Chiro Group Consensus-Priorities on Public Trust and Equity
Written by John Weeks
Chiropractic Consensus Group Calls for Internal Integrity, External Equity
An invitational consensus conference among chiropractic leaders, convened by research and integrated practice leader Jay Triano, DC, PhD, spent three days in February exploring the challenges and opportunities facing the chiropractic profession. The intent of the meeting, held at National University of Health Sciences, in Lombard, Illinois, was to determine changes required to produce a "fuller integration of chiropractic education and practice into the US healthcare system," according to a press release following the meeting. The 75 leaders endorsed a resolution which called for both significant internal self-regulation and for more equitable public support.
The participants of the Chiropractic Strategic Planning Conference included top researchers such as William Meeker, DC, Scott Haldeman, DC, Bob Mootz, DC, MPH, NIH NCCAM staffer Partap Khalsa, DC, PhD, former NIH NCCAM head of health services research, Christine Goertz, DC, PhD, educators including Reed Phillips, DC, PhD,
Jay Triano, DC, PhD, meeting organizer
and James Winterstein, DC, accreditation chair Joseph Brimhall, DC, integrative practice leaders including the Mayo clinic's Ralph Gay, DC, MD, and "chiropractor to Congress" William Morgan, DC. Among those providing outside perspectives were Wayne Jonas, MD, futurist Clem Bezold, PhD, and Catherine Dower, JD, with the Center for Health Professions at the Univeristy of California at San Francisco. The meeting was moderated by researcher Scott Haldeman, DC, PhD, MD.
Participants openly discussed problems that they believe segments of the profession have brought on itself, urging more stringent self-regulation. A resolution passed the final day highlighted the following two elements:
"Integrity and trust. The inappropriate treatment and billing practices adopted by some members of the profession that place the economic interests of the chiropractor before the bets interests of the patient undermines public trust in all members.
"Equitable public support for education and research. There is an absence of fair and equitable publicfunding and other support for chiropractic education and research in either public or private institutions. Specifically, there is a lack of support within the academic and interdisciplinary environments, including participation with publicly-funded universities and health care facilities."
In reference to the first part of the resolution, Triano told the Integrator Blog that "it was a mea culpa" -- an acknowledgement that part of the profession's problems are self-inflicted: "We have some members of the profession whose inappropriate treatment and billing practices place the economic interests of these chiropractors before the interests of their patients. We are calling on the chiropractic profession and its leaders to address this issue."
Traino adds, however, that the group felt there is a shared responsibility for chiropractic's current status: "There are external reasons that chiropractic has evolved as it did. Some of what we are was foisted on the profession by the politics of medicine and our exclusion. The society needs to say that chiropractic is at the table. Society needs to say CAM is at the table." Referring to the potential impact of acting on the two resolutions, Triano adds: "Let's all step up to the plate and let's go after the only thing that counts - helping people improve the quality of life." He notes that the specific action steps are expected to come out of a follow-up meeting expected to take place this summer. Contact:
Comment: The participants in the meeting, in which I was given the opportunity to participate, displayed the integrity and williness to engage in self-criticism which they are asking of their entire profession. Kudos. Triano's point about how chiropractic's sometimes problematic ways were "foisted" on the profession is evocative. What if the profession's coming of age hadn't required fighting a pitched, 10 year legal battle against the AMA's restraint of trade against chiropractors? What if, following the early 1990s consensus guideline for treating low back pain from the US Agency for Health Care Policy and Research (now Agency for Healthcare Research and Quality), which found that chiropractic and watchful waiting were the best options, that our culture had set itself to better integrating chiropractic, rather than politically gutting the agency, which is what happened?
The consensus group's call for equitable governmental and philanthropic support resound throughout the licensed CAM disciplines. One recalls that it was the massive influx of federal funds into MD schools in the 1950s which prompted that discipline's growth and interest in research. What would happen to our present integration dialogue, our differences, and the chips on various shoulders, were the playing fields actually levelled.
