Is Gov. Schwarzenegger's Support of Chiropractic Fading?

A little over a year ago, Dynamic Chiropractic reported that actor-turned-politician Arnold Schwarzenegger had succeeded in his bid to become governor in California's gubernatorial recall election, ousting former Gov. Gray Davis. Doctors of chiropractic across the state endorsed the former "terminator" for the position, due in large part to his vocal support of the chiropractic profession over the years.¹

"Let me tell you, there is no better profession than chiropractic," Schwarzenegger proclaimed at his annual Arnold Bodybuilding Classic in 1995. "You really helped me. Every day, you are preventing injuries; every day, you are helping people. You let them walk out of your office feeling great about themselves and feeling good in their bodies, relieving pain. I can tell you this from firsthand experience."²

But recent actions by the governor fly in the face of his longtime support of chiropractic. In September, the governor vetoed Assembly Bill 1812, which would have given chiropractors the authority to perform required medical examinations on school and youth bus, public paratransit and farm labor vehicle drivers. The bill, endorsed by the California Chiropractic Association (CCA) and sponsored by the California Academy of Physician Assistants (CAPA), would have amended section 12517.2 of the California Vehicle Code to allow doctors of chiropractic, advanced practice nurses and licensed physician assistants to conduct these exams in addition to medical doctors.³

In a message addressed to the California Assembly, Gov. Schwarzenegger explained his reason for the veto: "This bill is unnecessary. Before reducing the current standard, the study required in this bill should be completed. I am directing the Department of Motor Vehicles to undertake this and make recommendations to the Secretary of Business, Transportation, and Housing on how this issue should be dealt with."⁴

Existing state law requires that anyone applying for an original or renewal license to drive a "specialized" commercial vehicle (school bus, school pupil activity bus, youth bus, general public paratransit vehicle, or farm labor vehicle) submit a report of a medical examination. Currently, only "physicians licensed to practice medicine" are approved to perform examinations for this purpose. (Section 12804.9 of the California Vehicle Code stipulates that doctors of chiropractic, physician assistants and various other "health care professionals" are authorized to conduct medical examinations for applicants of "standard" commercial driver's licenses.)⁵

The California Medical Association (CMA) opposed AB 1812, apparently because it believes that doctors of chiropractic are not "appropriately trained" to perform physical examinations. An analysis of the bill mades the association's position on chiropractic clear: "CMA opposes this bill because it includes DCs within its language."⁶

"[While] the bill would not have had a significant financial impact on California doctors of chiropractic, the measure afforded the opportunity for both CCA and the Southern California University of Health Sciences to demonstrate to state lawmakers the education, training and scope of practice of DCs," said CCA President Dr. Dennis Buckley. "As a result of these efforts, the bill received overwhelming bipartisan support in both houses of the Legislature.

"Although [the veto is] disappointing, CCA and SCUHS look forward to working with the governor and his administration to ensure the scope and abilities of the chiropractic profession are clearly understood, with the goal of reintroducing the bill in the future."⁷

State Assemblyman Rudy Bermudez, the bill's author, expressed extreme disappointment with the decision. "The governor did a poor job; he obviously got some bad advice. This is an important bill that would have helped get people back to work. It's devastating, especially [considering] this was a bill that was bipartisanally supported."⁸

This is not the first time Gov. Schwarzenegger appears to have missed an opportunity to support the chiropractic profession in California. Soon after taking office, he signed SB 899 into law.⁹ The bill amended more than 40 sections of the California Labor Code; however, it failed to address the cap on the number of visits an injured worker could make to a chiropractor. That cap, stipulated in a bill signed by former Gov. Gray Davis just prior to his departure from office, limits workers injured on or after Jan. 1, 2004, to a maximum of 24 chiropractic visits per industrial injury.¹⁰

SB 899 also included language whereby California DCs retain "physician" status and are required to be included in the system's new "medical provider networks" panel. The networks will be established on or after Jan. 1, 2005, by insurers or employers, with the goal of providing medical treatment to injured workers. However, this concerns the CCA for several reasons:¹¹

• CCA is concerned that in implementing SB 899, some insurance carriers are inappropriately interpreting ACOEM [American College of Occupational and Environmental Medicine] guidelines to deny legitimate treatment. For example, some carriers appear to be applying the guidelines for treating acute injuries to clearly chronic conditions and patients. CCA is compiling evidence of alleged improper denials to present and convince elected officials of the suffering injured workers are facing because of care denial.
• CCA is concerned that the medical network panels created by SB 899, and the draft regulations implementing those panels, would shift future medical award patients from their current doctors of chiropractic to the network panel doctors.
• CCA is concerned that injured workers will not fully understand the workers' compensation system, and will not be made aware of their ability to choose a doctor of chiropractic as their primary treating physician. CCA is strongly advocating a full disclosure of an injured worker's rights when he or she is injured.

Is Gov. Schwarzenegger's support of chiropractic fading? If his actions since taking office are any indication, he certainly doesn't seem overly concerned about protecting the state's doctors of chiropractic, much less expanding their scope of practice. Look for further developments in future issues of DC.

References

1. Hasta la vista, Gray Davis: Arnold Schwarzenegger wins California recall election. Dynamic Chiropractic, Nov. 3, 2003. www.chiroweb.com/archives/21/23/08.html.
2. Arnold Classic and ICA Symposium are a match. Dynamic Chiropractic, April 24, 1995. www.chiroweb.com/archives/13/09/04.html.
3. Text of Assembly Bill 1812. www.leginfo.ca.gov.
4. AB 1812: veto message from Gov. Schwarzenegger. Sept. 25, 2004. www.leginfo.ca.gov.
5. California Vehicle Code. Examination and Driving Test: Classifications. Section 12804.9.
6. AB 1812: bill analysis. www.leginfo.ca.gov.
7. E-mail correspondence with Bill Howe, CCA executive director, Oct. 15, 2004.
8. Interview with Assemblyman Rudy Bermudez, Cal State University Long Beach, Oct. 15, 2004.
9. New Calif. workers' comp law: a mixed bag for chiropractic. Dynamic Chiropractic, May 20, 2004. www.chiroweb.com/archives/22/11/20.html.
10. California caps chiropractic workers' comp visits. Dynamic Chiropractic, Oct. 20, 2003. www.chiroweb.com/archives/21/22/17.html.
11. E-mail correspondence with Bill Howe, Oct. 15, 2004.