The Congress of Chiropractic State Associations (COCSA) has passed a "Resolution on National Unity" demanding that the American Chiropractic Association (ACA) and the International Chiropractors Association (ICA) agree to "set aside their philosophical and political differences and begin the process of merger." The bold resolution, passed on March 10, 2007, "urges the ACA and the ICA to begin immediate action toward merger with a target completion date of January 1, 2010."
The merger resolution passed by COCSA reads as follows:
Congress of Chiropractic State Associations Resolution on National Unity
Whereas, the Congress of Chiropractic State Associations (COCSA) represents 58 state chiropractic associations nationwide which, in turn, represent the vast majority of doctors of chiropractic throughout the United States; and,
Whereas, it is the mission of COCSA to provide an open, nonpartisan forum for the promotion and advancement of the chiropractic profession through service to our member state associations; and,
Whereas, the advancement of the chiropractic profession is dependent upon resolution of issues of national scope; and,
Whereas, the chiropractic profession has two competing national associations, the American Chiropractic Association (ACA) and the International Chiropractors Association (ICA); and,
Whereas, the existence of the two competing national associations has prevented the chiropractic profession from speaking with one national voice; and,
Whereas, the existence of the two competing national associations has resulted in lost opportunities for the chiropractic profession and its patients; and,
Whereas, the existence of the two competing national associations has resulted in duplication of effort, needless waste of precious chiropractic resources and perceived disunity of the chiropractic profession; and,
Whereas, the conflict resulting from the existence of two competing national associations serves as an impediment to the advancement of the chiropractic profession; and,
Whereas, COCSA has spent a decade attempting to facilitate unity between the ACA and the ICA with unsatisfactory results; and,
Whereas, the disunity between the ACA and the ICA is impairing COCSA's ability to serve its state association members; and,
Whereas, the political and economic challenges facing the chiropractic profession have become too great and its adversaries have become too strong to justify the continued existence of two competing national associations,
Therefore, be it resolved, that the board of the Congress of Chiropractic State Associations (COCSA) demands that the ACA and the ICA set aside their philosophical and political differences and begin the process of merger for the greater purpose of creating a single national voice for the chiropractic profession.
Be it further resolved, that COCSA will merge its functions with the resulting new association for the purpose of creating a single national voice for the chiropractic profession.
Be it further resolved, that COCSA will offer whatever mediation, facilitation or other support services necessary for creating a new unified national association.
Be it further resolved, that COCSA urges the ACA and the ICA to begin immediate action toward merger with a target completion date of January 1, 2010.
Be it further resolved, that COCSA will not relent in its pursuit of a single national voice for the chiropractic profession.
Congress of Chiropractic State Associations
Board of Directors
March 10, 2007
The resolution was drafted by the COCSA Board of Directors. Leading the board is President Jerry DeGrado, DC. In a recent interview, Dr. DeGrado had much to say about the resolution:
Q: Can you tell us what series of events or discussions brought the COCSA Board of Directors to the point that it chose to develop and publish this resolution?
A: When my board of directors, the COCSA Board of Directors, came together earlier this past month in Dallas for a major planning meeting, the question that I put forward to our board was, "What are the state associations' greatest needs, and how can we help them in those areas?" We came to the conclusion that the greatest challenge facing our state associations today is how to assist doctors in dealing with parity and reimbursement issues impacting their livelihoods. In virtually every state, doctors will tell you that they are working harder and harder for less and less. Access to patients, limitations on scope and ever-shrinking reimbursement levels have taken their toll upon our profession.
These problems cannot be successfully addressed at the state level because they are problems of a national origin and scope. So, further discussion led to the consensus among my board that much of what is happening nationally is being driven by how chiropractic is treated in Medicare. It is the model that the third-party payers use to justify the limitations placed upon the availability and reimbursement for our services.
The more we talked about an approach to the matter, the more we came to realize that if we ever expect to resolve the Medicare issue, the profession must first all be on the same page. Our efforts must be clearly aligned behind a single objective. We must be one body, one voice.
Over the course of the weekend, it became clear to us that COCSA can best serve the state associations by working together to ensure unity of our two national associations. To that end, we authored the resolution calling for a merger of the ACA and the ICA, as it is our intent to actively work to ensure that this merger takes place in a timely fashion. This is a renewed effort by COCSA. We've been pushing for unity for the past 10 years.
Q: What do you think chiropractic could accomplish if we had one national association?
A: Well, I think what we could accomplish is defeating the things that are set up against our profession. I think that collectively, the state associations represent a mass majority of our profession. The initial response and the call for this merger have been incredibly positive; that's the feedback I'm getting.
We could be more pertinent. Once we get the structure where we have a national association that has lobbying and affects national policy at governmental levels, and then you have your state associations aligned underneath those initiatives, you've got your troops on the ground. You've got a massive amount of doctors who can get ahold of a massive amount of patients, who can persuade congressional leaders at the national level to get something done.
Q: You've given the ACA and the ICA until Jan. 1, 2010 to complete the merger. That's a little more than two-and-a-half years from now. Do you think this is realistic?
A: Yes, I think it's realistic.
Q: What is it going to cost the profession if it doesn't happen?
A: I think with national health care breathing down our backs, if we try to do what we've been doing, which hasn't worked - what is it, insanity? To continue to do the same thing that's not working to try to get different results. Isn't that the definition of insanity? I think that basically we can't accomplish [anything]. When you're divided, you're split. It's not going to happen for our profession.
Q: What can the rank and file do?
A: Well, they need to make some noise. They need to e-mail the ACA [President Dr. Richard Brassard at: rgbdc1@aol.com] and the ICA [President Dr. John Maltby at: jmaltby@telis.org]. Doctors need to let the COCSA, the ICA and the ACA know how they feel about this matter. They need to voice their opinions in this situation. I see great hope that our profession can take a step all together.
In our government, we have Republicans and Democrats who don't like each other, but they would lay their lives down for this country. It's time for the doctors of chiropractic in the ACA and ICA to lay their egos down for this profession.
Q: What about vendors? Is there something vendors can do?
A: I think [that] the vendors I've talked to, and the people in and around our profession - those who are not doctors of chiropractic - see the absolute common sense of this initiative. They totally understand the fact that one voice united can accomplish so many things. For as many years as I know - I've been in practice for 21 years and looked at this profession 10 years before that and been interested in it - the profession has always had division. It has never been walking in one direction.
Q: Do you have any sense of how big our national association could be if the two were to merge?
A: Well, let's look at it this way. If you've got about 6,400 members of the ACA and you've got about 2,000 members of the ICA, from what I have heard, you've got maybe 8,400 who are members of the two national associations. And you've got around 65,000 to 70,000 total doctors. You can see the percentage that has a vital stake and a vital part in leading our profession.
If you look at the state associations through COCSA, you've got 58 state associations and around 30,000 doctors who are members of those state associations. Now, you are going to get some crossover between the 8,400 and the 30,000. Together, that's more than half the profession working toward one goal. Believe me, there are a lot of doctors who I believe are sitting there in their offices right now waiting to join the new national organization, who are tired of the same old egos. They want to see things get done. They want to see us have a unified voice on Capitol Hill.
Q: What would COCSA's role be, or what would COCSA be willing to do to support this merger, should it take place?
A: COCSA would be a part of this new national association. COCSA would align itself with the new national organization so that it would be defined and become an organization with national initiatives that get to the doctors' offices very quickly, so that you can have a quick turnaround on your grassroots efforts to try to get national issues solved.
Q: Let's look at the worst possibility. Let's assume one organization is willing to merge and one isn't. What kinds of things is COCSA contemplating should this take place?
A: I would hope my profession would grow up enough that we will not have to think about that. We need to sit and wait and see what those two do. We have three different decisions to make once that merger happens or if it doesn't happen. We do have ideas of what we can and what we won't do, and we won't just sit idle, but to tell you what we are going to do right now, I'd be stepping outside my bounds as COCSA president. I just know what my board has approved. I know what's on the table for COCSA right now, and it is [that] we will align ourselves with a merger. Nothing else for COCSA is on the table.
Q: The resolution is essentially signed by the COCSA board of directors. Are you looking for other organizations to sign this resolution?
A: Yes.
Q: Give us some examples. Would it be state associations, vendors, publications - who?
A: Yes, all those - associations, vendors, publications, college presidents, anyone who has anything to do with our profession.
Q: What about individual doctors? Would you be looking for them to sign it as well?
A: We would want that. I've had ranking ACA and ICA people thinking this is very important.
Q: So, this [resolution] would ultimately act as a demand from the profession for this merger?
A: Correct.
Q: Is there anything we haven't covered that you would like to share?
A: I just want to say that it's an excellent time for doctors to become a part of their state associations and, as the COCSA president, I would like to encourage doctors who don't feel comfortable about being a part of the national associations to please join their state associations because together, we can begin to take the first giant steps toward ending discrimination against this profession. Now is the time to be proactive. Now is the time to do it.
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.
