Dynamic Chiropractic – June 28, 1999, Vol. 17, Issue 14

The State of Chiropractic in Israel

By Ofer Baruch
Israeli Army Makes Chiropractic Services Available

The chiropractic profession in Israel is booming, as is alternative health care in general: acupuncture; reflexology; shiatsu; homeopathy; naturopathy and osteopathy.

Many Israelis are in constant search for relief of pain syndromes. And while Israel is one of the world's leading countries in medical research and facilities, the resources of its social medicine services are severely strained. The result is that pain patients receive little attention; they're often told their pains are age-related and are given medication or physiotherapy.

It is mandatory for every person in our country to serve in the Israel Defense Army (IDA) and the reserves. The physical demands of the military service result in many common low back and neck injuries that are expressed as discopathies and arthropathies. Recently the IDA began recognizing chiropractic and initiated a pilot chiropractic reserve service plan for DCs to practice in a multidisciplinary medical center of the IDA.

There are 61 DCs practicing in Israel. They practice in private clinics, at five major hospitals (pain relief and complementary medicine units) and in complementary medical centers of HMOs. Most of the Israeli DCs received their chiropractic education in the U.S, although three attended CMCC, one attended the Anglo-European College of Chiropractic, and one studied in South Africa.

The Israeli Chiropractic Society (ICS) provides membership to most of the DCs who hold the CCE approved college diploma. There are, however, many other practitioners who define themselves as chiropractors without going through chiropractic college. They learn adjusting techniques from PTs and from practitioners from the Far East and eastern Europe.

The political and legislative position chiropractic holds in Israel is progressing slowly but surely. Chiropractic is still considered under the umbrella of alternative health care and as a treatment regime, but we are closer to mainstream acceptance. Chiropractic, through the ICS and the Israeli Ministry of Health, is pushing toward special scope of practice for chiropractic, which would mandate us (not the PTs or other practitioners) the right to provide high speed, low amplitude adjustments.

The battle for primary care provider status, including making musculoskeletal diagnoses using ICD codes, continues. Since there is no legal definition of chiropractic in Israel, eastern European immigrants, shiatsu and naturopathic practitioners proclaim they provide chiropractic and are chiropractors.

The academic progression is not far behind the political one. There are one to two elective continuing education chiropractic seminars being given each year by world renown experts. There have been chiropractic articles and research papers published: one on the effects of MUA on degenerative spines, and another on the neurophysiological effects of the chiropractic adjustment on the "H" reflex. There are two other multidisciplinary research projects being launched: one to verify the efficacy of chiropractic care in comparison to other alternative health care modalities; and one to compare chiropractic vs. epidural steroid injections for disc herniation. Both projects are financed and managed by major hospitals in Israel.

Many health care organizations and hospitals realize the public awareness and demand for natural health care modalities and are trying to match the demand. There are four major HMOs in Israel: two of them opened a national network of complementary medical centers, hiring DCs and other alternative practitioners. They provide their members with about 12 discounted chiropractic visits per calendar year; the other two HMOs are signing up DCs to give their enrollees access to chiropractic in private clinics at a 50 percent discounted fee. There are five or six major insurance companies who have recently realized the health trends in Israel and have begun issuing complementary health policies that provide chiropractic coverage in the private clinics of DCs. The insurers are allowing about 20 visits per calendar year, and up to 80 percent reimbursement of the full fee.

The general Israeli public who seek alternative health care solutions is still largely misinformed about chiropractic. We're mostly accepted as "practitioners who can help."

We would be happy to accept any political or professional advice to advance chiropractic in Israel.


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