Don’t Rain on Our Parade

With recent legislative victories, 2002 looks to be a red-letter year for chiropractic. One exciting, hot-off-the-press moment for me was while putting the February 2002 issue to bed on January 23, I received an urgent email from Felicity Feather, vice president of communications for the American Chiropractic Association (ACA), stating that President Bush had just signed a bill that allows veterans broader access to chiropractic care. The February issue included the Legislative Watch column by Jay Witter, ACA vice president of government relations, who had written that President Bush had yet to sign the Department of Veteran Affairs (DVA) Health Care Enhancement Act (HR3447). I happened to peruse my email in the eleventh hour before sending the magazine to the printer and was able to include the DVA legislation.

Another triumph is that the Department of Health and Human Services (HHS) prohibits physical therapists from performing manual manipulations to correct a subluxation. In answer to the question, “Which practitioners are authorized by law to perform manual manipulation of the spine to correct a subluxation as a Medicare-covered service?” Operational Policy Letter #23 issued on January 15, 2002, states, “The statute specifically references manual manipulation of the spine to correct a subluxation as a physician service. Thus, Medicare+Choice organizations must use physicians, which include chiropractors, to perform this service. They may not use non-physician physical therapists for manual manipulation of the spine to correct a subluxation.”

My celebratory mood was quickly dampened by an American Physical Therapy Association’s (APTA) press release: “...This legislation [HR3447] also contained a chiropractic provision that is significantly scaled back from the original House version (HR2792) [which] would have established chiropractors as primary care providers within the VHA [Veterans Health Administration] and mandated chiropractic care at all 172 VHA health centers without additional funding...As a result of the concentrated education effort by APTA and other organizations, including the American Medical Association, the American Osteopathic Association, the American Academy of Family Physicians, the Disabled Veterans of America, and the Vietnam Veterans of America, several provisions were deleted to retain a primary focus of ensuring high-quality overall health care for America’s veterans.”

I was floored by the audacity of the statement “ensuring high-quality overall health care,” which basically says that the APTA does not believe chiropractors can provide the level of care that physical therapists are able to. This is the kind of vituperative comments that the chiropractic community must continuously battle. A January 23 Rehab Wire news brief stated, “APTA is pleased with the bill, and it notes that the final bill is much better for rehab providers than a prior version would have been. Justin Moore of APTA’s government affairs department notes that the original bill would have led to more extensive [chiropractic] services without additional funding for them—meaning the money would have come out of the existing budget for rehab.”

Is this the motivation for their guerrilla tactics? So they don’t have to share? What a shame. Because it is the patients who ultimately suffer.

“...there are certain shining stones [which] the Yahoos are violently fond of...they will dig...and hide them...but still looking round with great caution, for fear their comrades should find out their treasure. One of his Yahoos...missing his treasure, by his loud lamenting brought the whole herd to the place, there miserably howled, then fell to biting and tearing the rest...”¹ —Jonathan Swift in Gulliver’s Travels

Miwon Seo
mseo@medpubs.com

Reference
1. Swift J. Gulliver’s Travels. Part IV: A Voyage to the Country of the Houyhnhnms, chapter 7.