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ICA Board Votes Active Support for North Carolina Legal Action

All friends of chiropractic are applauding the recent decision of the Federal Court of Appeals upholding the district court findings against the AMA in the Wilk case. We, in the ICA, are fully aware of the significance of this victory, but we understand that to realize the fruits of this decision, years of struggle on many fronts, including the courts, lie ahead. In the state of North Carolina, an equally important legal struggle is underway. Thanks to the courage and determination of Dr. Ron Cohn, the chiropractic profession has the opportunity to secure, through federal court action, a major breakthrough in the area of hospital privileges.

The ICA has long been active on the question of hospital privileges. We have had an active, indeed, aggressive Hospital Rights and Privileges Committee for many years, have conducted seminars and workshops on the subject across the nation, and have published the state of the art manual for DCs interested in practicing in the hospital context.

The ICA has adopted this activist attitude for a variety of reasons, the most important of which is recognition of the chiropractor's obligation to the patient. Hospitals are where the sick people are. It is a disservice to our patient population to resign ourselves solely to the status of outpatient-care providers. Secondly, it is in hospitals that the overwhelming proportion of clinical research is conducted in the United States. Finally, hospitals are the logical point of interaction between health care professions. They offer a setting where the effectiveness of chiropractic can be objectively demonstrated and where other professionals can be appropriately educated about chiropractic theory, science, principles, and practice.

For many years I have enjoyed the personal opportunity to practice in a hospital. The benefits to my patients, my practice, and my sense of professional and personal fulfillment have made it worth far more than the trouble to which I had to go to secure such practice rights.

We at the ICA have always believed that it is ethically repugnant, as well as bad health care policy for doctors of chiropractic to be arbitrarily barred from any health care facility. It is especially irritating when hospitals and clinics funded by our own tax dollars engage in such institutional behavior. As a profession, chiropractic has been slow to respond to the hospital challenge. Thanks to the persistence of chiropractors like Dr. Cohn, and with the support of state and national organizations, I hope we are on the brink of major changes.

Most doctors of chiropractic in America may not be familiar with Dr. Cohn's case, and while we do not presume to tell Dr. Cohn's story for him, to us at ICA the facts show that discrimination against DCs is still pervasive, and his case is quite clear and compelling.

Dr. Cohn's battle with Wilkes General Hospital began in August 1984 when he first requested appropriate forms to apply for hospital privileges. In January 1985, after numerous unanswered phone calls and correspondence, he finally received a medical application that did not apply to chiropractors. The hospital administrator asked Dr. Cohn to fill out as much of the form as he could.

In March 1985, he received his first rejection. The reasons stated were as follows:

  1. "Privileges requested are not permitted under North Carolina Law."

  2. Medical staff did not have "knowledge and understanding of the tenets of chiropractic."

Dr. Cohn responded to the credentials committee by asking for an interview, (as is granted to other doctors,) so they could properly review his request. He also sent them: -- a copy of N.C. Public Code Ch. 90, Section 90-53 that states, "chiropractors may have access to and practice chiropractic in any hospital or sanitarium in this state that receives aid or support from the public", and -- a protocol from another hospital that had chiropractors on staff to educate the medical staff on the tenets of chiropractic.

Over the following months, Dr. Cohn appeared before the Hospital Executive Committee and the Board of Trustees and was denied credentials both times. Then his associate, Dr. Richard Cohen applied and was denied as well. Again after months of the hospital's non-cooperation, Drs. Cohn and Cohen decided to apply for limited privileges. They were again denied because "no other hospital had chiropractors doing them on staff."

North Carolina has a law authorizing doctors of chiropractic to practice in hospitals in the state, but it is obvious this particular hospital staff credentials committee has taken it upon itself to challenge this right to access. Dr. Cohn has had the courage to confront them over this issue in a court of law.

At the 1990 Annual Meeting of the Board of Directors of the International Chiropractors Association, Dr. Cohn made an impressive and convincing presentation on the merits of his case and on the importance of the hospital issue to every doctor of chiropractic in America. Needless to say, he was before a highly receptive audience.

Dr. Cohn attended ICA's Board Meeting at the invitation of our president, Dr. Fred H. Barge. He is not an ICA member but, as a professional society, we recognize an obligation to actively involve ourselves in any issue of importance to the chiropractic profession. ICA has never been hesitant to support anyone fighting for the future of chiropractic because of organizational identities.

At ICA's March, 1990 meeting in Tampa, Florida, the ICA Board of Directors unanimously adopted the following policy position:

"ICA commends Dr. R. Ernest Cohn for his courageous and principled efforts to secure chiropractic hospital privileges via legal action in North Carolina, and pledges all possible assistance in public relations and education, such fund raising efforts as may be appropriate and legal, and such technical and professional support as may be helpful."

As a member of ICA's Board of Directors, I can assure Dr. Cohn and everyone concerned with this important legal action that ICA will be actively and aggressively working to support their efforts.

We will be working to educate the chiropractic profession through news releases, feature articles, guest columns, and interviews in the chiropractic press. We will be supporting the effort financially as well as working to organize a national fund raising effort on behalf of the suit. I personally feel the chiropractic profession has not done nearly enough to financially support this long and extremely expensive undertaking. We have the opportunity now to correct this deficiency and put our money behind what is not only a just cause, but what I firmly believe will be a victorious cause.

I urge every chiropractor in America to renew his or her commitment to the future of the chiropractic profession by writing a check today to support Dr. Cohn's courageous action. He deserves our support. He is fighting our battle. When he wins, it will be our victory.

Please write a generous check today to:

Moore & Brown
(Cohn Antitrust Fund),
Attorneys and Counselors at Law
The Branch Band and Trust Building
8 West Third Street, Suite 240
Winston-Salem, NC 27101-3904

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