September 2006

Look what's happening in California

by Dr. Terry A. Rondberg

Anyone who's been reading The Chiropractic Journal for the last few years knows that I have had clashes with the California Chiropractic Association (CCA). As far back as 1989, I reported on questionable actions and policies that organization was taking, and its incestuous relationship with the California Board of Chiropractic Examiners. I felt that Michael J. Schroeder, who served as the attorney for both the CCA and the Board, was having a destructive influence on the two entities. And I was vehemently opposed to the CCA's recommendation to add additional requirements for the acceptance of accrediting agencies that, in effect, prevented graduates of several subluxation‑based colleges from sitting for the licensing examination in California.

Of course, I also gave credit where credit was due and reported when the CCA fought against statutory change that would have limited a DC's right to provide patients with diagnosis and treatment using physical therapy, ultrasound, soft‑tissue manipulation and thermography. I never felt these therapies were a mandatory part of chiropractic, but the CCA at least was acting in what it felt was the best interests of a portion of their constituency.

I applauded the CCA when they passed a resolution ending its support of the Mercy Guidelines, saying they "no longer represent the present state of scientific evidence," and noting that they have been misused by some "individuals or entities in the insurance and health care industry."

Through it all, the World Chiropractic Alliance is establishing relationships with several CCA officials and has kept a watchful eye on the organization's evolution. There are increasing signs that it's changing into an organization willing to support the entire spectrum of chiropractic perspectives rather than just the broad‑scope camp.

I've talked recently with CCA President John Bueler, Jr., DC, and I've been impressed with his dedication to chiropractic and his desire to make certain changes in the organization so it would reflect the mainstream thinking of the profession and become inclusive like the ACC Paradigm instead of exclusive as many perceive it to be.

For example, we know from several professional surveys that the vast majority of DCs want to retain the term "vertebral subluxation complex" (88.1%, according to the 2003 survey conducted by Ohio Northern University's Institute for Social Research). That same survey (which, given that it was underwritten in part by Dynamic Chiropractic, Footlevelers, and Palmer College, can not be accused of being biased toward the subluxation‑based community) found that DCs rate the subluxation as a significant contributing factor in more than 62% of all visceral ailments.

It was therefore surprising to me when I discovered that the word "subluxation" didn't appear once on the entire CCA website, even though the site contains a public information section. After discussing such issues with Dr. Bueler, though, I get the strong impression things will change in the near future. The site, after all, does explain to the public that "The purpose of chiropractic is to provide a first health care contact for wellness and the optimization of health." That's a heck of a lot better than some chiropractic organization sites that talk about back pain relief! I like, too, the CCA's definition of chiropractic as "a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery." as stated in the ACC Paradigm.

The next step I hope will be to take out the misleading statement that "Doctors of chiropractic are trained to diagnose all conditions." Even the more radical broad‑scope DC would be hard pressed to make that claim. Does our chiropractic education really prepare us to diagnose restrictive cardiomyopathy, deep vein thrombosis, or ovarian carcinoma? Is that the role chiropractors play in health care?

Two steps forward ... one step back. Yet, I still look with cautious optimism at the progress the CCA is making. I know the organization is in the middle of its review of the Council on Chiropractic Guidelines and Practice Parameters' Best Practices Lower Back Draft Document, and I will not be surprised if they fail to endorse, or even outright reject, the document.

I'm the first to admit that I can be too trusting. I talk with people and usually tend to believe what they're telling me. But Dr. Bueler was more than just persuasive. He sounded sincere and his dedication to chiropractic was genuine even if his vision was slightly different from my own. I'm firmly convinced we share a commitment to maintaining chiropractic as a separate and unique health care approach that emphasizes subluxation correction.

Dr. Buhler sees the advantage and power of more doctors uniting in the state. While I told him I agree with him, my emphasis is making sure the CCA can be a safe home for all doctors of chiropractic, including doctors who want to limit their scope of practice to the diagnosis and correction of vertebral subluxation. This would provide a live‑and‑let‑live environment for all licensed California doctors and be congruent with the ACC Paradigm. I also stated that I believe this would go a long way in uniting the state of California and Dr. Bugler assured me he agreed with this position.

There are many wonderful state organizations working hard to protect and advance chiropractic and preserve its distinctive place in the health care arena. Until recently, I wouldn't have put the CCA into that category but I believe we're witnessing something momentous and important there. With 10,000 active chiropractic licenses in California, the CCA's attitudes and actions could have a tremendous impact on the profession as a whole.

If, as I foresee, the CCA moves toward a more inclusive and mainstream stance in regard to the role of vertebral subluxation correction and lifetime wellness care in chiropractic, I think thousands of more subluxation‑based DCs in the state can support the group in good conscience, without compromising their principles.

In fact, I don't think California doctors should take a 'wait and see' attitude. They should consider joining the group to support and advocate for the changes envisioned by Dr. Bueler. Forget what the CCA used to be and judge it on what it is and what it can become!

As I have stated so many times to the profession about joining the WCA, dues are like votes. If you don't like what the organization does, stop paying your dues. Let's come together in the next year and join the CCA. Consider it an experiment with me and let's see how inclusive it is becoming. After one year, we can review what has changed and determine if it can truly represent all of us.