Don’t Bogart That Joint, My Friend
POLITICS
A Discussion about the Pros and Cons of DCs Having Rx Rights
Roderic A. Lacy
Here are the questions: Should DCs have Rx rights? Should we split as a profession? These questions divide our profession and they need to be addressed now.
Face it, drugs are everywhere and easy to get. So, why would a DC want to have the right to prescribe controlled substances, and why would our profession need to allow it? These questions are valid and need to be addressed very soon before we destroy ourselves. This is the 500-pound gorilla sitting in the corner—you and I both know it.
Back up a little and remember that in three states, maybe more, limited prescriptive rights are within the scope of a DC’s license. Also, one must make note that in New Mexico, “advanced practitioners” not only can prescribe on a limited basis, but they also now have a federal drug ID number. So anyone saying that our profession is drug-free is incorrect. Furthermore, in Europe several nations allow DCs to prescribe medications without limitations.
I am sure that no one would argue that it would be great if we were now recognized as equals in the medical community—enjoying parity. That would be nice, but that is not the way it is. The only way to achieve parity is to have equal laws. With this thought in mind, I ask you, is it is time we open the Rx discussions in every state in the US and remove the gorilla from the room?
This question looks great on paper—should we have Rx rights? However, it will be very hard to answer. It appears many DCs do not want to discuss this issue, and since we are all humans, we all want it our own way, so it will take some serious effort by every American DC for our profession to make the correct decisions on these issues.
In this discussion, there are two very important and distinct issues to be addressed, not just about prescribing as many might argue, but prescribing and "describing". Both are equally important. Obviously there are other concerns, but these are the two biggies. One can argue that DC Rx rights will lead to more scripts and less natural healing, which is a very valid argument and definitely is on the top of the list. What about "describing"? Is this equally as important?
As I see it, the real issue is describing and the general policing of drugs, not whether we can write a script. That is where we as DCs step in. DCs will need to police drugs, i.e.,
making sure the right drug is prescribed for the correct condition, the correct way and better yet, making sure the drug is necessary. (As a licensed MD, I can attest to the idea of a DC being able to reduce the poison a patient takes if you have the power.) This is known as "describing" by all First Chiropractic Physician Association of America (FCPAA) members. It is a concept that also deserves a lot of consideration. How can you remove a patient from a poison if you cannot prescribe the poison? You can’t. As of now, the only thing that DCs can do in most states is shake their heads and smile when a patient asks about an Rx. I have to ask you: How can you claim to be counseling patients about their health if you cannot even comment on their chemical intake? It is simple: you cannot.
I agree that we need to keep our natural philosophy. Our schools set that tone for the profession. Our legislators only give us the power to use what we are taught, but they do not set the tone of the average DC. It all starts with our schools.
I cannot stress this enough: our schools are the key to keeping our natural healing philosophy. If our profession embraces the idea of parity, and we are finally on an equal playing field—equal to other physicians—we will have to be very careful that our schools do not lose the zest they have toward our profession being a natural profession. I am sure you will all agree that for us to stay alive as a unique profession, then we must keep our roots and not become another pill-pushing profession. I bet 99% of us all agree with this.
Again, I must reiterate that the school’s job is to keep us on track. If we deviate from the pure naturalistic healing philoso-
phy, we need to blame the schools. If we fail as a profession because we failed to advance, we need to blame our state associations. There is a huge difference between philosophy and laws. We must not confuse the two.
In a perfect world, our schools would openly teach a full curriculum—you know, a chiropractic/medical curriculum and each DC would have the legal right to “describe” as well as prescribe. And within that curriculum, the schools must never lose a breath of “natural philosophy” as in, “Go, natural, go.”
What if we graduated the best of the naturalists? What if we had the home court advantage of a full education with laws allowing us to step up to the plate and demand that we be able to do what is needed for our patients without restrictive legal parameter worries? What if we could be the best of the best? What if our leaders would unite and do what needs to be done to advance us into the real world of health? How cool would that be? Very cool. The world is waiting for us, and yet, we sit and debate.
OK, let’s look at the other track we can take—no advancements, no prescriptive privileges, and obviously no “descriptive” rights. Let’s say we go totally straight—no new ideas and without meds—and we withdraw to the state we were during the early ’70s or earlier—when adjustment ruled and we all had punch cards to keep track of the visits or a box on the wall for payments. What happens first, second, or third?
First, would our schools’ enrollments decrease to what they were in the early ’70s? Secondly, would the schools focus on their university status to supplement the lost income due to the low enrollment of the DC college?
Third, would the universities grow by adding and offering additional, more lucrative degrees in areas such as PA, nursing, dental, etc.? Could it be that once they introduce more colleges, the universities would grow and slowly phase out the DC colleges? Look around. You might be surprised to see what is happening already.
Before I go any further, I have just been told that the Colorado Chiropractic Association recently voted and now supports DCs adjusting without an evidence-based diagnosis. What does this mean on the street? It means Colorado DCs might be able to see patients without an objective exam and be backed by the CCA, and they are closer to being able to adjust legally because of the “touch” diagnosis. This might allow adjusting “mills” to open up all over, and allow for DCs to bang bones until their heart's content without any objective findings. Where will that lead us? Maybe to the level of a licensed massage therapist (LMT). This is where it gets even hairier. OK, we see a patient, palpate and adjust, and send the patient on his or her way. Great, everyone is happy? Not really.
Financial and emotional thoughts come into play at this point, which is where the schools should clearly see the problems coming into focus. Why would any levelheaded young person want to pay a ton of money and spend many years to earn a degree that has been devalued to the level of an LMT? The answer is they might not want to, and if the potential students shy away, then the chiropractic schools within the universities might fail.
And here is where it gets even trickier. So LMTs are adjusting and now have the ability to carry the “adjustment torch.” What have we done by not advancing our rights? We have shifted the responsibility of adjusting to the LMTs and killed the chiropractic profession. The adjustment will remain alive and kicking. It will be a matter of who does it, and it will just be shifted to where it was 100 years ago—to a short course, the LMT.
In wasting time and arguing about advanced rights, we may have destroyed the one chance we have to help the entire world. If we allow the adjustment to be swept under the advancement table only to land on the massage table, then we will have managed to do a great disservice to the world.
I know. You say we can lobby to keep LMTs from adjusting. Good luck. They are doing it now. Come on—a different name is still the same animal. It does not take a rocket scientist to figure out that all you have to do is rename it. They adjust now and are calling it “thrusting,” and they will continue to do so.
I hate to break the news to you, but the world has discovered the adjustment. They are coming out of the woodwork
to provide the sick with what they need, and the adjustment is part of the plan. The issue is rights not philosophy.
Oh, and do not forget the doctor of physical therapy (DPT), guys and gals. I get ads almost monthly for seminars sponsored by DCs where they teach the art of adjusting to DPTs. These DPTs are focusing on adjusting and proud of it, and since they are in the medical community, they are part of the medical family. Plus, they are gaining Rx rights across the nation and graduating as doctors.
It is a new morning and unless we wake up and save our schools, save our heritage, and save ourselves, then we will perish like many other professions have already. Remember the homeopathic profession? Dead. How about the chiropodist? Changed their name and mission statement, doing great, and all surgeons now. My son-in-law is a dentist, and he performs more surgery than most MDs.
Have you checked out naturopathic medical doctors (NMDs) lately? Years ago, I met my first NMD, and he told me that they were doing great. I did not believe him because I had been told by some of our chiropractic leaders that the naturopathic profession was failing. Apparently, that was not so then, and it is not so now. They are all over the country. NMDs are always looking for new and better ways, and unlike DCs, they are united in their future—expanding their rights.
How can we expand our rights? The idea is simple. We have two choices. We need to unite as a profession and demand expanded rights with the support of our schools, or we need to split and separate. We need to remember our past and race to the future. We need to be leaders and not followers. We need to do what the world needs and not be selfish and allow a great profession to fall to the wayside. We need to accept that chiropractic is not a religion but a science. The world needs us now.
So, what are the arguments? I get so confused sometimes. At times, I almost forget what the debates are all about. Some days, I think they are about Rx rights. Some days, I think they are about being able to take patients off drugs. Some days, think they are about being paid for services provided. Some days, I think they are about saving our schools. But you know what I always think they are about? The survival of our profession and the patients we serve. Do we unite or separate? This is the real debate—whether it is time to split as a profession or unite and teach the curriculum that is needed to allow every DC to treat his or her individual patient as he or she deems necessary. What do you think?
Dr. Lacy is a licensed MD and a retired DC. He is a Palmer graduate who understands the value of natural health with a mix of modern medicine. Dr. Lacy is the CEO of the Florida Chiropractic Physi-
cian Association (FCPA), www.myfcpa.org, and the CEO of the First Chiropractic Physician Association of America (FCPAA), www.myfcpaa.org. He can be reached by e-mail at myfcpa@gmail. com.
