Team B Regulatory Issues in CAM Wk 2

REGULATORY ISSUES IN CHIROPRACTIC THERAPY 1

Regulatory Issues in Chiropractic Therapy

Team B

Kim Eschler, Paige Holmes, and Robert Taylor

SOC201

November 19, 2011

Chad Wiet


Regulatory Issues in Chiropractic Therapy

Chiropractic therapy offers relief to thousands of people daily. There is something

tremendous about hearing the crack of one’s bones to rest the mind, or the touch that puts a bone

back in place that elevates the pain one is experiencing. With the joy that this alternative

treatment offers, there are also scary facts that if done wrong can cause serious and permanent

damage. With the risks high the regulatory issues should be clear and understandable for the

practitioner and the consumer. This paper will cover what Chiropractic therapy is, current

regulations and oversights, deficits in these regulations, alternative processes, possible

improvement, and potential obstacles.

Chiropractic Therapy

The word Chiropractic is derived from the Greek words cheir meaning ‘hand” and

praktos meaning “done.” There for meaning done by hand. It can be traced back several

thousand years in the ancient Greek and Chinese civilizations. It was referred to as spinal

manipulation. The twentieth century has seen growth and development of the profession

worldwide, gaining a place in the primary care environment. In little more than 100 years

chiropractic has grown from a small profession to become the third largest independent health

care profession in the western world. In the 1960s rapid growth was taking place in Europe yet

students had to travel to the USA to receive education.

The chiropractic modality and practice is based on scientific facts relating to the nervous

system. Because it controls the function of every cell, tissue, organ, and system of the body, any

interference to the nervous system by the movable bones of the spine is a common known cause

of ill health. A problem relating to the electric flow impairment is called a vertebral subluxation

complex and is known to be the underlying cause of many health problems.


Regulations and Oversights

Chiropractic practice is regulated individually be each state. Most states require

chiropractors to earn continuing education credits to maintain their licenses. They are not

licensed in any state to perform major surgery or prescribe drugs.

Compared with CAM therapies (few of which are reimbursed), coverage of chiropractic

by insurance plans is extensive. Very few CAM therapies are reimbursed by insurance and health

organizations. Chiropractic treatment is covered extensively with insurance plans. It is shown

that 50% of health maintenance organizations and more than 75% of private health care plan

were covered as of 2002. In more than two dozens states Chiropractors are covered under

Medicaid. Chiropractors can bill Medicare.

The State Statutes concerning the primary definitions and practice parameters can be

found on the ICA website yet it also brings awareness that each state has other regulations. These

other guidelines can be in context of workers’ compensation, personal injury, public health

arenas dealt with in individual states. These additional regulations can normally be found on

each states official website.

Deficits

Each state developing individual rules for medical practitioners shows a large deficit for

those seeking treatment. If someone is seeking help and could receive pain medicine in Florida,

but a patient comes to Utah where the same patient cannot obtain the identical medicine, this

difference is an inconvenience to the patient.

The American Chiropractor Association (ACA) has very clear outlines of what is

expected from doctors in every aspect of their practice, from their business facilities to trials and

research. With each state additionally setting or limiting the rules already set by ACA, this does


not permit for best practices nationwide.

Adverse Outcomes

Adverse outcomes vary from state to state, each state posses their own regulatory rules.

When new information is received, this communication can take time reaching practitioners who

see patients daily. The majority of visits to Chiropractors are to alleviate lower back pain,

according to Science Based Medicine (2009) studies had been done that manipulating the lower

back caused higher risk for further damage, cost twice as much, and only was a fraction more

successful than traditional physical therapy. The concern here is the higher risk, and without

further studies, and a true understanding of what benefit, is happening at what cost to the

patients’ health.

Alternative Regulatory Process

Effective October 2011, new rules have been put in place by the Federal Government that

affect practitioners in ways that include how to bill Medicaid, what types of bonus they can

receive, compliance regarding new programs that have yet to be defined. ACA is preparing to

fight back against these silly and unclear regulations that have little to do the alternative

treatment offered to assist patients.

Currently there are two bills before Congress that would expand Chiropractic health

coverage to military veterans. This coverage, if passed would give veterans a choice to access a

chiropractor for treatment of neuromusculoskeletal ailment, back, and principally joint disorders.

It is on record that these particular ailments are on top of the list from veterans returning from

current war.

Improvements to the chiropractic system will continue to be left to individual states

discretion. Continuing to allow each state to make their own rules, based on information lobbyist


can obtain at the time these decisions are being reviewed.

Improve Consumer Protection

Consumer protection for chiropractic medicine is a large concern within the alternative

medicine industry. It is the goal of the NACM, the National Association for Chiropractic

Medicine to offer consumer assistance in obtaining the member practitioners. Most associations

formed within the Chiropractic medicine industry, are formed to further the advancement and

interests for the professional individuals and focus little on the consumer and the public. It is the

belief of the NACM that the interests of the public must come first, before those of the general

practitioners.

For those who wish to become affiliated with the NACM the practitioners must define the

scope of their practice and accept that they are not considered primary care providers.

Practitioners must work together with other health care professionals in providing the best

solutions and care to their clients.

Potential Obstacles

Whenever new plans and procedures are to be implemented, there is always the task of

overcoming potential obstacles that relate to the implementation of the new ideas. In this

particular case, the implementation of new regulatory issues within the chiropractic industry will

provide affiliation of like-minded physicians committed to the highest levels of academic and

professional excellence, the opportunity to focus on the rights of consumers. There will be

obstacles that will need to be overcome during this process. One of the greatest obstacles that

will need guidance is how to change the mindset of long time practitioners who have been

involved in this form of alternative medicine for several decades. Before the formation of this


new organization, practitioners were primarily focused on the furthering of their practices rather

than best practices relating to the health of their patients.

Conclusion

Consumers need to remain cognizant that the reason this form of alternative medicine is

available, is to create a healthier mode of living for the consumer. The regulatory issues

expressed in this paper will further the advancement of this type of alternative medicine.

Consumers will also gain the piece of mind knowing that their health and safety are the primary

focus of the chiropractic community.


References

American Chiropractic Association (2000) Current Policies. Retrieved on November 13, 2011

from www.acatoday.org/level2_css.cfm?T1ID=10&T2ID=117

Fontaine, K. (2005) Complementary & Alternative Therapies for Nursing Practice, Second

Edition, Published by Prentice Hall.

National Association for Chiropractic Medicine. (2011) Retrieved on November 13, 2011 from

www.chiromed.org.

National Center for Complementary and Alternative Medicine (2011) Retrieved on November

13, 2011 from nccam.nih.gov.

Necela, T. (2011) New Rules & Regulations for Chiropractors Anger 39 Healthcare

Associations. Retrieved on November 13, 2011 from strategicdc.com/new-rules-

regulations-for-chiropractors-anger-39-healthcare-associations.

Novella, S (2009) Chiropractic- A Brief Overview, Part I and II. Retrieved on November 13,

2011 from sciencebasedmedicine.org/index.php/chiropractic-a-brief-overview-part-ii/.

Documents

Team B Regulatory Issues in CAM Wk 2