Concluding four years of initial development, the Federation of Chiropractic Licensing Boards (FCLB) has been widely circulating a draft copy of the design of uniform standards for licensing boards to use to approve continuing education.
Entitled PACE - Chiropractic (Providers of Approved Continuing Education - Chiropractic), the program sets forth a system of outcome-based criteria to address in-person and distance-learning methods.
"We developed this program in response to requests from the licensing boards and the CE program providers," commented Dr. Wayne C. Wolfson, FCLB president. "The current process is quite burdensome and costly."
"Sometimes change is difficult, but we want to assure the profession that there is nothing philosophically restrictive about this voluntary program," Dr. Wolfson continued. "We urge people to study the draft program and be part of its continued development. We welcome constructive suggestions for its improvement."
The PACE criteria will be established and maintained by the Council on Chiropractic Education (CCE), and applied by the FCLB's PACE Committee. If approved by the CCE and FCLB boards of directors, the PACE program could be implemented sometime in 2003.
As co-chair of the FCLB task force to develop a uniform CE approval process, FCLB vice president Dr. Richard Cole described the underlying rationale. "Continuing education is a requirement for chiropractic relicensure by 49 U.S. boards and a number of Canadian provinces as a critical ingredient in the regulatory mission to protect the public. We all realize that learning does not end with the award of the DC degree, and boards have recognized the importance of quality ongoing education.
"What we learned from extensive surveys of colleges, boards and CE providers is that there are significant problems with the current process. ...The task force sought to address these problems, to create a win-win-win-win situation. The new, centralized approval process benefits practitioners, program providers, state associations, licensing boards and the public. In short, the real winner is the chiropractic profession."
Observing that most licensed health professions have a centralized approval process with uniform standards, Dr. Cole noted the program design was able to take advantage of the experience of programs which have proven track records of success. "The CE task force has focused on approving 'providers' rather than individual programs. We believe that the vast majority of CE currently offered will easily qualify for PACE approval, with few or no changes to their existing programs."
Dr. Wolfson explained that boards will be encouraged to retain the current system whereby they may approve individual programs, in addition to adopting the PACE Criteria and program. "We recognize that some excellent CE programs may be suited for a limited audience, and the provider may not wish to apply for PACE approval or seek partnership with another PACE provider. These may choose to apply directly to the state board for approval, since participation in PACE is not mandatory."
Briefly, the PACE program is designed as follows:
A $1,500 initial application fee (of which $500 is nonrefundable) is required to process the application and review the provider's compliance with PACE requirements. This includes the first year's recognition fee if the applicant is approved. Additional recognition may be granted for up to three years.
"We understand from the postgraduate programs at our colleges that both the cost and frustration have been high to apply to multiple jurisdictions with varying requirements, "Once a provider has 'recognized' status, they simply register their programs with the FCLB for a modest fee. This central registry assures practicing doctors that their CE will qualify for relicensure credit and helps them comply with varying requirements in different jurisdictions. The public is assured that PACE programs meet reasonable and uniform Criteria to help professionals continue to develop their skills."
Dr. Wolfson pointed out the benefits to state associations. "Our professional associations are often on the front line with legislatures, asserting that the profession is meeting sound standards for quality public health care. The PACE credentialing standard helps them immensely.
"Also, an association may partner with a PACE provider (such as the post-graduate department of a chiropractic college) to sponsor quality programs at association meetings, or may even decide to become PACE providers themselves," he said.
A second component of PACE provides for extensive data storage support for chiropractic regulatory boards and field practitioners.
Dr. Wolfson described this benefit to practitioners: "Regulatory boards have relied on tedious random audits, placing a burden on doctors to produce evidence of fulfilling CE requirements. The $10 PACE attendee records fee will not only remove this burden from the doctor but also greatly reduce the workload for boards, as reports can be generated by computer to guarantee compliance with state law. It also complies with an emerging trend of mandated tracking of regulatory data."
Dr. Cole commented, "The costs of operating the PACE program are significant. It's not an easy task for the FCLB to assure initial and continued compliance with these voluntary criteria - and also allow for ongoing modifications to reflect growth in educational methods and content.
"However, by spreading those costs out over a broad spectrum, we believe the net cost to the entire profession is greatly reduced. Working together literally pays off for chiropractic."
The FCLB has circulated the draft design extensively this fall among its member boards at regional meetings, and with an extended group of advisors that includes major CE program providers. the draft (including the Policies & Procedures and Criteria) is posted on the Federation's Web site at www.fclb.org.
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.
