Will Changes in State Associations be enough to Hinder Cartel’s Plans?

Matthew McCoy DC, MPH
Will Changes in State Associations be enough to Hinder Cartel’s Plans?

One thing is for certain and that is the Chiropractic Cartel is a more centrally organized group than the conservative, traditional faction of chiropractic.

Through years of painstaking efforts, the Cartel has developed a very deep, centrally organized and coordinated structure. This structure includes the American Chiropractic Association (ACA) as the largest national trade organization representing chiropractors. Adding to this structure is the control the Federation of Chiropractic Licensing Boards (FCLB) and their member boards have over licensure. The individual state chiropractic boards have mandates in most states that only graduates from a school accredited by the Council on Chiropractic Education (CCE) can get a license. The FCLB receives a bulk of its funding from the National Board of Chiropractic Examiners (NBCE). The Cartel exerts its international reach through the World Federation of Chiropractic (WFC) as well as the international arms of the CCE.

For good reason, the conservative, traditional faction of the chiropractic profession is generally on the outside looking in when it comes to this power structure and have little to no power with which to thwart their efforts. The only exception to this are the few groups such as the International Chiropractors Association (ICA) and several supposedly conservative schools and vendors that belong to the Chiropractic Summit Group which is believed to be controlled by the ACA and the rest of the Cartel as well as having the interests of the Cartel foremost in mind.     

Then there are the various state chiropractic trade organizations scattered throughout the 50 states. Historically, there have often been two state organizations operating within each state. One representing the interests of the broader scope, insurance focused, ACA types and those representing the conservative, subluxation based groups.

While there is no data available on the topic there does appear to be some disruption in the state organization world of chiropractic. The most dramatic of recent memory was the supposed merger in New Jersey of the two groups there into the Association of New Jersey Chiropractors (ANJC). In reality, there still remains an “alternative” group – the Garden State Chiropractic Society that states they represent “straight” chiropractic in New Jersey. Reports from practitioners in New Jersey reveal frustration at what happened following the development of the ANJC and the direction it headed in.

In New York State, the New York Chiropractic Council (NYCC) was born in the early 90’s to offer an alternative to the New York State Chiropractic Association (NYSCA) but both groups have recently entered into formal merger negotiations, though there is a great deal of contention surrounding such discussions including the threat of another organization being established should the merger go through.  
Just last week, in a meeting held by the Iowa Chiropractic Society (ICS), a vote was taken on the issue of giving the ACA permanent representation via a Board seat. It was reported that the membership asked why the ACA and no one else would get a board seat. The ICS response was that it was intended to improve communication with the ACA. The ICS membership voted it down - at least this time.

Georgia has two state chiropractic associations – the Georgia Chiropractic Council (GCC) which represents subluxation based chiropractic and the Georgia Chiropractic Association (GCA) which is an ACA Affiliate. While the two groups have a tumultuous history together, both organizations promoted and cheered their joint efforts to address an outdated scope of practice several years ago. Though it is widely felt that absent the GCC’s involvement, subluxation would have taken a beating in the revised scope, if it survived at all.

Michigan got rid of its two state organization system and merged into one several years ago. Results are mixed depending on who you talk to over whether the merger turned out to be good or bad.

Generally speaking, chiropractors on both sides report greater cooperation on legislative issues with one association. But the double edged sword reveals that many of these efforts revolve around insurance reimbursement and scope issues which even many in the conservative camps wish to see. It is this focus on third party pay and scope expansion that riles those members of the conservative faction that feel they are sacrificing principle in order to demonstrate unity.    

There is talk of new organizations starting up in some of the states with only one organization. Typically that organization is tied to the ACA. These include Minnesota and Wisconsin.

But will the emergence of additional state organizations representing traditional chiropractic be able to counter the efforts of the ACA and Cartel backed groups? The answer may lie in how many conservative state organizations emerge, how coordinated they become and how many members they enroll.

Currently, the Congress of Chiropractic State Associations (COCSA) purports to represent the whole of state associations under their umbrella. However, they do not provide a list of member associations on their website. Since they also include the conservative groups, then taken together COCSA is actually the largest trade organization representing chiropractors’ interests. However, it is believed that since the bulk of the ACA and broad scope associations have larger memberships within the states, that COCSA essentially represents their views.  This is demonstrated by COCSA’s adherence to the state’s rights doctrine regarding scope where they defend each state’s right to expand scope as they see fit. 

If the traditional, conservative faction of the profession would muster the will to exert its influence through COCSA this might be one viable way to affect the political structure within the profession. This could be accomplished by the conservative groups establishing a Special Interest Group (SIG) either within COCSA or outside of it if the controlling factions of COCSA disallow it. This SIG could then strategize on how best to recruit new members and collaborate with like minded groups such as the many EPOCH type groups that have sprung up around the country and other national and state organizations.

They could also use this new formed power to address many of the state board issues facing the conservative, traditional faction such as the CCE mandate, drugs and other scope related issues. Such dialogue might lead to getting more conservative chiropractors onto the boards which is a recognized problem.

While all politics is local, the reality is that the state based groups have the potential to influence national and international politics relative to chiropractic. The challenge is the inherent nature of the “go it alone” attitude of many conservative chiropractors which is then reflected in the groups and organizations they form. While this makes for strong “tribal” culture, it does little to address the control exerted by the Cartel due to their centrally organized structure and web of influence. This will need to change if the traditionalists wish to protect their rights and advance the cause of subluxation based chiropractic.

Foundation for Vertebral Subluxation