After receiving a strongly worded letter from American Chiropractic Association (ACA) legal counsel, the American Medical Association (AMA) has announced that it will take "immediate and visible steps to counteract any potential confusion" regarding language in its Guides to the Evaluation of Permanent Impairment, Sixth Edition that restricted chiropractic impairment evaluations to the spine only.
Specifically, the language in question, found on page 20 in a section titled "Fundamental Principles of the Guides," states: "A licensed physician must perform impairment evaluations. Chiropractic doctors, if authorized by the appropriate jurisdictional authority to perform ratings under the Guides, should restrict rating to the spine." Upon learning of this language, ACA general counsel Thomas R. Daly sent a letter to the AMA on Feb. 7 that stated, in part:
"In our view, the action of the AMA in issuing this standard unlawfully restricts competition and excludes a competitive rival, i.e., doctors of chiropractic from the provision of impairment ratings. We note that neither the ACA, nor any other major chiropractic group, was approached or provided input in the standard setting process that established this new restriction."
"I would also point you to Wilk v. American Medical Assoc. ... You may recall that the United States District Court for the Northern District of Illinois, following an eight-week trial, held that the AMA was guilty of engaging in a nationwide illegal boycott in violation of the Sherman Act and imposed a nationwide injunction that is still in force."
"My client therefore believes and will argue that your recent action which implements a new and onerous restrictive standard on the practice of doctors of chiropractic violates existing antitrust law as well as the provision of the existing permanent Wilk injunction."
In a Feb. 20 response to the ACA, the AMA said it will change the language to read: "Impairment evaluation requires medical knowledge. Physicians duly recognized by an appropriate jurisdiction should perform such assessments within their applicable scope of practice and field of expertise." The AMA also said it will take the following steps immediately:
As of press time, the ACA has just sent a second letter to the AMA, suggesting an alternate revision to the language in question: "Impairment evaluation requires medical knowledge. Doctors who are qualified in allopathic, osteopathic and chiropractic medicine duly recognized by an appropriate jurisdiction should perform such assessments within their applicable scope of practice and field of expertise."
In its follow-up letter, sent Feb. 22, the ACA notes, "[T]his language would track the existing language used in Chapter 2, page 23, which states as follows: 'Who performs impairment ratings? Impairment evaluation requires medical knowledge; therefore mostly doctors who are qualified in allopathic or osteopathic medicine or chiropractic medicine use the Guides to evaluate permanent impairment.'"
The second ACA letter also pointed out several instances in which the Guides use the term "medical doctor(s)" and omits mention of other providers. The ACA feels this language "gives the perception of discrimination against any other doctors (osteopathic, chiropractic, podiatric, etc.)." As of press time, the ACA has yet to receive a response from the AMA regarding these additional concerns.
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
