Chiropractic (General)

More Progress for Chiropractic in Italy

But the medical profession keeps causing headaches.

Editor's note: As reported in DC last year (Feb. 12, 2008 issue), chiropractic is now officially recognized as a primary health care profession in Italy. The following is an update courtesy of Dr. Baiju A. Kahnchandani, vice president of the Association of Italian Chiropractors (AIC).

Following a three-hour meeting in June 2008 (originally scheduled for 15 minutes), the Italian Ministry of Health, together with the Association of Italian Chiropractors, produced a document outlining the regulatory framework for chiropractic. The document includes these key points: (1) Chiropractic is a primary health care profession; (2) Councils on Chiropractic Education International (CCEI) and ECCE standards and colleges are recognized. This means the "grandfather" clause will only accommodate graduates of those colleges; and (3) Chiropractors will perform functional chiropractic diagnosis, and scope of practice covers care of the "neuromusculoskeletal system."

The June 2008 meeting involved, among others, Dr. John Williams, president of the AIC (who has had nine meetings with the Ministry since the passage of the chiropractic legislation in late 2007); Health Ministry Director General Giovanni Leonardi; Senator Luigi Lusi; Dott. Paolo Roberti di Sarsina of the Consiglio Superiore della Sanita (CSS), an important committee with oversight for health matters; and members of the international chiropractic community including Dr. Reed Phillips of the Foundation for Chiropractic Education and Research; Dr. Fabrizio Mancini, president of Parker College of Chiropractic; Dr. Ken Vall, principal of the Anglo-European College of Chiropractic; and Prof. Jennifer Bolton of the European Council on Chiropractic Education (ECCE).

The next step, already underway, is a process of concertazione: a piloted (semi-imposed) endorsement of the document by other stakeholders such as the CSS, the medical profession, and the regional governments. Crucially, the Health Ministry, not just the AIC, is impressing upon these stakeholders that Parliament expressed its will in December 2007 recognizing chiropractic and that the profession must now be regulated. Following broad agreement, the document will be enacted through parliamentary process.

The medical profession is not sitting on its hands. In 2002, nine alternative health care professions were declared to be "medical acts." Of course, the AIC reduced this to eight with the passing of the chiropractic law. However, in June 2008, the medical profession published a position paper on health care re-declaring its opposition to new health care professions unless under its subordination.

Several law proposals have been presented by the medical lobby aimed at allowing MDs to become specialized in alternative medicines, including chiropractic, by simply enrolling in short courses. Four universities have already developed courses of 30 credits for nine different complementary medicines and are presently recruiting medical doctors seeking complementary medicine credentials.

The AIC has brought this matter to the health minister's attention and is preparing a case for the Senate Healthcare Commission to explain why chiropractic should be removed from the list of professions abusively taught in these courses. Hopefully, ECCE candidate status with the European Network for Quality Assurance in Higher Education and other arguments will dissuade the creation of a two-tiered chiropractic profession consisting of MDs specialized in chiropractic and professionals possessing the doctor of chiropractic degree. The ECU Convention in Alghero, Sardinia, May 21-23, 2009 (www.ecuconvention.eu) will be an important impetus to the legislative efforts of the AIC in Italy by highlighting that chiropractic is a distinct and separate profession.

April 2009
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