On Jan. 24 1978, the New Zealand governor-general referred to a Commission of Inquiry an investigation to determine the desirability of providing for reimbursement of chiropractic benefits under the New Zealand Social Security Act and the New Zealand Accident Compensation Act. The commision's findings would impact chiropractic worldwide for decades to come.
World Federation of Chiropractic Quarterly Report
Multi-Nation Study on Nonmusculoskeletal Responses Completed
In 1999, JMPT published a study from Leboeuf-Yde, et al., showing that patients in Sweden seeking care for musculoskeletal problems reported many other improved symptoms after chiropractic care. Many improvements were related to the digestive and circulatory systems. The number of spinal areas treated was positively associated with the number of nonmusculoskeletal reactions reported. (JMPT 1999;22:559-64).
In 2001, the WFC, with funding from NCMIC and with Dr. Charlotte Leboeuf-Yde as coordinator, sponsored a multi-nation study to see if the Swedish results could be replicated with patients in various countries and cultures. Participating countries were Australia, Canada, Hong Kong PRC, Japan, Mexico, South Africa and the United States.
The study is now complete and was submitted to JMPT for publication in January 2004. Details of the results must await publication, but findings largely confirm those in Sweden. Most commonly reported nonmus-culoskeletal improvements for patients receiving chiropractic care, including adjustment for back and neck pain, were related to digestion, circulation and breathing.
After these preliminary research projects, the recommendations by Leboeuf-Yde, et al., are that there now be more stringent research that should concentrate on specific disorders identified as more likely to produce a positive result, such as digestive disorders.
The WFC acknowledges and thanks the research officers who coordinated this practice-based research in their various countries - Dr. Ray Hayek, Dr. Max Walsh and Dr. Peter Bryner (Australia); Dr. Greg Stewart, Dr. Christian Beaudry and Dr. Kim Humphries (Canada); Dr. David Cosman (Hong Kong PRC); Dr. Hideki Tanno and Dr. Brian Budgell (Japan); Dr. Octavio Terrazos-Rio (Mexico); Dr. Junaid Shaik (South Africa); and Dr. Bill Meeker (USA). Special thanks to the overall coordinator, Dr. Charlotte Leboeuf-Yde of the University of Southern Denmark, and to Dr. Anthony Rosner of FCER, who administered the project.
Country Reports
Australia
Australia has become the latest country to publish national guidelines for the management of patients with acute musculoskeletal pain. These interdisciplinary, evidence-based guidelines, developed with chiropractic participation, can be found online at the National Health and Medical Research Council Web site: www. nhmrc.gov.au. There is an extended guideline document, followed by summaries for clinicians and consumers.
Canada
Last month, the chiropractic profession was successful on each of three applications for new government research funds in Ontario for improvement of primary care. First, on a project led by Dr. Silvano Mior, who has been on secondment to the Ministry of Health from the Canadian Memorial Chiropractic College (CMCC) during the past two years, $1.9 million has been granted for pilot studies in which chiropractic and medical doctors will work together in reformed primary care centres.
Second, $400,000 has been awarded for a demonstration project over the next two years, in which chiropractic services will be available at St. Michael's Hospital in Toronto, a teaching hospital affiliated with the University of Toronto. One of the two treating chiropractors will be Dr. Deborah Kopansky-Giles of CMCC, newly elected to the WFC Council.
Third, $680,000 has been given for chiropractic services at the Carlington Community Health Centre in Ottawa, establishing public funding for services initially provided for the needy by members of the Ottawa Chiropractic Society on a voluntary basis.
Chile
Following final examinations given by faculty from the Anglo-European College of Chiropractic in Santiago in February, AECC is about to confer the equivalent of a bachelor's degree in chiropractic to approximately 75 kinesiologists in Chile. This follows postgraduate studies with the Southern California University of Health Sciences (formerly LACC) and AECC in a transition course since May 2001.
These kinesiologists/chiropractors, whose undergraduate program involved six years of university study, are members of the government-recognized Corporation for the Study and Development of Chiropractic (CCHQ). A condition of AECC working with the CCHQ was that the two organizations would partner with a Chilean university to establish a full chiropractic program at the internationally recognized level, and negotiations for such a program are now underway with a university that has expressed strong interest.
Hungary
Dr. Zsolt Kalbori of Budapest, a Palmer graduate serving as president of the Hungarian Chiropractors' Association, confirms that there are currently five DCs in practice in Hungary. In an environment in which there is no formal recognition of chiropractic, and spinal manipulation is regarded as a medical act, chiropractors must practice under a massage licence, but are free to promote themselves as chiropractors - and do so. Contact for Dr. Kalbori: dr.kalbori@axelro.hu.
New Zealand
Dr. Greg Oke, president of the New Zealand Chiropractors' Association, reports that there are now approximately 350 chiropractors in New Zealand and that the country's one chiropractic school, the New Zealand College of Chiropractic in Auckland, which opened in 1994, is now well-established. There is public funding for chiropractic services under the national accident compensation scheme (ACC). This is according to detailed Chiropractic Treatment Profiles agreed upon by the ACC and the NZCA, and which can be found at the ACC's Web site: www. acc.co.nz.
Thailand
Dr. Oat Burana-somati, president, Thai Chiropractic Association (TCA), reports that after meetings with senior Ministry of Health officials in February, Thailand is moving closer to legislation recognizing and regulating the practice of chiropractic. This follows a legislative initiative commenced by the TCA three years ago, and study by an advisory committee appointed by the ministry. Dr Buranasomati is the chiropractic representative on this committee, which reports soon to the minister. There are currently 15 duly qualified chiropractors in the country.
World Health Organization Report
by David Chapman-Smith, WFC secretary-general
(dchapman-smith@wfc.org)
Official Relations: All nongovernmental organizations (NGOs) in official relations with WHO have this status reviewed every three years. In January 2004, the WHO Executive Board reviewed the WFC's work plan for the next three years and renewed official relations for 2004-2006.
WHO's Tobacco Free Initiative: WHO invited NGOs representing health professions to a summit meeting in Geneva January 28-30, 2004 to discuss ways in which health professions could help implement WHO's top priority public health initiative - the Tobacco Free Initiative (TFI). WFC's 1st vice-president, Dr. Anthony Metcalfe (U.K.) and I represented the WFC. Many valuable contacts were made and the meeting led, among other things, to:
- a Jan. 30 WHO Web site news bulletin noting the role of chiropractors in supporting this public health initiative. The importance of this is the profession being seen to work at an international level on a major public health issue not directly related to its own self-interest.
- an invitation to a further meeting in Geneva in mid-February, discussing a proposed survey of primary health care professionals and their role in encouraging smoking cessation. At this meeting, the WFC was represented by Dr. Anthony Rosner, director of education and research for FCER. The goal is inclusion of chiropractors and chiropractic students in any survey work done by WHO.
- the gathering of much new and additional information on tobacco control. Note that the International Union of Cancer Societies, funded by its members and the European Commission, has developed a comprehensive and highly regarded new Web site with broad information on all aspects of tobacco use and control - www. globalink.org.
- plans to start research to implement and test the effectiveness of the Chiropractors Against Tobacco (CAT) campaign - see more on this below.
CAT Campaign: Many members have yet to understand the importance of the CAT campaign and the quality of the information and documents available to all chiropractors at www.wfc.org. [Click on the "Chiropractors Against Tobacco" link.] Materials prepared by the WFC's Health-for-all Committee, chaired by Dr. Rand Baird of California, include downloadable information for chiropractors (which gives brief relevant background and then specific questions to be incorporated in patient histories), a four-color patient brochure and a choice of four-color posters.
In a partnership involving the WFC, Parker College, Palmer College and the Chiropractic Division of the American Public Health Association, there are now plans for studies in the U.S. and internationally to test the clinical appropriateness and effectiveness of the CAT campaign materials. These studies will answer the question of whether the use of these brief and simple interventions in chiropractic practice is effective in causing smoking cessation and reduced exposure to secondhand smoke. Dr. Cheryl Hawk, director of research, Parker College, will shortly commence a field test in which 100 U.S. chiropractors in a practice-based research network will use the CAT campaign protocols with 10 patients each to test practicality and the results achieved at 4-6 weeks follow-up.
WHO Documentation on Minimum Standards of Chiropractic Education: This long-delayed project is moving forward now that WHO's Office of Traditional Medicine has received substantial funding for the project from the regional government of Lombardy in Italy. Following negotiations with the WFC, WHO, which was originally considering the possibility of using a nonchiropractor as its principal consultant on this project, has retained WFC past-president Dr. John Sweaney of Australia, whose extensive educational and accreditation experience in Australia, and more recently Japan, has given him the appropriate expertise in the educational and professional issues involved.
Dr. Sweaney has submitted first-draft documentation to WHO for its review. In the months ahead, this documentation will be widely circulated for review by WHO and for input - including circulation to the WFC, its member associations and educational organizations within the chiropractic profession. Second-draft documentation will then be prepared, followed by a further round of public consultation, and then a conference for invited participants and observers, at which point WHO's final guidelines on minimum standards of chiropractic education will be finalized.
FICS Report (Federation Internationale de Chiropratique du Sport)
Tom Greenway, DC, (U.K.), general secretary
(tgreenway@fics-online.org)
World Games: Following a meeting of the technical delegates, FICS has signed a contract to supply 15 chiropractors to the World Games in Duisburg, Germany in July 2005. This marks an important step forward for sports chiropractic, as it represents the first formal contract to supply chiropractors to a major games.
IOC and World Olympians Association: At the International Olympic Meeting of the Athletes Commission in Athens on May 8, 2004, the World Olympians Association (WOA), on FICS' behalf, asked the powerful Athletes Commission to support the inclusion of chiropractic services into the polyclinics established for all athletes at the Olympic Games. The WOA has already written to Sergei Bubka, president of the commission, on this matter, and this level of support from representatives of the athletes is an exciting development for the profession. We thank Dr. Liston Bisette, secretary-general, WOA, and Dr. Tom Hyde of Miami, Florida, for negotiating this advancement.
Pre-Olympic Congress: This congress will take place in Thelannoski in northern Greece over the weekend of Aug. 7, 2004. It is a large, multidisci-plinary sports medicine congress and has representatives from all the health care disciplines involved in sport. For the first time, a chiropractor is presenting a research paper: Dr. Scott Paton (U.S.) is to be congratulated.
Editor's note: Information on the FICS is available via its Web site: www.fics-online.org; to contact the WFC or learn more about the WHO, visit www.wfc.org.