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Chiropractic Politicians and Potential Collusion with Insurance Carriers

Dear Editor:

For too many years our profession has been run by doctors who have concurrent business relationships with insurance carriers through consulting or by performing IMEs or peer reviews. When I consider the allegiance "scale," are they going to side with the doctors who elected them and the profession they serve, or the carriers that pay their mortgages?

I have always held to the adage that you cannot be a "slave to two masters," and why should this be any different? If there is a choice between volunteering in a political organization or earning a living to support your family through a carrier, I believe the answer is clear.

I also support doctors with integrity working for the carriers, but I also consider it a clear conflict to serve both with integrity because they often clash, leaving the doctor impossible choices they should never be in a position to make.

When we look historically at carriers' efforts to minimize payments and their panels of experts, they are often filled with those in our chiropractic political organizations at various levels. I also realize there are restraint-of-trade issues, leaving the membership with the power of our vote or membership dues and nothing more. With those two choices, it creates an inherent system of checks and balances should the membership pay attention.

In the past, I was offered, based upon my credentials, to be on a few panels that were created to limit chiropractic care. I declined. I also know many in the chiropractic political arena in my state and nationally who do work for insurance carriers and are part of a panel of experts. In the past, I queried an entire board for a state organization, and the insurance company employed 100 percent of those board members. Whom were they ultimately serving?

Many of the insurance companies consider nine visits as usual and customary, and can get away with it because they have experts to back them up who are well-credentialed. Unfortunately, in our profession, "well-credentialed" has typically meant holding a political office and is not based upon academic accomplishments.

On a go-forward basis, we as a profession need to pay exquisite attention to whom we are putting into office in our county, state and national political organizations – perhaps adding into the bylaws a disclosure mandate demanding transparency so members can make an informed decision about whom we choose to vote for based upon the facts of their allegiances versus their rhetoric of support for our organizations.

Every organization survives on membership dues and support, and I support organizations that function with transparency and integrity. I strongly urge you to consider the credentials and allegiances behind those who are making policy regarding utilization of care, utilization of X-rays and every other issue you hold important to our profession and your practice. Then let your vote and dues speak for you.

Mark Studin, DC, FASBE(C), DAAPM, DAAMLP
Adjunct Associate Professor of Chiropractic
University of Bridgeport, School of Chiropractic

November 2018
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