In 1992, the Australian government established a committee of inquiry on competition policy reform, which published its findings in the Hilmer Report. This was an extension of the country's economic reform policies of the 1980s, which sought to help establish a more flexible and outward-reaching economy.
In 1995, following the Hilmer recommendations, the government developed the National Competition Policy (NCP), an ambitious plan to promote and enhance competition. A National Competition Council has since been created to assess the governments' progress in implementing the NCP.
The Canberra Times is now reporting that chiropractors and GPs down under are in a turf war over who performs spinal manipulations. At the heart of the matter, ironically, is the NCP, the government's policy to promote competition. However, the NCP mandates the "review and reform of all laws that restrict competition, unless it can be demonstrated that the restrictions are in the public interest."
Under the NCP, according to the Chiropractors' Association of Australia (CAA), health professionals are not registered by profession, but by the range of "restricted core practices." Under this rubric, DCs, MDs, PTs and osteopaths are the four groups registered to perform spinal manipulations. As the focus of chiropractic is spinal manipulation, and DCs have the preeminent training in that regard, the argument runs that DCs are the most qualified to perform spinal manipulation. And as MDs and PTs perform much fewer spinal manipulations than DCs, it's in the public interest, as a matter of public safety, to have all spinal manipulations performed by the most qualified health practitioners.
In the Times article, Andrew Vincent,DC, president of the Queensland's branch of the CAA, acknowledges that MDs and PTs are trained to assess and diagnose musculoskeletal conditions, but that they do not have adequate training in spinal manipulation; that they are essentially part-time adjusters who pose a potential risk to their patients by doing the procedure.
Robyn Napier, chairwoman of the medicine advisory committee of the Australian Medical Association, called Dr. Vincent's comments "remarkable," and said MDs were "fully qualified to carry out manipulations."
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
