Walter R. Rhodes, DC, FCCC
Cut and slash -- that was the way most chiropractors learned about the "paper review consultants." What was cut and slashed were their billings for services rendered. Men who had never seen the patient or his x-rays were presuming to reduce charges as "medically unnecessary," "undocumented satisfactorily," or using a variety of other excuses, all under the guise of "cost containment."
They were interfering with the doctor-patient relationship and causing a wholesale loss of patients from chiropractors' offices by their presumptuous recommendations. They even managed to maintain a facade of usefulness by insisting that they were weeding out the outrageous. Which sounded good until you discovered they cut and slashed even when the charges were already low. Finally, it reached the point where nothing was more outrageous than they.
The "paper review consultants" were becoming more brash and brave, hiding behind insurance carriers, as they determined the scope of practice, standards of practice, and the rules of the game. But they had weaknesses: (a) they were untrained, (b) unaccepted, and (c) pursuing a course destined to conflict with the chiropractic profession. If they were ever forced into courts against trained doctors, they would begin losing on a big-time basis. First, we had to train them.
Dr. J.P. Johnston, then the president of Texas Chiropractic Association, in cooperation with Dr. John M. Nash, the Texas Chiropractic College postgraduate director, decided to offer a 120-hour course of instruction leading to certification as a chiropractic consultant -- the first in the nation.
The principles behind the class were simple: These doctors would be trained to consult on the basis of patient need, based on clinical knowledge and scientific principles which could be backed up. We were not the least interested in what the insurance carriers wanted; therefore no "paper review consultants" were utilized in the teaching program.
As chairman of the Education Committee of the Texas Chiropractic Association, and a member of the Postgraduate Planning Committee of Texas Chiropractic College, I was given the job of coordinating the efforts of the two institutions.
In September 1987 the first class convened. We had to have 25 doctors to make a class; when we got 43 registered, we knew we had a winner if attrition didn't hurt too badly.
Attrition took its toll: the second class had 62 participants. And the third one, combined with another event, sported 189 doctors. We had a winner on our hands.
As the classes were given and the 120 hours of study mark was approached, the class, which had formally chosen a name and selected officers, decided to offer a 300-hour diplomate program in consulting. More than half the class elected to pursue the diplomate status and by February 1990 we will have about 30 to 35 diplomates.
The curriculum has been formalized and set in modules so the same program may be duplicated throughout the country. It begins anew in Dallas in January 1990, another begins in New Jersey in March 1990. Classes are in the process of being organized in Colorado, Florida, and Northern California.
The Congress of Chiropractic Consultants is composed of Certified Consultants and Diplomate Consultants and is self-governing according to a Constitution and By Laws approved by the membership (and subject to change.) Although it started in Texas, it is not to be considered a local institution. The Congress will certify and issue diplomate status to those qualified by hours of study and the passing of appropriate tests, no matter where they are from. Incidentally, there is no provision for "grandfathering" -- every certified or diplomate consultant has taken every hour of study proscribed.
Are we affiliated with ACA or ICA? No. We have asked each of them to recognize us benevolently, but have not received as much as a courtesy reply, which pictures better than words why we did not choose to go through them in the first place. This is an educational project, not political. Having pursued it as an educational project we are now able to present the feat accomplished, instead of trying to explain to a disinterested party how it might be beneficial in some future time.
How interested could ACA, ICA, and CCE be in solving the "consultant problem" when many of their officers and board members were paper review consultants?
The need for specialized training had existed for years and our professional problems were mounting. Texas Chiropractic College and Texas Chiropractic Association are proud to be innovators of this very special program serving the needs of chiropractic doctors and their patients.
For additional information contact:
Dr. Angela Lundy, Corresponding Secretary
Congress of Chiropractic Consultants
Cedar Creek Plaza
1313 Briarcrest Drive
Bryan, Texas 77802
(409) 776-2828
