Says ACA is Largest, Most Preeminent Organization that Represents Mainstream Chiropractic
On September 13, 2012 the American Chiropractic Association (ACA) filed an Amicus Curiae Brief in the Court of Appeals of the State of New Mexico inserting itself on the side of drug prescriptive rights for chiropractors in that state.
History
The New Mexico Chiropractic Board, encouraged by a growing chorus of supporters within the profession and two colleges seeking an advantage in the marketplace in order to stem the tide of decreasing market share and reimbursement, is trying to gain the right to prescribe drugs for some doctors of chiropractic. They are accomplishing this by tiering the profession through the creation of an Advanced Chiropractic Physician designation and then adding prescriptive rights for those that hold the credentials.
New Mexico was successful on both parts: establishing the Advanced Chiropractic Physician designation and gaining approval on a formulary. However, according to the International Chiropractors Association, on August 30, 2011, at an official rulemaking hearing and meeting, the New Mexico Chiropractic Board adopted new rules to greatly expand the chiropractic formulary to include certain dangerous drugs and drugs to be administered by injection that had not been approved by either the New Mexico Medical or Pharmacy Boards as specifically required by state law. At that same hearing, lawyers representing the State of New Mexico were very clear in their advice that the Board was acting outside their authority and should not proceed. The Chiropractic Board ignored those admonitions and acted to adopt a new formulary anyway, stated the ICA.
The ICA Intervenes
Stating they were acting on behalf of concerned ICA members in New Mexico and out of concern for the integrity and credibility of the chiropractic profession at large, the International Chiropractors Association (ICA) filed a memorandum in support of a motion to stay what is being held to be illegal actions on the part of the New Mexico Board of Chiropractic Examiners.
The ICA urged the court to focus on the letter of the law and the protection of the public and chiropractors and prevent the New Mexico Board from implementing its rule to establish a drug formulary that includes drugs that are dangerous to the public health and drugs that are injectable. The ICA maintains that the New Mexico Board is acting outside their authority under the law.
The ACA Files Amicus Curiae Brief
In its brief, the ACA argues the following two points:
- That chiropractic physicians are highly trained and highly skilled health care providers whose professional perspective, provided through the Board of Chiropractic Examiners, should be given the same consideration by the Court as the state’s Medical Board and Board of Pharmacy; and
- That ACA is the nation's largest and preeminent chiropractic professional association representing chiropractic, whose long-established policy is to recognize that local doctors in each state are best equipped to determine matters of scope of practice.
The ACA asserts the “comparable nature of chiropractic and medical education” going so far as to provide a side by side comparison of Western States chiropractic program to the Medical Program at the Oregon Health Sciences University.
After actually listing the general year by year coursework to attain a chiropractic degree, the ACA States:
“The fourth year often consists of a clinical internship. In addition to treating patients under the supervision of an experienced chiropractor, many students experience a clinical rotation through an integrated health care facility such as a hospital or veterans clinic.”
The reference to integrated facilities, hospitals and veterans' clinics is an obvious attempt to gloss over the fact that chiropractors do not routinely engage in rotations or residencies comparable to the training of a medical physician. Such rotations and residencies expose medical physicians to the wide variety of case management strategies needed to practice as primary care physicians.
The ACA further asserts that chiropractic training is “…very comparable to the level of the education and training received by medical doctors” by quoting the National Board of Chiropractic Examiners “…that today’s chiropractic training is of equivalent standard to medical training in all pre-clinical subjects.”
The ACA’s argument on the equivalency of a chiropractic education to a medical one is reinforced by pointing out the role of the Council on Chiropractic Education (CCE) in mandating the 4200 hours of instruction in this coursework that is required by the CCE.
Following the argument on medical equivalency, the ACA turns its sites toward the ICA. In the Brief, the ACA contends it is the largest, most preeminent chiropractic organization and that it represents mainstream chiropractic. The ACA alleges in the Brief that it represents 13,000 members and that it is “three times the size” of the ICA in terms of revenue and budget. Despite these assertions, previous reports have questioned the actual size of the ACA and the ACA has not made any effort to disprove those reports.
While the ACA tries hard in its Brief to couch its intervention in the name of “States’ Rights” those following the actions of the ACA over the past couple of decades realize that they are walking a fine line with their membership that prefers the profession to remain drug free. The Amicus Brief in the New Mexico case should however put to rest any doubt that the American Chiropractic Association is in full support of the inclusion of drugs within the scope of chiropractic practice.
