New Mexico Advanced Practice, Chiropractic and the National Associations

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Published 05/05/2010 - 11:18 a.m. CDT

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In March 2009 the State of New Mexico adopted a provision to provide for Chiropractic Advanced Practice Certification. Says New Mexico Law, as found at this location, "'Certified advanced practice chiropractic physician' means advanced practice chiropractor who shall have prescriptive authority for therapeutic and diagnostic purposes as authorized by statute and stated by the board..." and defines that “'Chiropractic formulary' shall mean those substances that are natural or naturally derived that have been approved for use by the chiropractor registered in advanced practice by the chiropractic board and as by statute with consensus between the New Mexico medical board and New Mexico board of pharmacy."

Further the law states "Advanced practice registration is authorized by [legal citations removed] and allows the use of approved naturally derived substances through injection for therapeutic purposes. A chiropractic physician shall have the prescriptive authority to administer through injection and prescribe the compounding of substances that are authorized in the advanced practice formulary. Those with active registration are allowed prescription authority that is limited to the current formulary as agreed on by the New Mexico board of chiropractic examiners and as by statute, by the New Mexico board of pharmacy and the New Mexico medical board. The New Mexico board of chiropractic examiners shall maintain a registry of all chiropractic physicians who are registered in advanced practice and shall notify the New Mexico board of pharmacy of all such current registered licensees no later than September 1st of each licensing period."

For the "non-advanced practice" chiropractor the law provides "A chiropractic physician without advanced practice certification may administer, dispense and prescribe any natural substance that is to be used in an oral or topical manner so long as that substance is not considered a dangerous drug."

Dynamic Chiropractic reports HERE that "The legislation will allow New Mexico chiropractors who have 'completed a minimum of ninety clinical and didactic contact course hours in pharmacology, pharmacognosy, medication administration and toxicology certified by an examination from an institution of higher education approved by the board and the New Mexico medical board [to] prescribe, administer and dispense herbal medicines, vitamins, minerals, enzymes, glandular products, naturally derived substances, protomorphogens, live cell products, gerovital, amino acids, dietary supplements, foods for special dietary use, bioidentical hormones sterile water, oxygen, epinephrine and vapocoolants."

Also in this article DC is reporting that the International Chiropractors Association is issued a press release expressing "grave concern for public safety" as a result of New Mexico's actions. Says the ICA: the ICA was "asked by members in New Mexico to become involved in the pending implementation of a recent legislative action that has the potential of fundamentally changing the nature of chiropractic practice as well as confusing the public and possibly placing the public at risk at the hands of a new category of provider. ICA, while fully recognizing the wherewithal for any state legislature to act as it sees fit on behalf of its citizens, believes that this change is in neither the best interests of the public in New Mexico nor the chiropractic profession nationally. Public safety is in question. The authority to prescribe and administer medications has traditionally been understood under the law as the practice of medicine. ICA holds that any member of the public, when interacting with any health care professional, has the right to expect that [the] professional has been trained and qualified at the highest level. We do not believe that this policy change provides that protection."

"The New Mexico law change represents a major paradigm shift for the chiropractic profession," reports the ICA. "Since its founding more than 80 years ago, the ICA has consistently held that chiropractic is and should remain a drugless science and practice." The report concludes stating ""Action is needed to avoid damaging chiropractic nationwide. ICA urges all organizations and institutions within the chiropractic profession to take a stand on this issue, supporting the maintenance of chiropractic as a drug-free profession, clearly distinct from the practice of medicine and to oppose the tiering of the chiropractic profession as is established in the New Mexico statute. ICA strongly urges the National Board of Chiropractic Examiners (NBCE) to not give this initiative credibility by the establishment of any national exam to be used for the purposes of prescribing drugs and practicing medicine."

In a separate story Dynamic Chiropractic reports HERE that Dr. James Edwards states "the ACA does not support a two-tiered profession. More importantly, I want to stress in the strongest possible terms that the ACA certainly does not support the inclusion of prescriptive drugs as a part of chiropractic practice. How do I know that? Very simple! The ACA Master Plan states, "Chiropractic is a drug-free, nonsurgical science and, as such, does not include pharmaceuticals or incisive surgery." What part of that clear, concise statement is hard to understand?"

"I am also pleased to inform you that the above official policy has been reaffirmed by the current ACA House of Delegates, which voted unanimously in February 2010 to remove all confusion....the ACA's core tenant that chiropractic is a "drug-free, non-surgical science. The bottom line is this. The ACA does not support a two-tiered profession or prescriptive drug rights, and anyone who says differently is either mistaken or has an ulterior motive."

With national health care reform and the health insurance coverage that all Americans will be required to carry, with a reformed practice act in New Mexico allowing for those who desire it to pursue "advanced practice", and with two national professional associations taking a "hands off", or even adversarial position, one wonders what will become of the chiropractic profession...in New Mexico and elsewhere.

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Added: April 09, 2012. 12:49 PM CDT

Updates

Since this article was written, the ACA has supported a broader scope of practice to include pharmaceuticals. The CCE has dropped the term "Subluxation" and "...without drugs or surgery" from the definition of Chiropractic.

The ICA has continued to lie and subvert the truth but they failed to have CCE removed as the official accrediting agency of the Chiropractic profession.

There is hope that this profession will continue to expand its scope and Chiropractors will fill the gap of the Primary Care Provider in the National Healthcare system.

Alan Di.

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Added: March 24, 2012. 08:17 PM CDT

Dearest Dr. Lee,
My chiropractic education... does include one year of classroom education of paramedical education

Anonymous

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Added: February 28, 2012. 07:28 PM CDT

I believe the ICA has no right to make decisions for all chiropractors. A lot of things have changed and education has changed and is backed up by research. As a doctor we need to do what is best for the our patients and every patient is different. An adjustment is our main tool in our practice but have extra tool to help our patient if they need it can also help. If you are totally against drugs or whatever else then you can choose not to do it, but you don't need someone else to tell you that you cannot do it, everyone has a right..., let everyone have a choice. It is already bad enough that medical board is attacking our profession, why do we need to fight amongst ourselves. It looks very bad from the outside. Also, just remember that we call our self doctor, and our goal is to get patient better. So as a doctor, we need to be aware of all the pros and cons of research that relates to treatment for our patients. We need to update in order to make the best decisions for our patients and not just go by theory.

aat

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Added: July 10, 2011. 09:03 AM CDT

Standard of Care Question

Please read the mission and the goal of the "straight" chiropractic organization. Does the exclusive location, analyisis, and correction of vertebral subluxation meet the standards of care in Texas? Does it serve the profession well to promote a separate and distinct position during a time when integration of our services and high quality, patient centered care supported by evidence is a Federal requirement?

The mission of the IFCO is to support and advance the practice of chiropractic that is exclusive for the location, analysis, and correction of vertebral subluxation because vertebral subluxation, in and of itself, is a detriment to the fullest expression of life. Our ultimate goal is to ensure the future of chiropractic as a separate and distinct profession to secure and insure public access to vertebral subluxation correction.

Dr. James J. Lehman

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Added: May 06, 2011. 01:23 AM CDT

Advanced Practice Chiropractic

Advanced Chiropractic is an answer to the expanding need in the health care system. With baby boomers entering the system, it is being overwhelmed. Primary care is being taken over by Nurse Practitioners, Physician's Assistants and foreign trained Medical Doctors.

If you will notice, Cleveland Chiropractic College L.A. is going out of business. Chiropractic schools have seen a great drop in their enrollment for the past several years and it probably won't get better any time soon.

Unless we address the needs of the population and expand our scope to include general medicine, we are doomed to be extinct by the end of this century.

Rather than fight the inevitable, contact your ACA /ICA representative and insist they back this as a solution to professional sustainability. And, while your at it, write to your state political representatives and ask them to back the idea of Advanced Chiropractic Practice.

Alan Dinehart, DC

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Added: April 14, 2011. 02:28 PM CDT

Go to medical school if you want to prescribe!

Why is it that so many paramedical practitioners are so intent on encroaching on the medical profession? Do you think 90 hours of continuing education is enough to be properly trained to prescribe? Physicians (real ones that is) cannot prescribe independently until completing residency - which represents thousands of hours of training. What you all desire is dangerous to patients, and the only reason you are promoting it is to line your pockets.

Lee, MD

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Added: January 17, 2011. 10:38 PM CDT

Thank God

How can a chiropractor pay back $200,000 or more in college loans if insurance companies do not pay a chiropractor. Insurance companies and drug companies are the same business. When an insurance company pays an MD they (The Insurance Company) probably nets out a 2% profit due to the mark up on prescription drugs, because the insurance company is the drug company due trillions of dollars of inter invested capital. It is all a matter of money, profit margins, bottom lines. So if Chiropractors do not position themselves to be able to have the right to prescribe "Drugs", they will soon evaporate like the mist on the morning matter when the Sun rises in the sky. So goodbye my brother Chiropractors. Thanks to Gerald Clum and all the straight chiropractors who will not accept the reality that Medicine/Chiropractic is a ART, SCIENCE, AND PHILOSOPHY but it is also a business and a Business is like an animal that must be; fed, given shelter and taken care of. The cost of Chiropractic College is not 20 dollars, its more like 250,000 thousand dollars without including the cost of running a business and the cost of living. Either Chiropractors prescribe Medicine or Chiropractors go extinct.

Anonymous

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Added: November 17, 2010. 05:10 PM CDT

Relevancy of Chiropractic Prescription Rights

Chiropractic Health Care has finally gained enough public acceptance that mainstream medical practice scopes are now expanding into our field. We should operate with the intent to serve the public in a way that is complient with our skills and abilities.

Being considered primary care physicians without having prescription rights handicaps the physician and complicates case management. Increasing case management complexity leads to increased health care costs and drives insurance premiums up and benefits down. The health and welfare of the public and ultimately the patient should be considered at the center of discussion regarding this topic. If we can manage to address several symptoms optimally by providing both pharmaceutical and physical medicine interventions at once, then we will in effect minimize case costs.

Dr. Frank Bucki DC CSCS

Dr. Frank Bucki

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