Leaders perplexed about 'disconnect' between DCs and reality of threats

The strategic planning meeting by executive directors of the Council on Chiropractic Practice (CCP) in mid January 2006 covered a lot of ground. Beginning with a general overview of the crisis facing subluxation‑centered chiropractic and its practitioners, it moved on to other issues, including the "disconnect between subluxation stakeholders such as the colleges, technique developers, professional policy makers and practitioners."

"The problems we discussed were among the most important facing the profession today," stated CCP board member Veronica Gutierrez, DC. "The issues are incredibly complex and finding viable solutions is absolutely necessary if we are to preserve the integrity and identity of chiropractic."

In addition to Dr. Gutierrez, the meeting was attended by CCP President Christopher Kent, DC, Vice President Matthew McCoy, DC, and Treasurer Terry A. Rondberg, DC. Noted chiropractic researcher Robert Blanks, PhD facilitated the meeting, which was held in St. Louis.

The first item on the agenda was a review of recent events shaping the practice of subluxation‑based chiropractic worldwide. While recent surveys indicate that the vast majority in chiropractic feel that correction of vertebral subluxation is central to their practice and professional identity, most are passive and seem unaware of the growing threat to their profession. They spurn membership in any professional association, are reluctant to finance or otherwise support efforts to safeguard chiropractors' rights, tune out news about existing or potential problems, and seem unconcerned about the direction the profession is taking.

"It's time for stakeholders in the future of chiropractic to become involved," Gutierrez emphasized. "We need their time, talent, and monetary support. I see a glorious future for the chiropractic profession if DCs will become more involved in shaping it."

The CCP executives worked to identify chiropractic "stakeholders" and understand the reasons for what they termed the "disconnect" between their obvious love of the profession and their willingness to face reality about the threats facing it.

The group formulated an initial plan to engage field doctors in the effort to protect the right of their patients to receive subluxation‑directed care, as well as to protect the right of chiropractors to provide such care.

"Chiropractors do not proactively support the things they need to get them out of trouble until they are actually in trouble ‑‑ then the phone starts ringing," Dr. McCoy noted. "We need to educate them that this strategy will not work in the coming health care environment and political climate."

Much of the weekend meeting was spent planning the next revision and update of the CCP's "Clinical Practice Guideline Number 1: Vertebral Subluxation in Chiropractic Practice," scheduled for completion by August of 2008. The CCP Guidelines were first published in 1998 and revised in 2003.

Because of an increased emphasis on research and evidence‑based care, the CCP recruited Dr. Blanks to oversee the revision process.

"I'm honored to be part of this historic effort," Blanks said. "Evidence‑based guidelines are an absolute must for all health care professions and can have a far ranging and powerful impact on the advancement of a profession."

Since their initial publication, the CCP Guidelines have won widespread support both within and outside of the chiropractic profession, in contrast to the highly controversial and widely rejected "Mercy" guidelines.

The Council on Chiropractic Guidelines and Practice Parameters (CCGPP) "best practices" document, being developed by many of the same individuals involved in the Mercy guidelines, have already provoked controversy. Many chiropractic leaders have expressed grave concerns about the CCGPP effort to regulate the profession through its latest guidelines.

"There were serious flaws in the way the Mercy guidelines document was developed as well as its conclusions," Dr. Rondberg pointed out. "The guidelines became the key weapon used by the insurance industry to limit chiropractors to 10‑12 visits for low back pain type complaints. We have seen no evidence that the new incarnation of Mercy, the CCGPP, will be any better for the profession or the public it serves."

The next meeting of the Council on Chiropractic Practice will be held in Washington, DC on May 7, 2006, following the May 5‑6 World Chiropractic Alliance International Summit. In keeping with its tradition of open deliberations, invitations have been sent out to all interested parties, including chiropractic leaders, technique developers, researchers, and field doctors.

For more information about the CCP, including a discussion of the differences between CCP and CCGPP guidelines, visit www.ccp‑guidelines.org.