March 2008

WCA opposes Kentucky's PT proposal

The World Chiropractic Alliance (WCA) joined other organizations and individuals in urging the Kentucky Board of Chiropractic Examiners not to vote in favor of a provision that would require all doctors of chiropractic to obtain training in physiotherapy.

In a letter to the Kentucky board, WCA President Terry A. Rondberg, DC, stated:

"On behalf of its members in Kentucky, as well as their colleagues around the world, I am writing to express the World Chiropractic Alliance's strong opposition to the regulatory proposal that would force all doctors of chiropractic to obtain training in physiotherapy.

Physiotherapy is one of many ancillary practices which chiropractors may incorporate into their practices, but it is not an integral part of chiropractic and is not taught in all accredited chiropractic colleges. In fact, the use of physiotherapy is prohibited in some jurisdictions and, where it is permitted, its use is discretionary, not mandatory.

By mandating training in an 'elective' discipline, Kentucky will, in effect, bar from practice any graduate of a chiropractic colleges that has, as its mission, to train practitioners to contribute to an individual's overall wellbeing by focusing on the correction of vertebral subluxation. Those doctors will be forced to seek training in a non‑chiropractic approach which is incongruent with their practice purpose.

Since physiotherapy is directed toward symptom relief and the treatment of specific medical conditions, it is contrary to the widely‑held chiropractic principle of subluxation correction. Mandating training in that approach, then, becomes a means to discriminate against that segment of the profession who choose to practice traditional, subluxation‑centered chiropractic.

Further, a growing body of scientific literature reports that passive physical modalities are of little or no value in addressing musculoskeletal pain, and may actually prolong disability. Evidence for this conclusion was provided in the Clinical Guidelines for the Management of Acute Low Back Pain, produced by the Royal College of General Practitioners in Great Britain and The AHCPR Guideline for Acute Low Back Problems in Adults. The proposal gives an implied endorsement of the procedures by the Kentucky Board, which contradicts this evidence and would therefore not be in the best interests of the profession or the patients it serves.

The World Chiropractic Alliance does not oppose the use of physiotherapy by doctors of chiropractic, if they choose to obtain adequate training in that approach. Nor does it oppose the use of other drug‑free and non‑invasive ancillary health care approaches often adopted by chiropractors, such as massage therapy, acupuncture and acupressure, nutritional counseling, ultrasound, electrotherapy, etc., so long as these adjuncts are permitted by state law. But it does oppose the mandating of any of these modalities.

I am familiar enough with the Kentucky Board to know that its members have the best interest of the profession and the public at heart. For that reason, I hope you will re‑consider the wide‑ranging and potentially negative ramifications of such a regulatory change and decide to continue with the policy of allowing, but not forcing, its doctors of chiropractic to train in the non‑chiropractic field of physiotherapy."