I am writing as president of the European Chiropractors' Union (ECU), in response to an article that appeared in Dynamic Chiropractic on 29 January 2001 from Andrea Clementoni (which also appears on the ChiroWeb site), under the title "Future of Chiropractic in Europe." (http://www.chiroweb.com/archives/19/03/03.html)
It is first necessary to correct a few inaccuracies, since the information was obviously intended for assisting the development of global policies within the chiropractic profession.
Chiropractic in Europe is considerably older than 40 years; the ECU was established in 1932, some 20 years after the first chiropractors started practicing in Europe. The profession in Europe is therefore rapidly approaching its centenary, and last year the British Chiropractic Association celebrated its 75th anniversary.
Recognition of chiropractic degrees in Europe requires accreditation by CCE Europe, which has reciprocity with CCE U.S., and therefore degrees issued in the U.S. are accepted in Europe. There may be some differences, but the academic experience is not fundamentally different, and in fact many of the educators in Europe are themselves U.S. trained. In countries where legislation exists the degree is only the first stage in registering as a chiropractor; both domestic and foreign graduates require subsequent postgraduate training. Future legislation in other member states is likely to mirror existing laws, so there is no discrimination against U.S. graduates in favor of European ones.
It should be noted that in addition to the university base courses listed for the U.K., there is also a course at The University of Glamorgan in Wales.
While we welcome interest in the future of the profession in Europe, we also feel that the best people to develop that future are the Europeans. In the same way as the profession in the U.S. would not welcome external intervention in its affairs, so the profession in Europe expects the same level of respect. We are involved in detailed discussions with both the European Parliament and the European Commission, and currently there is interest in the chiropractic profession. The profession is now involved with the COST B13 initiative (European Low Back Pain Guidelines) for which we have a respected chiropractor and researcher in the person of Alan Breen,DC, on the advisory panel. I have had correspondence and discussions with representatives from the commission and the Parliament in Brussels, and was in Brussels earlier this month examining the barriers to Euro-wide recognition of qualifications. This is an issue that the commission is now looking into since they are aware of the anomalies that currently exist. There is a favorable climate at the moment, but the main obstacle is that at the EU summit in Fontainebleau over 10 years ago, it was agreed that issues relating to health policy should remain the responsibility of the individual member states. This cannot be altered while the principle of unanimity remains in place with relation to adopting EU-wide policy changes.
We are aware that the way forward for the profession in Europe is to increase the availability of undergraduate education. While historically privately funded institutions have been able to develop and flourish in Europe, it is now becoming increasingly obvious that the best way forward is university-based courses such as those at Odense in Denmark and the University of Glamorgan in Wales. The private institutions, such as AECC in the U.K. and IFEC in France, have relied heavily on the ECU for financial support, and are going to face increasing competition from university-based courses that attract state funding. There are also linguistic barriers within Europe, and locating a private institution outside the university sector capable of catering for the whole of Europe will be very difficult.
The ECU continues to work toward the full recognition of chiropractic in Europe, and is in command of its brief. There are many cultural differences within the EU, and we have to ensure that they are all taken into consideration.
Fixated on Philosophy
The most recent article written by my friend, Dr. James Winterstein, is right on! (See "Our Bullet-Riddled Feet," DC, May 21, 2001.) This is the most recent attempt by our ICA brothers to promote limited chiropractic care. Last year I and a few brave leaders in Rhode Island proposed a nomenclature change in our state statute. As everyone involved in health care knows, chiropractic is basically mainstream health care. The ICA zealots came out, with the help of a patient who was the secretary of the HEW committee that killed the acupuncture bill this year. The ICA representative, Chris Black, went "all out," even having letters sent to the governor from presidents of some chiropractic schools. You don't have to guess what schools sent letters opposing the nomenclature bill.
Though we fight for our patients' rights and ours, there is that very small percentage in this profession that cannot see the forest from the trees. I had my first encounter with the ICA in Dallas in 1987 at a meeting that was called to discuss a merger, which I call a "baptism by fire." Recently, we voted to reach out to the ICA to possibly "discuss" a merger. Their answer was "no." This profession is over 100 years old, and still, we are fixated with philosophy.
Bob Mastronardi, DC
Warwick, Rhode Island