During the American Chiropractic Association’s (ACA) annual House of Delegates meeting in February, delegates passed resolutions supporting key elements in scopes of practice and the creation of the ACA College of Pharmacology and Toxicology. Based on membership responses, these policy resolutions have proven quite positive. To no one’s surprise, however, other organizations and special interest groups have associated these policies with “incorporating drugs into the scope of chiropractic practice and promoting the term chiropractic medicine.”
In fact, the resolution on the six key elements of a modern scope of practice act supports the terms chiropractic physician and chiropractic medicine. These terms are part of the ACA lexicon as they support our profession’s ability to practice to our full level of training and competencies. As the leading organization supporting contemporary chiropractic practice, we have embraced this terminology. (To read the policy in full, visit www.acatoday.org/policies and scroll to “Six Key Elements of a Modern Chiropractic Act”.)
Further defined in the scope of practice resolution are full management, referral, and prescriptive authority for patient examination, diagnosis, differential diagnosis and health assessment. As we are all aware, this language protects our ability to maintain first-contact, physician-level authority to manage our patients. This language is consistent with ACA’s mission to preserve, protect, improve and promote the profession and the services we deliver for the benefit of the patients we serve.
Through research, we have found that some existing state practice laws and regulations can limit the optimal health care workforce when they create a mismatch between legal scope and professional competence. In order to be inclusive in new and emerging health care delivery and payment models, our members should be allowed to practice in all states and territories uniformly and to levels consistent with their full training and competencies.
To be clear, there is no language in this scope of practice policy that promotes or supports prescription pharmacotherapy in the practice of chiropractic.
Now let’s consider the policy that supports the creation of the ACA College of Pharmacology and Toxicology. The College will function under the auspices of the ACA Council on Diagnosis and Internal Disorders. These subjects are currently being taught in chiropractic institutions and tested for on the national boards. The International Chiropractors Association, in its opinion response to this policy, called it the “Pharmaceutical College.” Perhaps that language conforms better to its mission to distort the facts.
Pharmacology is defined as the discipline concerned with the use, effects and modes of actions of drugs. Pharmacotherapy, on the other hand, is medical treatment by the use of drugs. The clinical understanding of pharmacology and toxicology is critical to our ability to comply with federally mandated meaningful use in electronic health records. Advanced training in drug-drug and drug-allergy dynamics is a necessary component of that mandate. Many ACA members are National Registry-certified medical examiners, which require them to have advanced knowledge and competencies in pharmacology and toxicology to perform Department of Transportation physical examinations for the nation’s truck drivers. The singular purpose of the College is to provide advanced training in this subject matter to those who are interested.
Do either of these policies support prescription drug rights? The answer is emphatically no. In fact, ACA supports the Chiropractic Summit statement that “the drug issue is a non-issue because no chiropractic organization in the Summit promotes the inclusion of drug rights and all organizations in the Summit support the drug-free approach to health.”
Health care in the United States is rapidly evolving. In order for the chiropractic profession to thrive and succeed in the delivery of value-based care, we need a strong, focused national association. The American Chiropractic Association is in a position to advocate for the chiropractic physician who wants to fill that role. I’m proud of the fact that ACA is comprised of a diverse group of experienced and dedicated volunteer leaders chosen by their peers to represent them. ACA will continue its focus on services and ideals that will preserve, protect, improve and promote the contemporary practice of chiropractic medicine.