Florida Medical Association Embarks on Marketing & Legislative Campaign to Limit Use of Doctor and Physician Title

Foundation for Vertebral Subluxation
Florida Medical Association Embarks on Marketing & Legislative Campaign to Limit Use of Doctor and Physician Title

Chiropractors May Be Among Professionals Targeted

According to the American Medical Association’s Truth in Advertising Campaign - the campaign:

"Highlights the need for health care providers to clearly and honestly state their level of training, education and licensing. Patients deserve to have this information when in face-to-face encounters as well as when they read health care practitioners’ advertising, marketing and other communications materials."    

State after state has latched on to this effort and have focused their sights on nurses, podiatrists, optometrists and of course - chiropractors.

The latest comes from the Florida Medical Association which had previously embarked on a marketing campaign using an image of two males wearing white coats and stethoscopes and asking:

"Can you tell the difference between the chiropractor and the Medical doctor?" 

This has now been followed up with a full fledged Scope of Practice Task Force that recently provided recommendations to the FMA Board of Governors. According to a Memo from the Task Force to the FMA BOG received by the Foundation for Vertebral Subluxation they met four times in 2012 to discuss how Florida compares to other states and to propose recommendations for the Board.

Rather than focusing on any single issue the Task Force recommends that the “FMA promote the concept of physician directed care that ensures patient safety while promoting access to care.”

They go on to state:

“As long as physicians remain the leader of the health care team, it may be appropriate for the FMA and specialty societies to consider, on a case by case basis, scope of practice expansions when sufficiently protective of patient safety and improved patient access.”  

In short the Task Force Recommendations include:

  • Creating a coalition of physician specialty associations to independently lobby and advocate on scope of practice safety issues
  • To explore defining the practice of medicine and specifying that such practice by any professional should be additionally regulated by the Boards of Medicine and/or Osteopathic Medicine
  • Promote team based models of care with Physicians as the leader
  • Collect data on adverse incidents related to scope of practice issues
  • Enhance and strengthen Truth in Advertising for non-physician providers
  • Engage in public education campaigns to distinguish physicians from non-physicians by education and competence   
  • Reaffirmed resolutions to oppose efforts by nurses to use the title of “Doctor” in health care settings.

In regards to chiropractic, the Task Force did not directly address chiropractic other than to use the profession as an example of what they refer to as the lines of professional credentials becoming increasingly blurred:

“For example, chiropractors and optometrists refer to themselves as ‘Doctors of Chiropractic’, ‘Chiropractic Physicians’ and ‘Doctors of Optometry’, respectively.”   

They go on to assert that patients are often unaware of the distinctions between physicians and on-physician health care providers stating:

“Similarly, neurologists are impacted when chiropractors refer to themselves as ‘chiropractic neurologists’”.

Just recently, Senate Bill 612 was introduced in Florida requiring that certain health care practitioners make specified disclosures when presenting themselves as “Doctor” or “Dr.”; providing criminal penalties for violations if there is an intent to mislead, etc. The Bill applies only to certain health care practitioners licensed under Chapter 464 (the licensing chapter for nurses). 

Florida is not an isolated case as there have been recent battles in states where chiropractors have attempted to expand their scope and the respective medical societies and boards have stepped in to oppose those efforts. Colorado and Texas are the most dramatic examples. But reports are that chiropractors are attempting to expand their scope in at least 19 states. New Mexico is the most famous example since they were the first state to allow chiropractors to perform injections and prescribe drugs. What is interesting about New Mexico is that the medical board and societies have not stepped in to put a stop to it while chiropractors opposed to these expansion efforts have.

It is rumored that the Florida Chiropractic Society, Florida Chiropractic Association and the Board of Chiropractic Medicine are discussing how best to respond to the FMA’s Task Force recommendations.

Florida Statutes

In the State of Florida, chiropractors are licensed by the Board of Chiropractic Medicine and are able to use the term “Chiropractic Physician” and “chiropractic medicine”.

The law in Florida states that the practice of “chiropractic medicine” is focused on the vertebral subluxation and is a:

". . . 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."

But then the law goes on further to define a very broad diagnostic scope for chiropractic physicians:

"Any chiropractic physician who has complied with the provisions of this chapter may examine, analyze, and diagnose the human living body and its diseases by the use of any physical, chemical, electrical, or thermal method; use the X ray for diagnosing; phlebotomize; and use any other general method of examination for diagnosis and analysis taught in any school of chiropractic."

While the treatment scope for chiropractic physicians in Florida does not include drugs or surgery the treatment scope is also very broad:

"Chiropractic physicians may adjust, manipulate, or treat the human body by manual, mechanical, electrical, or natural methods; by the use of physical means or physiotherapy, including light, heat, water, or exercise; by the use of acupuncture; or by the administration of foods, food concentrates, food extracts, and items for which a prescription is not required and may apply first aid and hygiene, but 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."

The law further reads:

"Chiropractic physicians may analyze and diagnose the physical conditions of the human body to determine the abnormal functions of the human organism and to determine such functions as are abnormally expressed and the cause of such abnormal expression."

The ability to “treat the human body” clearly goes beyond locating, analyzing and correcting vertebral subluxations in Florida.

The Florida Chiropractic Society issued the following statement in their January 2013 News Bulletin:

“Recently there have been insinuations that the Florida Chiropractic Society supports the possibility of a Chiropractor no longer being able to use the term ‘doctor’. The distress this has caused is unfortunate and we would like to be clear on our position. As our mission statement declares we are steadfast in our efforts to keep chiropractic ‘drugless’. However, we are also steadfast in fighting for our rights and out ability to be DC’s . . . Doctors of Chiropractic. Many before us have fought for this right and we will continue to do so. Any allegations to the contrary are baseless and are being used to stir up controversy and division within our profession. We are involved, vigilant and concerned and are always working for what is best for our membership and chiropractic in the state of Florida.”    

The Foundation for Vertebral Subluxation has issued a statement in response to inquiries regarding the situation in Florida – CLICK HERE to READ

Foundation for Vertebral Subluxation