Chiropractic drug wars heat up again

Chiropractic drug wars heat up again

The International Chiropractors Association is once again girding itself for battle with its brethren in the American Chiropractic Association over chiropractic scope of practice.

The ICA represents the "straight," or pure subluxation-based, chiropractors. The ACA, on the other hand, started off as an organization representing the "mixers," those who incorporated diagnoses and treatments beyond the "detection" and "correction" of the non-existent subluxation via spinal "adjustments."  It was this branch that briefly held the promise of moving chiropractic beyond pseudoscience and into some form of evidence-based musculoskeletal specialty with a concentration on back problems. This transition might not ever have happened, considering what they were up against, but a few chiropractors evidently tried. 

Hopes of  a progression from pseudoscientific cult to mainstream practice has been pretty much dashed by overreachers, who have concocted a grand scheme to rebrand chiropractors as primary care physicians. This effort has been met with resistance by an odd-bedfellows combination of straight chiropractors (the ICA), medical doctors and pharmacists. 

 I've chronicled the chiropractors' intra-fraternal wars on Science-Based Medicine: The DC as PCP?The DC as PCP? RevistedThe DC as PCP? The battle continuesDept. of Education to Council on Chiropractic Education: Straighten Up! and The Council on Chiropractic Education Straightens Up?  Harriet Hall wrote a post on the subject as well: Chiropractors as Family Doctors? No Way!

This time, the ICA is upset about

a new effort recently taken by the American Chiropractic Association (ACA), to establish a College of Chiropractic Pharmacology and Toxicology, and to promote the term "Chiropractic medicine."

As the ICA explains, this is in clear contravention of an agreement reached by a group called "The Summit," apparently a reference to a gathering of warring chiropractic factions, including the ACA, at a 2013 pow-wow. According to this agreement

The drug issue is a non-issue because no chiropractic organization in the Summit promotes the inclusion of prescription drug rights and all chiropractic organizations in the Summit support the drug-free approach to health care.

Maybe the ACA had its fingers crossed behind its back?  The ICA goes on:

Adding drugs to our profession would make it simply another branch of medicine," said ICA President Dr. Michael S. McLean. "Does our society really need another drug-dispensing profession?"

No, it doesn't, especially ill-trained dispensers whose education is woefully inadequate to the task and who simply use prescription privileges as another offensive weapon in their armamentarium of pseudo-medicine.  

I learned about this in an email from the ICA, but, so far, no further information about these recent events is available on its website.

The ACA website is similarly devoid of details. However, we do learn that the ACA has hatched a scheme to get their hands on more Medicare money. Or, as they put it, 

a comprehensive strategy to ensure that doctors of chiropractic are recognized as being able to provide all existing Medicare services, as allowed under their state scope of practice, to beneficiaries.

This would be a substantial expansion, as they are now limited by Medicare to the detection and correction of -- you guessed it -- subluxations. 

Presumably as part of this "comprehensive strategy," the ACA is pushing for revision of the state chiropractic practice acts, because

Variability of state chiropractic regulations has created uncertainty and confusion for the general public, chiropractic patients and chiropractic physicians, impeding development and progress of the profession.

I suppose "development and progress" is code for "chiropractors practicing as PCPs." And, of course, they need to get their hands on drugs to accomplish this scheme.  So, the ACA is promoting establishment of the aforementioned College of Pharmacology and Toxicology. This purpose of effort is 

to further educate the chiropractic profession on clinical matters related to the widespread use of both prescription and over-the-counter medications and nutritional supplements.

Right. Those "clinical matters" presumably being chiropractors prescribing drugs. 

This battle will no doubt continue to evolve. We'll be watching. 

 

Points of Interest 03/09/2015
Weasel Words

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