Three years ago, two members of the Pennsylvania Chiropractic Association (PCA) contacted me, complaining that a local hospital in western Pennsylvania was no longer accepting scripts for X rays from doctors of chiropractic. The hospital told the DCs they could only accept scripts from hospital staff doctors. When I contacted the president and medical director of the hospital, they commented that indeed their "new" policy was to no longer accept scripts from chiropractors. That answer was not what the PCA wanted to hear, so we contacted the Pennsylvania Department of Health.
We uncovered a specific hospital regulation (127.32) that clearly and unequivocally states that a doctor of chiropractic (or any health care provider, for that matter) needs to have hospital privileges if they want to send their patients to a hospital for diagnostic tests (X ray, MRI, CT, etc.). Apparently the hospital was relying on this regulation to deny chiropractors (but apparently not other health care providers) the ability to write scripts. Ironically, chiropractors could still get their patient scripts processed at a free-standing, independent facility, but not at a hospital.
Although we were encouraged by numerous parties to basically let this issue slide (the concern was that we could end up creating an even larger issue), the PCA could not ignore the new policy and the inequities it created for our members We felt our profession was being singled out and did not understand why, especially considering we have educational training and certification to take X-rays.
From September 2005 through January 2006, we had countless meetings before the legislative assembly and regulators, to no avail. The then-secretary of health would not issue an order or memorandum clarifying/correcting the regulation, which was now being followed by other hospitals across the state. What once had been standard procedure for hospitals (accepting scripts from chiropractors) had effectively been prohibited statewide.
Then the Department of Health took the matter to another level. The secretary of health issued a letter to every hospital CEO, advising them that hospitals could only accept scripts from health care providers who were members of the medical staff or who had clinical privileges at the hospital. Hospitals could not accept a script from a DC or any health care provider not affiliated with the hospital - even though state law authorized these professionals to write orders for diagnostic radiology tests.
We continued to pursue this issue by every imaginable means. Legislators began writing and our members began calling hospital CEOs. (Surprisingly, many hospital CEOs contacted the PCA seeking our help in getting the regulation amended.)
Finally, in January 2008, we brought the issue before the director of the Governor's Office of Health Care Reform and explained how it was deterring patient access, something directly contrary to the governor's "Patient Access Legislation." We explained that our position was not about reimbursement; our only concern was quality patient care. We emphasized that forbidding hospitals to accept scripts from a DC or any other unaffiliated health care provider was counterintuitive and against the central tenets of expanding access to quality care.
We finally got our meeting before the Department of Health's acting deputy secretary for quality assurance and her staff, who listened to our plea and indicated they would consider our request. Within a month of that meeting, by June 2008, directives were being drafted for our review and consideration. Hospital CEOs were notified that if they requested a waiver to Regulation 127.32, the Department of Health would approve one, something they had previously been unwilling to do. In February 2009, the Department of Health announced the final (revised) regulation.
Doctors in Pennsylvania are once again writing scripts for their patients who need X-rays and other diagnostic tests in a hospital setting, hospital CEOs are happy - and the Hospital & Healthsystem Association of Pennsylvania was so pleased with the outcome that it published numerous communications to members on the regulation change. As always, I just smiled and enjoyed knowing I had a small part in the process.
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?
