While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
What Constitutes "Professional Discrimination"?
The concept of professional discrimination is not new. The profession of osteopathic medicine encountered it during their first 50 years of existence. With the advent of World War II, the U.S. Medical Corps initially denied commissioning of DOs. However, with the overwhelming increase in U.S. war casualties, Congress (against the opinion of the medical corps) authorized the commissioning of DOs into the Armed Services Medical Corps. Thus, DOs became employed as civilians at government hospitals after the war.
Since the chiropractic profession has never provided allopathic treatment, being the specialty profession that it is, the road to acceptance in the public workplace will take a different legislative route than osteopathic medicine. Remember, DOs never had the luxury of government research, or a Navy project, or even the U.S. Public Health Service favoring them before Congress commissioned them.
In the meantime, until DCs are commissioned and then become employed as civilians at government hospitals years later, I have drafted a proposed definition of what constitutes "professional discrimination." My definition is certainly open to debate within the chiropractic profession and I welcome all discourse.
Professional Discrimination -- Definition
"Any state tax-supported facility (e.g., hospital), providing service for a common condition (e.g., acute low back pain), that denies employment to a licensed professional qualified to deliver that service (e.g., a chiropractor) as has been determined by agreed research (e.g., Rand study of short-lever manipulation/chiropractic) and government decision (U.S. Public Health Service Guidelines for Acute Low Back Pain), constitutes professional discrimination."
Paul M. Kell, DC
San Diego, California