This article is to appraise you of recent and ongoing activities of the New England Chiropractic Council (NECC). The NECC has been active on a number of fronts in seeking to advance the chiropractic profession in our region and nationally. A historic overview may better help those of our colleagues who are not aware of the organization's past programs, activities, and achievements.
The NECC was formed in the early 1970s as a forum of communication and education for the New England region. The council is comprised of the largest state association representing each of the New England states inclusive of Rhode Island, Vermont, New Hampshire, Massachusetts, Maine, and Connecticut. Over the past three years, we have had the support and active participation of New York and New Jersey as well.
The voting board of the NECC are the presidents of these eight state associations who represent over 7,000 active chiropractic licenses in our region, and the NECC executive board. Other regular attendees at our meetings and active participants are the regional chiropractic colleges (New York Chiropractic College and the University of Bridgeport Chiropractic College). Activities of the NECC had in the past included coordinating conferences and regional seminars on chiropractic, and seeking to interact with the regional leaders. The current NECC Board includes: Dr. Barry Freedman, vice president (Quincy, Massachusetts); Dr. Tom Auget, secretary (Brunswick, Maine); and Dr. James Bilodeau (Dudley, Massachusetts).
The NECC has coordinated a number of demographic reports regarding the chiropractic profession in our Northeast region. The most recent was performed in 1994 and was enthusiastically received, especially by the chiropractic colleges whose students seek to have the most up-to-date and comprehensive information so as to hopefully insure their successful entry into practice. The NECC has and continues to be an avenue of support for new practitioners in our region.
Over the past decade, our focus has been more directed toward providing a forum of information exchange, communication, and education among our region's leadership. The NECC has held conferences on: 1) media relations, to empower our leadership and enable them to work with the media and effectively deal with any crisis situation that may affect the chiropractic profession; and 2) leadership, emphasizing the coordination and effectiveness of our state associations, which helps to assist and direct our young leaders as future committee chairpersons, board members, or presidents of state associations.
Our most recent conference included representatives from the state licensing boards, and the National Board of Chiropractic Examiners. Regional considerations of state licensing statutes, licensing of new doctors, and examinations were among many topics included on the agenda. These conferences have been well attended and received excellent reviews.
The NECC meets every four months. We have brought in key people to discuss vital issues regarding many aspects of our profession, including leaders of our national association, research institutes, health care consultants, public relations firms, etc. These meetings provide an ongoing exchange regarding legislative activity, insurance issues, membership services, etc.
This year, the NECC has coordinated meetings with those of the ACA delegates of our region to enhance state and national association communication. Valuable recommendations were made to the ACA regarding PAC fund effectiveness, and reevaluating the 1994 position statement of the ACA regarding primary care. It has been the concerted efforts of the NECC, in conjunction with the ACA Council of Family Practice and a coalition of the ACA Specialty Councils, to modify the neuromusculoskeletal position regarding chiropractic's role in primary care. Amendments have been submitted to the ACA for review at their winter meeting. The language has been carefully chosen to eliminate any perceived limitation to the scope of chiropractic practice which may have existed with the emphasis on "neuromusculoskeletal" contained in that document.
The NECC has been aware of a window of opportunity afforded the chiropractic profession relating to the new interest in alternative therapies. Dr. Eisenberg's 1993 article in the New England Journal of Medicine on alternative health care and its extensive utilization by the American public was a shock to the established medical and health insurance powers. It has created an opportunity which will allow a new niche to be defined in the mainstream American health care system and reimbursement and research networks. One would think that chiropractic, having been positioned over the last 100 years as the most accessible and utilized alternative healing art in the United States, would clearly be placed in a leadership role in this new paradigm.
However, as we have seen in recent articles and magazine exposes in such publications as Time and Life magazine, on television, or at professional health care conferences, chiropractic barely gets mentioned. The window of opportunity that now exists will likely close over the next five years as the health care pundits and financial wizards seek to control, absorb, define, and assimilate the dollars being spent on alternative health care into their own coffers.
This writer believes that with the vast body of research that has demonstrated the effectiveness of spinal manipulation, medical and other health professions will be seeking to utilize it. Other effective treatments utilized by the chiropractic physicians to assist patients in getting well and doing so in a cost-effective manner will also be vulnerable to assimilation by other professions. Why utilize chiropractic physicians when you can utilize physical therapists, osteopaths, physiatrists, massage therapists, acupuncturists, and those general family care practitioners who may feel inclined to pursue a limited certification program in alternative or manipulative therapy? These practitioners are already "medically" controllable or acceptable.
The public itself is confused regarding chiropractic's role. The fact is that a patient will seek health consultation if necessary from multiple medical physicians and/or hospitals or clinics for successful diagnosis, treatment, and ultimate resolution of a health disorder. When it comes to chiropractic evaluation and treatment, a patient will often only pursue one or two attempts with chiropractic physicians or alternative health centers for the effective resolution of a health problem. This reveals a lack of understanding or respect in the chiropractic health model. It has been my observation over the past 10 years that while more patients are seeking chiropractic care for back and neck pain, less are pursuing treatment for the vast array of other health conditions which we can manage effectively.
In our meeting with FCER back in 1994, significant dialogue was exchanged regarding a shift in focus from spinal manipulation as an effective treatment of back and neck pain towards more research in viscerosomatic or organic dysfunction, conditions which chiropractors have been collecting significant anecdotal evidence on for decades. The NECC was seeking at that time to shift the research emphasis away from the narrow niche of neck and back pain and expand it to open the door further to more clearly define the overall domain of beneficial chiropractic procedures.
Any doctor who is involved in nutrition is aware of the active lobbying efforts of the organized nutritionists and dieticians who, through their national associations, are seeking limitation and control of any other practitioner's utilization of orthomolecular therapy (vitamin, mineral, and nutritional supplementation programs, etc.). The physical therapists are regularly submitting bills to limit our utilization of physiotherapy procedures. In Rhode Island, our rights as physicians (statutes which have been in existence over 75 years) are now being challenged by the acupuncturists. The acupuncturists fought for and got a licensing law in 1986. They are now pushing the state department of health to rule that no one except a certified acupuncturist or a physician who takes their equivalent training can provide these services to the public. They are now also lobbying for third-party reimbursement. There are chiropractors in Rhode Island who along with the state association have been fighting this. Currently the state department of health is taking under consideration what requirements and restrictions they will place on a chiropractic physician's ability to practice acupuncture. It is ironic that it has been the chiropractic physician who for the prior 65 years, before the acupuncturists' law existed, were virtually the only practitioners utilizing these concepts and therapeutic interventions in their offices! I hope we will see our Rhode Island state practice statutes upheld. (Our rights as physicians currently allow us to do all that is in our training to help a patient, other than utilization of drugs and surgery.) The Rhode Island Board of Examiners will be updating us shortly on the outcome of this situation.
A document recently was created by the NECC for both the NCMIC leadership summit and the forthcoming ACA-ICA conference. This document puts forth a number of recommendations for the profession to take under consideration to help ensure its future. (A copy has been provided to this publication and I urge you to read it.) Recommendations from a unified body of the practicing profession, reflective of over 7000 DCs, is a valuable tool to be utilized in our united efforts to advance chiropractic health services.
In closing, let me state that the NECC has been an effective forum for the Northeast regional state association presidents, national delegates, and chiropractic college presidents to coordinate and facilitate true foresighted goals and directions for the profession. At our most recent conference on November 2-3, we were updated on the Council of Chiropractic Colleges unified agreement on the definition of the chiropractic paradigm, position on chiropractic, and subluxation. This is a great milestone for our profession. When the president of the National College of Chiropractic can agree with the president of Life College of Chiropractic regarding the definition of subluxation, there is a great opportunity to focus on the big picture and move forward in the expansion of our profession. The NECC seeks to facilitate the successful advancement of quality chiropractic care, for the public, for chiropractic physicians, and for the chiropractic profession. Your input is always welcome.
Alan R. Post, DC
Newport, Rhode Island
Fax: (401) 847-6610
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