Mexico by creating two classes of chiropractors and tiering the profession. Those prescribing drugs are called Advanced Chiropractic Physicians.

Similar to Brimhall who framed his support for drugs and scope expansion as supporting the “Good of the Patient”, Stiefel states that “. . .expansion of scope is “clearly in the best interest of patients economically and in their efforts to regain and maintain their health.”

Brimhall and other chiropractic drug supporters assert that such expansion would also allow chiropractic "physicians" to help patients avoid “unnecessary drugs and surgery”.  The notion that chiropractors help patients avoid so called “unnecessary drugs” was endorsed by several chiropractic leaders and organizations and incorporated into the Council on Chiropractic Educational Standards two years ago.

This was after the CCE removed “without drugs and surgery” from the definition of chiropractic in the accreditation standards.  The language of avoidance of “unnecessary drugs” was placed in as a compromise and ostensibly to allow the introduction of drugs into chiropractic while still maintaining compliance with the CCE Standards because, unlike medical doctors, chiropractors would only ever prescribe drugs that are necessary.

Stiefel asserts the “necessity for the chiropractic profession to shed old, unsupported ideologies and embrace current evidence and current research as the foundation for professional progress.”

Dr. Stiefel does not state what “old, unsupported ideologies” the profession needs to shed but the comment is consistent with Brimhall who asserts in his letter to the WCA that those institutions choosing to “restrict” their educational offerings by not including drugs do so based on “dogmatic precepts and/or philosophical tenets” and that such actions “interfere with the needs of patients”.

In his letter to the WCA Stiefel references two other letters apparently sent to the WCA regarding their decision to pursue scope expansion and drug rights. One was from Guy Riekeman, President of Life University and the other from Dennis Marchiori, Chancellor of Palmer, however the text of those letters is not provided.

Stiefel takes issue with the notion that the majority of chiropractors are opposed to the inclusion of drugs in chiropractic and in fact there is evidence from a study by McDonald from Ohio Northern University that 48% of chiropractors do want to be able to prescribe drugs.      

According to his bio:

“Dr. Stiefel always had a dream to someday practice medicine. His mother had been a thoracic surgeon and he'd fallen in love with medicine at a very early age. "I remember being very young and pulling down Grey's Anatomy and books on operating procedure from our bookshelf. I loved the acetate panels and the descriptions of surgery," he recalls. Following that dream, Dr. Stiefel decided on a career in chiropractic medicine in 2001 when he learned that the profession embraced primary care and allowed for residency training in the field of diagnostic imaging.”

Dr. Stiefler boasts in the opening to his letter that he is “President of one of the oldest and most established educational institutions offering the Doctor of Chiropractic Educational program”. In recent years however, NUHS has attempted to change the name of their program to “Doctor of Chiropractic Medicine”.

NUHS has even gone so far to suggest they would bypass the Council on Chiropractic Education to confer a post DC Doctor of Chiropractic Medicine degree.  

NUHS responded to professional concerns regarding United States Department of Education oversight of a “Doctor of Chiropractic Medicine” degree by asserting the CCE accredits its program and not the degree.

NUHS went so far as to query the regulatory boards in each state to determine which states would allow the use of the DCM degree by its graduates. According to NUHS, the majority of states would not have a problem with the DCM degree. 

Despite NUHS assertions that it is one of the oldest and most established chiropractic programs, according to IPEDS data from 2010 through 2013 their chiropractic program has seen a steady decline in enrollment.

The efforts to expand chiropractic scope of practice and include drugs and other procedures that are the practice of medicine are believed to be a response by schools to increase their declining enrollments and to increase practitioners' ability to generate additional income. Nevertheless they frame it as expanding primary care access to those in need.