Dry Needling: Florida Chiropractic Association Seeking Declaratory Ruling to Expand Scope
CLICK HERE for a copy of the FCA's request
The request is listed on the Agenda for the FBCM Board meeting being held on August 17, 2023, at 8:30 A.M. which is being held at the Holiday Inn Disney Springs 1805 Hotel Plaza Boulevard Lake Buena Vista, Fl 32830.
CLICK HERE to view the website
Michael Roberts DC is also Past President of the Florida Chiropractic Association and a current member. Not only is Roberts already performing incisive surgical procedures by needling citizens of Florida, he claims on his website that the Florida Board has "certified" him to do so stating:
"Our chiropractor is certified by the Florida Board of Chiropractic Medicine and will assess your condition to determine how you will benefit from this treatment option"
Roberts is not alone in violating the Florida practice act. The FCA includes 8 letters from chiropractors encouraging the FBCM to expand the scope and allow dry needling with two of them already performing the procedure according to their websites: Jessica Stranman DC and Steve Muscari DC. Perhaps their memberships in the FCA protect them from Board actions.
The crux of FCA's argument attempting to justify the use of an incisive and combative procedure is that "dry needling is included in Florida’s scope of practice by the inclusion of manual therapy and physiotherapy in Section 460.403(9)(c)1, Florida Statute"
The FCA specifically and unequivocally declares that the use of dry needling is not acupuncture.
The FCA claims that: "It is logical to conclude that considering PT's and AT's may both perform manual therapy to include dry needling, so, too, can Chiropractic Physicians perform dry needling as a type of manual therapy."
In a round and round circle of distorted reasoning the FCA argues:
"Because dry needling is now specifically incorporated into the physical therapy scope of practice and because physical therapy or physiotherapy is included in the chiropractor’s scope of practice, by inclusion it is likewise included within a chiropractor’s scope of practice."
What the FCA fails to point out is that while Florida citizens may go directly to a physical therapist without a physician's referral and receive treatment for 30 days, the fact is that after 30 days, the therapist will need to get a treatment plan signed by an approved healthcare provider. And Athletic Trainers operate only under a physician's supervision.
The FCA also leaves out any mention of relevant language in the statute that specifically disallows surgical, incisive and combative procedures.
The Florida Statute states chiropractors are prohibited from performing surgical procedures:
"Chiropractic physicians are expressly prohibited from prescribing or administering to any person any legend drug except as authorized under subparagraph 2., from performing any surgery except as stated herein, or from practicing obstetrics."
In Florida, "surgery" is defined as any manual or operative procedure performed on a living human body. Surgery as defined in Florida also includes the removal, incision, or curettage of tissue or an organ, insertion of natural or artificial implants, electro-convulsive therapy, endoscopic procedure, or other procedure requiring the administration of anesthesia or an anesthetic.
If that doesn't make things clear then certainly the declaration in the statute that chiropractic is "non-combative" makes things crystal clear:
"Practice of chiropractic medicine means a non-combative principle and practice consisting of the science, philosophy, and art of the adjustment, manipulation, and treatment of the human body in which vertebral subluxations and other malpositioned articulations and structures that are interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated, or treated, thus restoring the normal flow of nerve impulse which produces normal function and consequent health by chiropractic physicians using specific chiropractic adjustment or manipulation techniques taught in chiropractic colleges accredited by the Council on Chiropractic Education. No person other than a licensed chiropractic physician may render chiropractic services, chiropractic adjustments, or chiropractic manipulations."
In the context of the statute from Florida that the FCA provided, the term "non-combative" refers to the approach and philosophy of chiropractic. It means that the practice of chiropractic is not aggressive, antagonistic, or combative. Instead, it emphasizes a gentle and non-aggressive approach to healing and treating the human body.
In this context, "non-combative" underscores that chiropractic does not involve invasive or aggressive techniques, but rather focuses on adjustments of the human body to restore the normal flow of nerve impulses and promote overall health. The statute outlines that chiropractors use specific techniques to adjust and manipulate the spine and other structures to alleviate conditions arising from malpositioned articulations, with the goal of restoring normal nerve function and health.
This term highlights the non-surgical and non-invasive nature of chiropractic practices and distinguishes them from more aggressive or invasive medical procedures.
Non-combative is a term that is commonly used to describe a peaceful or non-aggressive situation. Synonyms for this word include bloodless, non-violent, peaceful, calm, harmonious, passive, gentle, placid, tranquil, and pacifist.
None of these can be considered applicable in the case of piercing the human body with a needle and dry needling cannot rationally be argued to be a method to reduce vertebral subluxations.
The FCA is no doubt hoping that the Florida Board of Chiropractic, which is now controlled by a majority who are dues paying members of the FCA and one is a Past President, will look past all of the obvious statutory roadblocks and instead focus solely on the use of the term "manual therapy".
This attempt by the FCA and the Florida Board to expand the scope of practice is just the first step for the board which is made up of a majority of members who belong to a single trade association in the state and that trade association has long pushed for expanding the scope of practice for chiropractic in Florida.
Recently, we reported that the Florida Board of Chiropractic Medicine was looking to expand the scope of practice to include drugs. According to Board member Anthony Oliverio DC this expansion includes: injectables, muscle relaxers, steroid packs, dry needling and trigger point injections.
CLICK HERE for that story
The final "connect the dots" on this latest effort to move chiropractic into the lane of medicine through scope expansion is that attorney Kimberly Driggers, J.D. who practices law in Fort Lauderdale, Florida and serves as the Assistant General Counsel for the Florida Chiropractic Association is the person who has submitted the request to the FBCM to expand the scope of practice. Driggers just also happens to serve on the Board of Directors for the National Board of Chiropractic Examiners (NBCE) which she has done since 2019.
