Arizona Association of Chiropractic Pushes Advanced Practice Certification & Injectables
Move Seeks to Expand Scope & Tier Profession
The Arizona Association of Chiropractic (AAC) has submitted a formal proposal asking for an expansion of the scope of practice to allow chiropractors to take a few hundred hours of extra classes and receive a certificate to be an Advanced Practice DC. The proposal uses New Mexico’s Advanced Practice certification as an example that other states are moving in this direction.
Chiropractors who get the Advanced Certificaiton would then be allowed to prescribe homeopathic medications, orthomolecular therapy and natural substances orally or by injection and IV.
The proposal by the AAC tell sthe legislature that there are currently four regionally-accredited chiropractic educational institutions that teach the use of injectables, including the University of Western States (UWS), Texas Chiropractic College (TCC), Southern California University of Health Sciences (SCUHS) and National University of Health Sciences (NUHS).
According to the proposal, NUHS President Dr. James Winterstein and Dr. Joe Brimhall are strong advocates for the expansion of practice scope for chiropractic physicians including the use of homeopathic medications and orthomolecular. They go on to state that Winterstein has committed that NUHS would be proactive in sending teachers to the state to certify and educate chiropractors on the use of injectables.
According to the Arizona Chiropractic Society:
“There are no definitions given anywhere for ‘orthomolecular therapy’ or ‘natural substances.’ The ACS attorney has advised that ‘natural substances’ could be interpreted to include opiates and any products made from them. This means that unless some limiting language is included, DCs could prescribe dangerous, addictive prescription opiate painkillers. The AAC has responded to ACS's concerns by promising to include language stating that natural substances do not include any drug approved by the FDA. We are having our health care lawyer study to assure this rules out any possibility of opiates in chiropractic practice.”
The proposal points out that along with the four accredited chiropractic institutions, there are also independent and certified providers who educate and instruct chiropractic physicians.
The Arizona Chiropractic Society stated in their September 10, 2012 Newsletter that:
“There is a third chiropractic lobbying group involved apart from both the AAC and ACS, registered with the Secretary of State as Reiner Kramer Russell Erhardt. Dr. Kramer is a DC and NMD based in Colorado but also licensed in AZ, and Dr. Erhardt is along time Arizona chiropractor. They have hired a separate lobbyist, High Ground, and are working independently to influence the language of the bill. Dr. Kramer apparently offers the exact courses you would have to take to gain the Advance Practice certification. ACS is investigating the interests and motives of this lobbying group.”
Kramer is well known for being one of the architects of tiering the chiropractic profession and went so far as to lay out the agenda for everything taking place today in the Fall 2002 Issue of the Journal of Chiropractic Medicine
The Arizona proposal adds an interesting paragraph regarding the Council on Chiropractic Education (CCE) considering all of the attention the CCE has garnered by removing “without drugs and surgery” from their accreditation Standards:
“In addition it is also important to note that the Council on Chiropractic Education ® has established educational standards for the accreditation of chiropractic education. The Council on Chiropractic Education gives schools autonomy in setting their own curriculum consistent with the individual mission of each institution. Any advanced practice legislation would not require schools to integrate homeopathic medication and orthomolecular therapy into the core curriculum of their doctor of chiropractic degree program; such advanced-practice curricula would remain elective.”
Despite all the assurances from the CCE that they had no intention of requiring schools to teach the practice of medicine and the use of pharmaceuticals this stands as stark evidence that the CCE was never worried about such an outcome since the power to enact such additions to the scope reside in the states. The removal of the “without drugs and surgery” language simply allows chiropractic institutions to teach such methods and not be in conflict with CCE Standards.
In related news two other states recently addressed the injectables issue: Colorado and Missouri.
The Missouri Chiropractic Board Issued a Memo on Injectables asserting that nutritional products are defined as legend drugs once they are administered via injection.
In Colorado, the Board is proposing the following:
All chiropractors that choose to administer homeopathic and botanical medicines, vitamins, and minerals. phytonutrients, antioxidants, enzymes and glandular extracts by means of injectable procedures shall be certified by the board. Applications for certification in lnjectables shall be made in a manner approved by the Board. Certification in lnjectables by the State Board of Chiropractic Examiners may be obtained by complying with the following:
1. Successfully complete a minimum of a combined total of 24 hours of theoretical study and supervised clinical instruction obtained from a college of chiropractic approved by the Council on Chiropractic Education (CCE) or the equivalent hours of study and clinical supervision obtained from an instructor recognized by the postgraduate facility of a chiropractic institution or approved by CCE to teach this course and
2. Passing a nationally recognized Injectable certification examination recognized by a CCE accredited chiropractic college.
Chiropractors are urged to remember that injectable nutrients are a very slippery slope. In Oklahoma, they are doing IV EDTA chelation and prolotherapy under the banner of injectable nutrients.