Chiropractic in Taiwan
Dear Editor:
Taiwan is an island nation of 21 million people. Currently, there are five licensed DCs on the island, but no legislation governing the practice of chiropractic. The Taiwan Chiropractic Association (TCA) was established to promote chiropractic and the eventual goal of having chiropractic legislated.
The Taiwan Chiropractic Association wishes to increase its membership of DCs, student doctors, suppliers, and anyone who is interested in the TCA. For those who are interested, please contact:
Dr. Gerald Liu (CCCLA, 1991)
168 6F1-1 Wen-Wu 2nd Rd.
Kaohsiung, Taiwan
Postal Code 801
Tele: 886-07-216-4379 Fax: 886-07-216-4378
Dr. Andy Hsu (CMCC, 1992)
36 Huang Hai Street
Kaohsiung, Taiwan
Postal Code 800
Tele: 886-07-227-1673
Gerald Liu, DC
Kaohsiung, Taiwan
Victory for Chiropractic in South Africa Dear Editor:
All general practitioners, medical specialists, dentists, and paramedical practitioners in South Africa are controlled by the South African Medical and Dental Council under legislation passed by the South African Parliament in 1938. Since 1938, the chiropractic fight for recognition and acceptance has been opposed by this powerful council.
In 1982, despite the vigorous protests of organized medicine, the practice of chiropractic and homeopathy was legitimized by Parliament, and under this legislation, two faculties of chiropractic were established in 1988. A series of meetings and negotiations continued to take place to persuade organized medicine to remove a regulation in their act which prohibited all registered MDs from cooperating or associating with DCs in any manner. This regulation kept DCs from being accepted as a legitimate profession and cast a cloud over the status of chiropractic care.
In an historic decision, Oct. 11, 1994, the S.A. Medical and Dental Council repealed rule 7(2) and thereby ended the long feud between medicine and chiropractic that had raged for over 50 years. Chiropractors are now legally entitled to handle workmens' compensation injuries, and to order any test or procedure from any medical specialist. They may utilize hospital facilities and receive copy of patient records. Inter-referals between the professions is now authorized and sanctioned. South Africa is possibly the first country in the world where chiropractic has been recognized by an act of Parliament and by the country's medical authorities.
This bodes well for the relationship between the professions. The benefits to the patient in economic terms and in terms of better health service are potentially enormous. Chiropractic has won its right to exist as a separate profession by the high level of conduct of its negotiators and their diplomatic skills in winning the hearts and the minds of the opponents to a once stigmatized and outlawed profession in South Africa.
Dr. M.L. Milani Chairman, Chiropractors, Homeopaths and Allied Health Service Professions Council of South Africa Groenkloof, South Africa
DOs vs. DCs: Inequality in ICD Codes Dear Editor:
It has recently come to my attention that there are a new set of osteopathic ICD-9 manipulation codes. These codes were established in 1994 and are based on the level and number of body regions manipulated. The fees are also accordingly based.
A Medicare bulletin recently reviewed shows the payment schedule Medicare allopaths for the different codes.
Why is it that the osteopaths have varying levels of manipulation services and can use ICD-9 codes with Medicare, whereas, we chiropractors are limited to one HCPC code of A-2000 no matter how extensive our adjustment services?
I wrote and asked the area governor over eight weeks ago. I have yet to hear from him.
How about if we develop our own chiropractic adjustment codes for the ICD-9 code book? Instead we seem to rely on other professions' codes.
If we are to be regarded as unique professionals in the eyes of the government and insurers, then we must act like it.
I would like to see the ACA and ICA get busy on this project.
Charles Sallahian, DC, DABCO
New York, New York
Drugs Are Not the Solution Dear Editor:
This is in response to the letter you received from the chiropractor that is having trouble paying off his student loans. I am a chiropractic student and president of the SICA at Cleveland College, Kansas City. I am completely appalled that this DC thinks the use of pharmaceutical products in our profession is the answer to the mounting problem of individuals who can not pay their student loans. I think it is simply pathetic that this doctor bases job security on whether or not he has the ability to prescribe drugs. It is the wrong message to be sending to the public. This doctor never said it would benefit his patients to have pharmaceuticals at his disposal. He bases the use of these on his success, meaning he can make more money by giving drugs to his patients. My suggestion to this doctor and the many other DCs out there pondering this dilemma, is to take some business classes, cut overhead, learn to market themselves in a different manner, do something but please do not follow in the footsteps of the osteopaths. Maybe that is the answer. He could go back to school and become a DO. Yes that's the answer, then he could even cut people open and take things out that don't need to come out and really make some money. I know these last few lines are sarcastic, but to many of us have lost the faith in what chiropractic can really do for our patients. Believe me, students need a far better role model then this want-to-be MD. So please don't talk about bringing drugs into my profession. They are not the solution to job security and will not make chiropractic any more acceptable than it already is. Thank you for your time.
Bill Pohlen, SICA President
Cleveland Chiropractic College, KC
A Clarification Dear Editor:
I would appreciate a clarification in "DC" that the Foundation for the Advancement of Chiropractic Education is headed by me and was originally incorporated in March of 1981; that we are a nonprofit organization that supports grants to various chiropractic colleges throughout the U.S. for the betterment of chiropractic. Further, we are in no way connected with FACE of Levittown, Pennsylvania, which to our knowledge does not give one dime to the profession.
William Harris, DC President, Foundation for the Advancement of Chiropractic Education Alpharetta, Georgia
Editor's note: Dr. Harris' clarification is necessary because the Oct. 17 issue on page 12 detailed Dr. Harris' Foundation for the Advancement of Chiropractic Education fundraising challenge to Logan College. Below that article was a "call for papers" from a group in Levittown, PA, which calls itself the Foundation for the Advancement of Chiropractic Education (FACE). Dr. Harris' foundation is a Florida nonprofit corporation with offices in Atlanta, Georgia.
Astonished in New Jersey Dear Editor:
I am astonished that you had the audacity to publish the article, "A Lifesaving Adjustment," by Victoria Arcadi, DC, in the Oct. 7 issue. This article described apparent lifesaving techniques that were wrong and certainly dangerous. Unfortunately it is articles of this nature that continue to label chiropractic physicians as charlatans and quacks with the public and the scientific community.
When someone is found at the bottom of a swimming pool, after establishing an airway, spinal immobilization would be an immediate concern. Any near-drowning victim is considered to have a spinal injury until proven otherwise. Performing a thoracic adjustment on this patient is not "a lifesaving adjustment" but a potentially dangerous and irresponsible act.
I question the physical indicators used by Dr. Arcadi to determine that this patient was actually in cardiorespiratory arrest. She indicated that the patient had no respiration, a faint pulse, and dilated pupils. No respiration is an indicator for rescue breathing, which if performed correctly and within several minutes after the respiratory arrest, would likely have revived this child in itself. She states the child had a faint pulse, yet someone else was performing CPR. Performing CPR on a patient with a pulse is certainly not indicated and potentially hazardous. Dilated pupils are not a good indicator for determining clinical death. In this case they may have indicated hypoxia, head injury, or cord injury. Did Dr. Arcadi consider the possibility that the "hypertonic suboccipital muscles" may be indicative of a serious cervical spine injury? Sometimes the best first aid is to call for help and do nothing.
In my experience, those truly in cardiac and/or respiratory arrest typically do not instantly regain consciousness (except on television); those that do are usually hypoxic, confused, and weak, and frequently were never in cardiac arrest. Specific reflexes causing vasoconstriction and depression of cardiac output may have suppressed this patient's pulse, making it difficult to detect. These same compensatory mechanisms may have decreased his level of consciousness and made him look dead. It is likely that a few minutes of rescue breathing followed by any type of stimulation (while maintaining spinal immobilization) would have successfully revived this patient. It is questionable that a child who was successfully revived from cardiorespiratory arrest secondary to a near drowning incident would have been released from the hospital the very next morning.
I was not present on this scene and am basing my information only on what I read in the article, but unfortunately a few chiropractors continue to take credit for resolving problems that are misdiagnosed in the first place. It is my recommendation that those involved in this incident or anyone who wants to provide emergency lifesaving procedure take a CPR course. I suggest that Dr. Arcadi stop publicizing her lifesaving techniques, since some other charismatic chiropractor may perform a similar stunt which may not have such a favorable outcome. One can assume whatever they want from this story but it is ridiculous to assume that the adjustment saved this child's life. Let's give credit to the one who rescued this child from the pool.
It is irresponsible for you to print such rubbish in your publication. Chiropractors are not the only ones reading your paper, and when the scientific, medical, and/or anti-chiropractic community read this article, their arguments claiming that chiropractors are uneducated and nonscientific will be enhanced. It must be made clear that Dr. Arcadi's procedures must not be repeated by any responsible doctor. If you want to learn appropriate lifesaving procedures, contact the American Heart Assoc. or American Red Cross and take a CPR course. These organizations have established standard and safe guidelines for these situations, which do work. Please don't let your publication become a vehicle for delivering misinformation of this nature in the future. It's time we started policing our own profession, and that starts with the editors of any publication that contains chiropractic information.
Nicholas Palmieri, MICP, DC
Linden, New Jersey
