Coalition Vision 2012 /CCE issues


D.D. Palmer founded the chiropractic profession on the discovery that vertebral subluxation (VS) occurs and interferes with the function of nervous system. Adjusting VS has always been the core value of the chiropractic profession.

Many chiropractors are dissatisfied with the anti-VS and medical direction the chiropractic profession has taken under the direction of the chiropractic cartel, involving the American Chiropractic Association (ACA), Council on Chiropractic Education (CCE), National Board of Chiropractic Examiners (NBCE), Federation of Chiropractic Licensing Boards (FCLB) and others. The designation “cartel” in reference to CCE was first used in 2006 by Dr. Lawrence DeNardis, a university president, former congressman and member of the United States Department of Education Office of Postsecondary Education, National Advisory Committee on Institutional Quality and Integrity.1

Those chiropractic organizations, faculty, students and individual chiropractors who wish to see VS remain the focus of the chiropractic profession have become disenfranchised through the actions of the cartel and need to make their voice heard clearly by supporting this vision for a sustainable chiropractic profession. Yes, the cartel organizations place a few DC’s associated with VS on their boards, but these appointments are so few as to be ineffective in shaping the future of the profession.

The cartel is moving chiropractic to be a primary, plenary, medically based profession that is centered on the diagnosis and treatment of conditions within the medical model. CCE Standards require for accreditation that colleges train their graduates “to practice as primary care chiropractic physicians.2” There are those in the cartel that openly advocate chiropractic disassociating itself from VS and eventually the spine. It is strongly suspected that there are others in the cartel that support this vision for chiropractic, but remain silent.

There also may be members of the cartel organizations who support vertebral subluxations remaining the profession’s core value, but they are too few to influence the direction of the profession.

The cartel has total control of the profession’s educational, testing and licensing systems. Its educational and testing arms, CCE and NBCE respectively, focus colleges so heavily on teaching medical subjects that insufficient time is available for them to teach subjects necessary to practice VS-centered chiropractic competently. The cartel further hampers relevant training related to identifying, characterizing and adjusting VS’s. Students are restricted in taking or ordering x-rays that follow chiropractic technique guidelines to help determine the misalignment and uniqueness of the subluxated vertebra. The degrading and elimination of VS-centered subjects due to the lack of curricular time; CCE site visitation teams’ restricting the use of x-ray analysis, and over-the-top emphasis on medical diagnosis and therapeutics have created an impossible situation for the sustainability of a VS-centered profession or its element within the profession.3

Enrollment in chiropractic colleges is declining, leading to financial challenges for many institutions in the US; alarming debt levels of new graduates place them in an untenable position; market share for chiropractic servicers and average earnings of practitioners are declining. As fewer people are able to find and receive high-quality chiropractic services, the public is being denied the great benefit of chiropractic.

A number of groups in the U.S. are working in support of the United States Department of Education (USDE) requiring CCE to come into compliance with over 40 of its Criteria for Recognition, most particularly, those areas relating to its organizational structure, policies; and educational standards having broad support of the profession. If these changes are made in good faith and are genuine, the profession will be much improved to the benefit of patients, practitioners and students. CCE has been in this position before and has gotten by through window dressing. This coalition is determined that such window dressing will not be successful again.

 

The Coalition values and strives toward:


  1. CCE BEING REPRESENTATIVE OF THE ENTIRE CHIROPRACTIC PROFESSION AND GUARANTEEING, THROUGH ITS ORGANIZATIONAL STRUCTURE, POLICIES AND STANDARDS, FAIRNESS AND OPPORTUNITIES TO BOTH VS- AND CONDITION-CENTERED PROGRAMS.
  2. NBCE GIVING EXAMINATIONS THAT REPRESENT CORE REQUIREMENTS FOR THE SAFE AND EFFECTIVE PRACTICE OF CHIROPRACTIC. NBCE should restructure its examinations so that subject areas such as physiological therapeutics and medical diagnosis are not interspersed throughout its tests, and it should eliminate or make available special examinations for states having such requirements.
  3. HAVING CONTINUED RECOGNITION OF CHIROPRACTIC AS A “DIRECT ACCESS” PORTAL-OF-ENTRY HEALTHCARE PROFESSION RATHER THAN A PRIMARY HEALTHCARE SUBSET OF THE MEDICAL PROFESSION. Chiropractic has far-reaching health effects, but its work is directed at the spine and not at the effects. As a profession, it is somewhat like dentistry or optometry in that it works on a limited part of the anatomy. Chiropractors, through case histories, examinations and referrals, take full responsibility to practice safely in determining and providing for patients’ chiropractic needs.
    The cartel defines chiropractic as a “primary” healthcare profession. This designation is inconsistent with mainstream terminology, wherein primary care is the management of substantially all healthcare needs.4 “Direct access healthcare profession” better describes chiropractic as offering healthcare for a particular class of healthcare needs with or without referral from another healthcare provider.
  4. PEOPLE OF THE ENTIRE WORLD, REGARDLESS OF THEIR GENDER, AGE, RACE, OR STATE OF HEALTH, HAVING ACCESS TO PERIODIC, SAFE, COMPETENT SPINAL EXAMINATIONS AND ADJUSTMENTS OF ANY VS THEY MAY HAVE.
  5. A PROFESSIONAL MISSION THAT STATES, “CHIROPRACTIC CONTRIBUTES TO HEALTH THROUGH THE ADJUSTMENT OF SUBLUXATED VERTEBRAE.” It is recognized that there is more to health than being free of VS, but adjusting VS is chiropractic’s important contribution to health.
  6. CHIROPRACTIC PRACTICE BEING REFERENCED BY AN EVIDENCE BASE RELEVANT TO VS RATHER THAN SYMPTOMS AND DISEASE. The body strives to maintain its own health and VS interferes with that striving. VS’s can be objectively identified. That biological fact, together with the accumulating knowledge about VS and its implications, is the basis for an ever-expanding, relevant knowledge base.
  7. HAVING A CHIROPRACTIC PROFESSION THAT ACKNOWLEDGES THE PRACTICES OF OTHER HEALTH PROFESSIONS, AS LONG AS THOSE PRACTICES DO NOT CONCERN VS ANALYSIS AND ADJUSTING. Professions have a right to protect their turf, but other than protecting turf, they should not make judgments about other practices. Chiropractic has suffered unfairly at the hands of the allopathic profession and is now suffering at the hands of the cartel, and it should not copy that behavior.
  8. HAVING A CHIROPRACTIC MISSION, LIKE ALL OTHER PROFESSIONAL MISSIONS, THAT IS LASTING AND CONSISTENT, AND A PHILOSOPHY, SCIENCE AND ART THAT ARE EVOLVING IN ACCORDANCE WITH ITS MISSION. Mission determines methods. People with the same mission, be they in the same or different professions, soon have the same methods. Different philosophical, scientific and clinical viewpoints should be encouraged, for it leads to professional advancement. A confused mission, leads to identity problems, professional confusion, stagnation and disintegration.
  9. A CHIROPRACTIC ADJUSTMENT IS PERFORMED ACCORDING TO ESTABLISHED CHIROPRACTIC TECHNIQUE PROTOCOLS AND THE CLINICAL JUDGMENT OF THE CHIROPRACTOR, BY INTRODUCING A SPECIFIC FORCE TO CORRECT THE SUBLUXATED VERTEBRA.
  10. CHIROPRACTORS SHOULD BE TRAINED AND WILLING TO RENDER FIRST AID.
  11. A CHIROPRACTIC EDUCATION THAT IS RELEVANT AND REASONABLY AFFORDABLE. The current educational program is unreasonable, unrelated to chiropractic’s mission of adjusting VS and unnecessarily costly. Replacing irrelevant content in the curriculum will render the education system efficient and effective both clinically and cost wise.

We, the undersigned, agree with the above stated Vision for a Sustainable Chiropractic Profession and wish for the Coalition for the Advancement of Chiropractic to strive on my behalf in support of that vision. The Coalition for the Advancement of Chiropractic can use my name in support of furthering this vision.

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References

  1. Dr. Lawrence DeNardis, a university president, former congressman and committee member, stated, “[S]ome of this, maybe most of it, is a consequence of, at least as I see it, a monopoly control of a profession which has led to the establishment of a virtual cartel.” Chairperson D’Amico responded, “Dr. DeNardis, I don’t know if you hate cartels and monopolies more than me. I think it would be a real contest. So I am sympathetic to your notion of can we send a message about cartels and monopolies and inclusion and the answer I am hearing is yes.” Dr. Pruitt said, “Madam Chairman, for the record, I’d like to tell you I have a long and distinguished record of also hating cartels as well. So I’d like to associate myself with that point of view.”
    Special Report: United States Department of Education Office of Postsecondary Education, National Advisory Com-mittee on Institutional Quality and Integrity. The Council on Chiropractic Education, Commission on Accreditation, Action for Consideration: Petition for Renewal of Recognition. Transcripts of Proceedings, 2006.
  2. Preface, CCE Accreditation Standards, January, 2012, page 9
  3. “Mandatory meta-competencies have been identified regarding the skills, attitudes, and knowledge that a DCP provides so that graduates will be prepared to serve as primary care chiropractic physicians.” CCE Accreditation Standards, Principles, Processes & Requirements for Accreditation, January 2012, Page 19
  4. A primary care physician is a generalist physician who provides definitive care to the undifferentiated patient at the point of first contact and takes continuing responsibility for providing the patient’s care. Such a physician must be specifically trained to provide primary care services… The style of primary care practice is such that the personal primary care physician serves as the entry point for substantially all of the patient’s medical and health care needs. American Academy of Family Physicians Definitions: Primary Care Physician, AAFP copyright 2012, http://www.aafp.org/online/en/home/policy/policies/p/primarycare.html, accessed January 12, 2012