What’s the Difference Between the ICA and ACA?

Matthew McCoy DC, MPH
What’s the Difference Between the ICA and ACA?

ICA Elections Process Heats Up

There is a joke going around within chiropractic political circles that goes something like this (and no I did not make it up):

Question: What’s the difference between the ICA and ACA?

Answer: About 5-10 years.

As a dues paying member of the International Chiropractors Association I have been following the ICA elections process very closely.  Politicians bank on people not paying attention so you hear a lot of stuff from them about who they are and what they stand for etc. and if you are new to the political game you just might believe what someone TELLS you. To go back and review their record is time consuming and in chiropractic little to no record exists of the political machinations that go on. But for those who have watched and tracked our chiropractic politicians closely, sorting fact from fiction is a little easier.

I have been openly critical of the ICA in the past several years going all the way back to the “WFC debacle.”  The relationship between the ICA and the World Federation of Chiropractic has been contentious at best. It was in fact the issue of WFC support that drove Fred Barge to resign from the ICA Board many years ago. Dr. Barge led an exodus of leaders to resign from the ICA as well as general members. This is how serious the WFC issue was and still is.

The WFC issue is not old news – it is in many ways the center of the universe regarding the direction of chiropractic around the world. After all it is the WFC that led an international consultation on the identity of the chiropractic profession which led to the adoption of chiropractic as the “Spinal health care experts in the health care system.”   The ICA participated in this process and agreed to this identity WITHOUT subluxation. In fact, Dr. Stephen Welsh, who is an incumbent running for ICA Secretary/Treasurer, and other ICA leaders have defended the ICA acceptance of this WFC definition without subluxation.   

This is just as Dr. Welsh has defended his decision to sign his name as a representative of the ICA to the recent CCE Consensus Statement that stated chiropractic is “. . .without unnecessary drugs and surgery” meaning that necessary drugs and surgery do have a place in chiropractic practice. That CCE Consensus Statement also has subluxation as being synonymous with something called neurobiomehancial dsyfunction.  Whatever that is.

The WFC position on the identity of the profession found its way into a national marketing campaign (which ICA endorses) that relies on third party endorsements from people suffering from pain syndromes to promote the profession. The latest ad I saw uses the Redskins Cheerleaders to promote chiropractic.  That same identity has been adopted by the West Hartford Group and was recently adopted by Palmer University.    That identity is the basis for chiropractic to be defined as primary care and gives credence to the efforts by the Chiropractic Cartel to change the very nature of the profession.  That identity along with the notion that chiropractors are primary care physicians is also the basis for the work of the Chiropractic Summit of which the ICA is a participating member.

What is most concerning about all of this is that respected leaders within the ICA not only allow this to continue but actually endorse it and are working hard to see its implementation.  Once again, the only reason this goes on is because membership either agrees with it or has so disengaged from what the leadership is doing that no one realizes what is happening.

Primary Care is the other area where I have been critical of the ICA since the ICA states that chiropractors are primary care providers.

I have been deeply involved in the issue of chiropractic and primary care for some time. Most of the comments I see regarding this issue reveal one thing and that is that there is a vast misunderstanding on the definition of primary care provider. Most simply confuse it with the concept of Portal of Entry provider. What concerns me is that even leaders in the ICA confuse the terms. What concerns me even more are people who know the difference but continue to perpetuate the myth. Then there are those, apparently even in the ICA, who want to change the definition of primary care to suit the political and financial goals of certain factions of chiropractors. The ICA (Dr. Welsh) also signed off on Primary Care in chiropractic in the CCE Consensus Document.

I recently asked both of the tickets running for leadership positions in the ICA to answer this question about primary care, chiropractic and the ICA’s position. The Rodnick/Welsh ticket didn’t even respond – keep in mind that I am a dues paying member of the ICA asking people who want to lead an organization of which I am a member – and they didn’t respond.  

McLean/Oberstein did respond and while I do not agree with what they said regarding primary care – at least they responded to a member with concerns.  I also believe that their ticket – given enough evidence – would actually see that they are wrong on definitional issues regarding primary care.  I hope for their sake and the sake of the ICA that I am correct.

One thing is for sure – new leadership is needed. A new direction is needed. That direction should not be the same as the ACA – as the joke circulating within the profession makes clear. We do not need another ACA , or ACA Lite. We do not need another organization that supports the Chiropractic Cartel and then turns around and tells its members that “all politics involve compromise” or that “we can change them from within” or “we need to have a seat at the table” – I’ve been hearing this from ICA leadership since my student days as a member. As Dr. Phil would ask: "How's that workin' out for you?"

Enough. Its not working and it won;t work. The only thing that working from within does is help the person working from within. 

Some have asked me why I bother continuing to pay dues and keep my membership with the ICA considering the clear contradictions of its actions. That’s a good question and it’s becoming a harder one to answer each time the ICA acts more like the ACA than the ICA.

For now my answer is that we are better off with a strong ICA than with a weak one, but I have to admit that in addition to not being able to convince some of my colleagues of this any more, I am having a hard time convincing myself.

Let’s see what happens in this election. If it’s not a mandate for change in the ICA then I suspect the punch line for the joke will come true.  That will be sad. But it won’t be the end because there are other organizations in this profession that are not confused about who they are and do not have leaders who are concerned about their own future instead of the legacy and stewardship of the organization.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH