Eighty-four years ago, a young man named George Herman "Babe" Ruth was just beginning his second season as an outfielder with the New York Yankees. Warren G. Harding had recently been sworn in as the nation's 29th president, and Alaska and Hawaii were decades away from being admitted to the Union.
Eighty-four years ago is also when the General Assembly of Georgia passed section 43-9-1 of its official code, also known as the Georgia Practice Act for Chiropractic. In effect since 1921, the act has gone relatively undisturbed since being signed into law; among other antiquated terms, it refers to X-rays as "electric X-ray photography."
A recent series of events has caused proponents of chiropractic to take a serious look at revising Georgia's chiropractic practice act. In October 2004, a decision rendered in the case of Colvard v. Mosley created seemingly dire consequences for the state's chiropractic profession. The ruling stated, among other things, that DCs could perform only those procedures listed specifically in the practice act. As a result, the Medical Association of Georgia (MAG) began to suggest publicly that medical doctors should be considered "gatekeepers" for all musculoskeletal conditions, and that chiropractic treatment should be delivered only after a patient receives a referral from a medical doctor.
Based on the ruling and the MAG's assertions, the state's leading chiropractic organizations, including the Georgia Board of Chiropractic Examiners (GBCE), the Georgia Chiropractic Association (GCA), and the Georgia Council of Chiropractic (GCC), have set to work on revising the Practice Act for Chiropractic. In August 2005, representatives of the three groups met on the campus of Life University to discuss legislation that would modernize the scope of practice for chiropractors. The result is a consensus document that the GBCE, GCA, GCC, and Life have spent the past year developing.
The proposed legislation will expand the scope of practice to include an entirely new range of treatments not listed in the original practice act, including myofascial therapy, hydrotherapy, vitamins, minerals, and rehabilitative procedures. In addition, chiropractors will be allowed to perform physical examinations, order laboratory tests, and conduct diagnostic imaging and neurodiagnostic studies as indicated.
Leaders from all four chiropractic organizations commented on the proposed revisions:
"There is a revolution in how health care is delivered, and consumers are demanding a health care system that reflects their values," noted Dr. Guy Riekeman, Life's president. He added, "These consumers are interested in living a healthy lifestyle and truly understanding their health care choices. Those consumers understand the value of eating right and exercising, and want a health care choice that reflects their proactive approach."
"The chiropractic profession has developed in ways no one could have anticipated nearly 85 years ago," commented GBCE Chair Jim Anchors, DC. "Students graduating today are prepared to care for the health needs of patients as direct access, portal of entry physicians. The legislation needs to reflect the depth and breadth of care chiropractors are educated to provide."
GCA President Robert Hayden, DC, PhD, explained that the new legislation is not a new practice act, but merely a modification of existing law: "The bill is not a broad, sweeping new practice act," he said. "It is a significant revision of the current act that modernizes the language [and] codifies some services that chiropractors provide routinely to patients during the course of a day."
"When the legislation was drafted in 1921, technology that is now commonplace for chiropractors was not yet invented," added GCC Vice President Brad Pizza, DC. "The legislation needs to be modernized to include these tools so that chiropractors can provide appropriate care for their patients."
Several current members of the Georgia General Assembly attended the meeting, including Rep. Sharon Cooper, chair of the Health and Human Services Committee; Sen. Renee Untermann (vice chair of the committee); Rep. Ed Rynders (vice chair); and Rep. Sue Burmeister, who also serves on the committee.
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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.
