Michigan Gov. Jennifer Granholm has signed legislation revising chiropractic scope of practice, considered among the most restrictive in the nation since the state's Public Health Code was rewritten in the late '70s. According to a press release issued by the Michigan Association of Chiropractors (MAC) following the governor's signing, Michigan's limited scope of practice has driven some chiropractors out of the state, discouraged new graduates from moving in, and caused some patients to travel to neighboring states such as Ohio, Indiana and Wisconsin to receive more comprehensive chiropractic care.
"Under our old scope, chiropractors across Michigan have had one hand tied behind their backs, and it's the patients who suffered because they were not allowed to receive the full range of chiropractic services," said Dr. Donald Reno, MAC president, who characterized the old scope law as "restrictive to the point that use of a blood-pressure cuff was illegal" in a phone interview with DC. "This is a giant step forward."
"The previous scope completely ignored not only the scientific and educational foundation of chiropractic care, but also the economic impact that a restricted scope has on the state of Michigan," added Dr. R. James Gregg, chairman of the MAC Government Relations Committee.
Dr. Reno explained some of the scope changes that will take effect under the new practice act, including allowances for extremity analysis with X-ray and adjusting techniques, and evaluation of joint dysfunction (inclusive of spinal subluxation) rather than spinal subluxation only. The MAC press release states that the act gives rule-making authority regarding these new services to the Michigan Department of Community Health (MDCH), which will work in conjunction with the Michigan Board of Chiropractic to determine specific testing procedures and other services.
What does this all mean for Michigan DCs? According to Dr. Reno, the new practice act lays the foundation for chiropractors in Michigan to teach/practice what they are educated to do, opens up requirements for fair payment by the insurance industry, and opens major lines of communication with businesses and other entities in terms of benefits.
Dr. Reno said that unification of the two previously adversarial associations - the Michigan Chiropractic Association and the Michigan Chiropractic Society, which merged in 2007 - and agreement on proper scope of practice were key to the legislation finally moving forward. Reno said Michigan legislators were reluctant, to put in mildly, to endorse pro-chiropractic legislation when the two associations were operating independently of one another, a point emphasized by Dr. Christophe Dean, chairman of the MAC Public Relations Committee:
"For more than 30 years, chiropractors in Michigan have tried to get our antiquated scope law brought into the current century. Each time we went to the legislature as two combating state associations, the politicians would say, 'Don't make us decide between your two organizations. Come to us with a single position!' When we did unify, it took us only three years to pass a good law; even going up against a strong alliance of the Big Three auto makers, the big insurance industry and the Michigan medical profession."
In his closing remarks to DC, Dr. Reno encouraged other states with multiple chiropractic organizations to unify as a way to facilitate a single message and legislative progress.
