December 2005

CCE again pushes for PT college mandate

The Council on Chiropractic Education (CCE) has once again proposed a revision in the revision to the Standards to include "Non‑Adjustive Therapeutic Procedures" as a required clinical competency. Currently this competency is optional and the change, if approved, would force all CCE‑accredited schools to include physiotherapy in their curriculums, even if they felt such studies were not consistent with their educational mission.

The CCE announced the proposal on Sept. 30 and allowed until Oct. 30 for input from the profession. The call for input was not widely publicized and did not appear on the CCE website's home page. Rather, it was buried in a "pdf" file titled "announcements." A web browser with an Adobe Acrobat plug‑in was required to click through several pages of material in order to find the proposal.

Enough vigilant chiropractic watchdogs, including the World Chiropractic Alliance, discovered the arcane notice and immediately submitted protest letters.

In a letter to the CCE, WCA President Terry A. Rondberg, DC, urged the CCE to reject the proposal.

"To require this of all colleges is inappropriate for numerous reasons," Dr. Rondberg said. "The practice of PT is irrelevant to the safe, prudent practice of chiropractic. It further infringes on the prior rights of another profession, and would interfere with one of the most basic precepts of accreditation, the rights of colleges to retain autonomy in their mission... This is yet another step in a disturbing pattern of behavior in which CCE accredited colleges that support vertebral subluxation‑centered models of chiropractic are consistently placed in positions requiring defense of their missions by the accrediting body."

Nothing in the current CCE standards prohibits schools from teaching physiotherapy if they choose, but the mandate would take the decision out of the hands of the colleges. The CCE would dictate that curriculums must include non‑chiropractic training deemed "necessary" by the accrediting agency.

Although very little time was provided to submit input, doctors used the Internet and e‑mails to quickly alert colleagues to the proposal. The response was large enough for the CCE to issue another announcement, acknowledging that it received "numerous comments."

The announcement noted, "Because of the magnitude of response generated by this proposal, we provide the following information as background to this submission." The additional information explained that every year since 2002, the proposal had been submitted by external organizations and individuals. It did not reveal which organizations or individuals submitted the proposal. "According to the parties that provided these submissions, regulatory and licensing requirements from a majority of jurisdictions in the United States formed the rationale that motivated the proposals," the announcement explained.

It also noted that, "At the 2005 Annual Board of Directors meeting, a subcommittee on therapeutic procedures and modalities was established to study the issue. The subcommittee was composed of CCE Board members and of other individuals representing a broad cross section of interests from the profession. After deliberation, the subcommittee has formally submitted a proposal to the normal CCE review process, which includes review and recommendation by the CCE Review Committee, review and recommendation by the CCE Executive Committee, and final review and decision by the CCE Board of Directors."

Critics were quick to point out that no mention was made of reviewing any input from the profession and nothing in the CCE regulations mandates that it take such input into account.

Earlier attempts to mandate physiotherapy were met with similar opposition from the profession. In 2003, the Chiropractic Coalition ‑‑ made up of the International Chiropractors Association, Federation of Straight Chiropractors and Organizations and the World Chiropractic Alliance ‑‑ issued a position paper opposing the proposal.

The paper read: "The Coalition affirms that colleges have the right to autonomy in determining their institutional missions and the Council on Chiropractic Education (CCE) Educational Standards must respect institutional autonomy and educational diversity. We assert that accreditation is intended to establish minimal standards for good practice in the field, evaluate institutions and programs according to those standards, and publish lists of colleges meeting those standards. The accrediting process should not be used to shape or reshape a profession. A standard mandating the teaching of physical therapy would violate these accreditation precepts and constitute a serious infringement on rights of colleges to formulate and pursue their institutional mission."

The CCE Board of Directors will meet in January 2006 to vote on the proposal.