A Washington Report

In 1981 the chiropractic disciplinary board of the state of Washington decided to tighten the philosophical screws on an ambiguous law, so that the DCs in that state could practice only the most ristricted form of chiropractic. This board, apparently composed primarily of super-straights, decided to impose their will upon all who sought to practice chiropractic. These self-anointed chiropractic holy men had decided just what everyone must believe and how they should practice. Any deviation and the heretic could lose his license. As with Michigan, the average DC went to bed a doctor and awoke a technician. In Washington you could take spinal x-rays and adjust only the spine. That was it. No physical therapy. No nutritional counseling -- nothing. Just read the words of B.J. and adjust.

No one cares what a straight wants to do. They may practice on a tightrope, in a tube, if this is their desire. The super-straights, on the other hand, have decided long ago that your business is their business and that they have some kind of holy mission to "protect" chiropractic from progress. The tragic aspect of all this is that the super-straights find ready allies in those who would destroy the entire profession and must relish, with great anticipation, the supers' proclamations of the past.

Fortunately, the words "in the past" can now be emphasized. For, since March of 1988, under the urgings of the Washington Chiropractic Association, meetings have been held on a regular basis to develop a more generally acceptable consensus about the scope of chiropractic practice in the state.

Marcia Holland, the executive director of the Washington Chiropractic Association, told me that while negotiations between the three chiropractic organizations in the state were at times difficult, the common goal of the welfare of the profession prevailed and that it is her hope that an eventual merger of all three associations will take place to present a united front. In spite of the unanimity from the chiropractic profession, the bill that would have enlarged the scope of practice was defeated in the financial committee of the legislature. While it might not seem like much, the expanded scope would have allowed diagnosis, nutritional counseling, and extremity adjusting, but the latter only if it directly affects the spine. How this would have placed an increased financial burden on the state, no one knows, but this was the idea postulated by the Department of Labor and Industry. "We're not giving up," said Holland, "our bill passed both the house and the senate, only to be defeated in the committee. We know who our enemies are and will have the bill passed because we are right and at last united."

Because of the importance of this legislation, "DC" decided it would be worthwhile if we contacted the principal participants in this progressive legislative step. To get a balanced perspective, it was felt that the same questions should be asked of the president of each of the state chiropractic organizations.

1. Why is this legislation necessary?
   


2. If passed, what are the most important changes it will bring about for Washington chiropractors?
   


3. How has the development of legislation evoked a new spirit of unity in Washington among the three associations?
   


4. Why do you feel the need for this bill at this particular time?
   


5. When can we expect the bill to be passed into law?

Robert Cummins, D.C. -- president of the Chiropractic Society of Washington:

1. To bring the chiropractic law into conformity with the existing case in the state of Washington. What is especially important is our right to use proper diagnostic procedures. We can't very well be primary health care providers unless we are able to determine which patients will best respond to chiropractic care and which should be referred. This is a responsibility we must accept for the welfare of our patients and the the insurance care providers.
   
   Extra spinal techniques, as they affect the integrity of the spinal column, must also be kept within the purview of the chiropractic practice. The adjusting of articular surfaces is what chiropractic is all about. When those articulations directly affect the spine it is important that we, as a profession, insure that only those qualified in this field of practice be allowed legally to do so.
   


2. It more clearly defines chiropractic, which will result in greater protection for what we do. It makes a clear statement on how the chiropractor should practice.
   


3. After many meetings, the three state chiropractic associations decided that the only way we could succeed with any kind of legislation was with a united front. Naturally, there were and still are differences, but the greater good of the profession caused compromises where they were needed and this had a unifying effect.
   


4. It's sometimes necessary to be realistic about where we are and about our future. The young men and women graduating from our colleges today reflect a more diversified approach, with different dimensions, than when people like myself graduated. It seems only right that we examine and build upon some of those dimensions.
   


5. There's little doubt in my mind that our legislation will be introduced at the next session. The bill was kept from passage by the finance committee chairman because he refused to let it be considered, even though the committee was strongly in favor of it. It's incomprehensible that only one person can do this to the public he is supposed to serve. If necessary, committee changes must be made. I will work for and expect passage of the bill within the next year or so.

Kelli Pearson, D.C., D.A.B.C.O. -- president, Washington Chiropractic Association.

1. The legislation helps bring the law governing chiropractic in the state of Washington up to speed in relation to the rest of the country. At the present time we have the most restrictive law of any of the states. It's imperative that the law be changed so that a chiropractic physician may practice at a level commensurate with their education.
   


2. When passed, the bill will allow us to do legally what we're doing already. It's especially important that we not be restricted to the spine alone, and that we be allowed to do extremity adjusting as it pertains to the spine. Personally, I have never seen a case of lateral epicondylitis that wouldn't affect the cervical spine through the brachial plexus and, of course, the other way around.
   


3. The very fact that we came so close to passing the bill seems to have inspired an even greater sense of unity.
   


4. Just having a unity conference a few years ago seemed to lead to the desire to pass some new, more realistic chiropractic legislation. At the time, we agreed to philosophically disagree and not let this affect our common desire for progress. Through more positive legislation we will bring ourselves to a new level of public respect. We have a tendency in chiropractic to believe that by continually praising ourselves, it will filter down to the public. This, unfortunately, just won't happen. We need an aggressive program of public education, and the unity that the promotion of constructing this piece of chiropractic legislation produced should go a long way in that direction.
   


5. The bill should pass in the next session of the legislature.

Michael Breneman, D.C. -- president, United Chiropractors of Washington

1. To contemporize the bills language and expand our scope of practice to approximate nationwide standards of care.
   


2. Washington remains the only state that prohibits extremity work by chiropractic doctors.
   


3. We have worked long and hard on this legislation, and the individuals that sat together week after week and month after month realize only too well that, in spite of our differences, unity is necessary for our survival. I would like to take this opportunity to thank each individual and their families for their time and energy.
   


4. To protect our growing piece of the health care marketplace and to better serve the citizens of our state.
   


5. We face tremendous opposition from the Washington State Medical Association, the insurance lobby, the Osteopathic Association, the Naturopathic Association, and others who wish to "protect the public" from these "dangers." It is my opinion that the bill is not likely to pass this session. Unfortunately, this means the athletes participating in the good-will games will not receive the care that they would be able to receive anywhere else in the world. We will, of course, be back in the capitol until it does pass, and as we are able to mature and unify, will be a formidable presence.

As you can see from the preceding -- we can work together toward a common goal. From a personal standpoint, of course, I would like to see each state and each country with the broadest possible scope of practice. If this can't be done, at least we can have, as in the case of Washington, men and women of good faith compromising enough individually for the benefit of all.