Two Legs to Stand On

When I first received the American Chiropractic Association’s (ACA) press release titled, "American Physical Therapy Association [APTA] Seeks to Intervene in ACA Lawsuit Against HCFA/HHA: PTs Seek to Secure Manual Manipulation to Correct a Subluxation as Their Own,"¹ I took umbrage that the APTA would wish to be the sole providers of manipulation and claim the term subluxation as their own. But as I continued reading, nothing could be further from the truth. In fact, it is the ACA that wishes to secure ownership, which is fine.

Demonizing one’s opponent is the tactic of politicians and should not be adopted by an organization seeking public respect. Instead of running to the courts, why not spend the money in public awareness of the benefits of chiropractic?

What is really at stake is the $25 million allowed by Medicare in 1999 for physical therapy services falling within the billing code for manual therapy techniques, including mobilization/manipulation of the spine.² Yet, the ACA claims that the APTA has no "alleged economic interest...to justify intervention."³

If the ACA wishes to restrict physical therapists from performing manual manipulations, then physical therapists may claim that only they are qualified to provide physical therapy. Guy Riekeman, DC, president of Palmer College of Chiropractic, says, "At Palmer College in Davenport, the full physical therapy course is offered as an elective, and is taken by 90% or more of the students on this campus. We have a high-quality program...our students have access to physical therapy equipment and faculty through our clinic program."⁴ Doctors of physical therapy (DPTs) can argue that a course in physical therapy is not sufficient for chiropractors to provide the necessary treatment expertise.

Let me clarify before I am inundated with angry letters—I am not saying that chiropractors should not provide physical therapy services. Personally, my first and only choice for any kind of manipulation of the spine is a chiropractor, since they are the acknowledged experts in this area. As for the arguments that the APTA does not have a direct and substantial interest and an economic interest, the ACA may not have a leg to stand on. In ACA’s defense, there are valid points, but the minor, inconsequential arguments mentioned above cloud the issue—chiropractors are the experts and should be the only ones to provide manual manipulation to correct a subluxation.

The dignified course of action would be to allow patients to decide. Healthy competition will increase the quality of service and can define and shape the future of chiropractic. I have faith in the marketing saavy of chiropractors. Ultimately, DCs are more than qualified to compete with physical therapists without government intervention. The courts should not be the one to interpret what is chiropractic and what is not.

Miwon Seo
mseo@medpubs.com

References
1. American Chiropractic Association. American Physical Therapy Association Seeks to Intervene in ACA Lawsuit Against HCFA/HHS. Available at: http://www.amerchiro.org/lawsuit_info/42001.html. Accessed August 23, 2001.
2. Reply Memorandum in Support of the Motion of the American Physical Therapy Association for Leave to Intervene as a Defendant. America Chiropractic Association v Thompson, case no. 98-2762 (JPG). Available at: http://www.amerchiro.org/lawsuit_info/. Accessed August 23, 2001.
3. Plantiff’s Response to American Physical Therapy Association’s Motion to Intervene. American Chiropractic Association v Thompson, case no. 98-2762 (SSH). Available at: www.http://www.amerchiro.org/lawsuit_info/. Accessed August 23, 2001.
4. Riekeman G. Who Should Be in Charge of Chiropractic College Curricula? Available at: http://www.chiroweb.com/archives/19/06/14.html. Accessed August 23, 2001.