Efforts to radically change the scope of practice in Wisconsin have been defeated by the efforts of a group of dedicated doctors in that state, with help from the World Chiropractic Alliance.

Early this year, the Wisconsin Chiropractic Examining Board -- at the direct request of the Wisconsin Chiropractic Association -- proposed changes to the wording of the practice act which would have mandated D.C.s to identify and refer medical conditions.

The proposed language would have made it compulsory for every chiropractor to "advise his or her patient to consult another appropriate health care provider if the chiropractor knows, or should know, that he or she does not have the skill, knowledge, or facilities to treat the patient's condition."

Since most courts would have judged only medical doctors to be "appropriate" health care providers, this phrase would have had the effect of making chiropractors refer patients to M.D.s for any non-chiropractic findings.

Another proposed language called for expansion of the scope of practice to the entire body, a change which many saw as an relinquishment of chiropractic's focus on the spinal column and adjacent tissues.

The Wisconsin association also proposed changes which would redefine chiropractic as "the principles of education and training common to the chiropractic and medical professions..." Since many "chiropractic" colleges are clearly stepping far over the boundaries of chiropractic practice in their teachings, this would have obliterated the distinction between medicine and chiropractic.

Wisconsin doctors opposing the destructive changes turned to the World Chiropractic Alliance for help in their battle. Jack Masche, D.C., the Alliance's Wisconsin representative, worked with other Alliance members to alert state doctors of the seriousness of the situation.

In a letter to his colleagues, Masche and his wife, Jacquelyn Loofboro Masche, D.C., pleaded with Wisconsin doctors to stand up to the state association.

"These rule changes will force all Wisconsin Chiropractors to embrace the medical model by forcing referrals and 'dutifully' coercing patients into a system that is already clearly dangerous and damaging to the health of our culture," they stated. "Chiropractic has always stood for freedom of choice, and spoken out against anything that would do harm to people from wherever it originates. We want all of you to think long and hard on this great potential loss to our pioneers and our principles."

Although some supporters apparently hoped the proposals would slip through the legislative process unnoticed, they were thwarted by the vigilance of World Chiropractic Alliance members like the Masches.

Gathering other state doctors -- both members of the World Chiropractic Alliance and non-members -- the Masches held a series of meetings to discuss the proposed changes. The World Chiropractic Alliance sent its legal advisor, noted Houston health care attorney Richard Jaffe, to Wisconsin to inform them of all the possible repercussions of the proposals.

Mr. Jaffe has had a long and productive relationship with the chiropractic profession, as well as other alternative health care practitioners. He represented New Jersey chiropractors in a successful federal racketeering lawsuit against officers of the Department of Insurance, Fraud Division and obtained a consent agreement whereby state agents agreed not to use extortionist tactics against health care practitioners.

He also successfully represented controversial Houston cancer doctor Stanislaw Burzynski in a federal criminal action brought by the FDA to incarcerate him for providing his un-approved cancer medication to patients. Currently, he is fighting for D.C. rights by demanding an injunction against the Federal Trade Commission to stop its discriminatory actions against chiropractic.

Jaffe warned the Wisconsin doctors about the ramifications of the "duty to refer" proposal, noting that it could expose them to greater liability, increase their malpractice insurance premiums, and necessitate extensive continuing education programs in pathology and medical diagnosis.

Working closely with World Chiropractic Alliance members in the state as well as with the organization's leadership in Arizona, Jaffe and opponents of the proposals demanded that the Board of Examiners hold additional public hearings so that state doctors could provide input.

After an article in the May issue of The Chiropractic Journal exposed the efforts of the Wisconsin Chiropractic Association's board of directors, the Board of Examiners appeared to back off from their support of the changes. One Board of Examiner member repeatedly reminded Jaffe that changes had been proposed by the state organization, not the Board itself.

Within weeks, there was evidence that even some of the Association's board of directors were trying to distance themselves from the proposals.

Frustrated in his attempt to pass the changes, Wisconsin chiropractic Association Executive Director Russ Leonard, who had spearheaded the proposal, lashed out at the World Chiropractic Alliance, rebuking it for sending "outsiders" to interfere with state affairs.

"We represent all chiropractors throughout the world," countered Terry A. Rondberg, D.C., president of the World Chiropractic Alliance. "We have a sizeable contingent of members in Wisconsin and we will go anywhere and do anything we have to do to protect chiropractic from those who would turn it into a medical therapy."

Opponents of the group's proposals lauded the World Chiropractic Alliance for its fast and decisive action and its willingness to expend considerable time and money to help the Wisconsin doctors who called upon it.

"Our members know that when they need us, we will come to their aid," Dr. Rondberg noted. "We aren't weighed down with an internal bureaucracy, and we don't need to set up a task force to study every issue which arises. We know what has to be done and we do it to the best of our ability. That's why our members feel free to come to us for help, whether they live across town or across the globe."

Rondberg said much of the credit must go to Richard Jaffe, who has shown, once again, his ability to persuasively and passionately represent subluxation-based chiropractic. He added, however, that the other real heroes of this situation were Jack and Jacquelyn Masche.