The Wisconsin Chiropractic Association’s (“WCA”) most recent legislative initiative has once again caused division within the profession and was initiated without accurate and open discussion of the issue. This time, the WCA sought to use the budget reconciliation process as a means of surreptitiously obtaining an amendment that would allow Wisconsin chiropractors to advise and counsel patients on the use of over the counter medication. (“OTC”) Although the initiative appears to be “dead” for now, this manner and method of introducing dramatic changes in the scope of chiropractic has to be done accurately and openly in the future in order to unite, rather than further divide, doctors within the state.
First, the profession requires accuracy with important changes of this nature. In advancing the proposal, the WCA disseminated information that doctors cannot “advise and counsel” on OTC within this state’s current scope of practice. Depending upon the definition of these terms, this position can be disputed for several reasons, including:
- The statute broadly relied upon by the WCA for prohibiting treatment by drugs, more specifically references the definition for that word to only include those “drugs” listed in s. 450.01(10) of the statutes. Those “drugs” listed do not include many OTC.
- The informed consent statutes affirmatively allow the DC to comment on the risks/benefits of OTC. (See s. 446.08)
- There has been very limited “risk” for the DC in discussing the risks and benefits of OTC. In fact, there are no recent examples of civil or administrative actions being taken against the doctor for such behavior. The only risk seems to follow situations where the doctor makes representations or promises about outcomes for the patient or overtly treats a patient through the use of drugs or similar procedures. (See CHIR 6.02(31) dealing with this limitation as it relates to nutritional supplements)
- Chiropractors (or for that matter, any interested person, including parents of a sick child or the employee at a GNC store) can legally comment, under our free speech rights, on the known risks and benefits of OTC. The FDA requires labeling and research on these products before approval for public consumption is granted. As such, the WCA commentary that DC’s cannot or do not know the key aspects or risks of such products is unfounded.
Additionally, openness or transparency with a subject such as this would also benefit the profession. Adoption of this type of amendment would have dramatic effects upon the public’s traditional understanding of chiropractic and manner by which it is practiced. By using the budget reconciliation process, the WCA attempted to avoid any open and expansive public hearing on this type of change in the scope of the practice. Many within and other professionals who are outside of chiropractic, united to aggressively oppose this budget amendment by arguing that this initiative was not just about “legally talking” about OTC, but actually part of the WCA’s continuing effort to expand the scope of care to allow patient treatment through the use of drugs. Moreover, it also came with a price for DC’s by requiring them to pay a fee to attend WCA sponsored programs to “educate” them on OTC if they ever wish to “counsel” patients on OTC. At least for now, it appears that the NET EFFECT of the WCA’s inaccuracy and lack of transparency has been further division within the profession and failure for their legislative initiative.
COMMUNITY.