“Because the damn chiropractors haven’t done anything with it!”
I recall just a few years ago I asked famed attorney George McAndrews why the chiropractic profession seems to be no better off than it was nearly 30 years ago in 1987 after he won the milestone Wilk v. AMA antitrust lawsuit.
Needless to say, George was pissed off by my question and said, “Because the damn chiropractors haven’t done anything with it!”
He was right. It reminded me of the 1964 Civil Rights Act that did little until MLK, Jr. and his followers took to the streets to protest urging the implementation of this federal law. Indeed, the law does nothing to create social change until someone presses the point.
In reality, we are still marginalized, we still endure ‘chirophobia’ embedded into our society by bigoted MDs, our image remains stained, we have no presence in the media, markets are closed or severely limited, and we remain a fractured profession with factions rather than solidarity. If it weren’t for our great clinical results, we would be gone with the political wind a long time ago as the AMA and the Committee on Quackery planned to “contain and eliminate” our profession.
Here in Georgia where I’ve practiced for 40 years, the most obvious places where discrimination against chiropractors still occur are at Robins AFB and in Georgia’s Workers Comp program. Although chiropractic is a legal benefit in TRICARE and the federal workers’ comp program, I never get referrals from RAFB despite the fact the 3 Army posts in Georgia have chiropractors on staff. The boycott of chiropractors by FECA (federal workers comp) at RAFB was evident in a 2012 FOIA report showing there were 2,512 spine-related injuries but there were zero referrals to local chiropractors. This is both an ethical and legal problem putting patients at risk by the lack of Informed Consent law to give injured workers “practical alternatives.”
The same is true for Georgia’s workers comp program. For example, the Georgia State Board of Workers’ Compensation’s own data is evidence of the medical dominance of market power. In a 3-year span (2013-2015) chiropractors treated just 219 of 11,064 (1.9%) spine-related injured patients (Neck Pain and LBP) and were paid the meager sum $420,095 of $281 million (0.149%). In 2018 (after HB 412 passed), chiropractors saw 25 cases of 2,565 (0.97%), which is 70% less than in 2013 at a cost of only $18,888.
Obviously the medical monopoly is in total control of these markets and the boycott remains intact despite the Wilk victory.
After my in-depth investigation that took months to research, I filed complaints with both the Air Force Office of Inspector General and in Atlanta with the state OIG. You can read my federal complaint at Putting Patients at Risk and my Georgia state complaint at Reforming Georgia’s Workers’ Compensation Program Through Choice, Competition, & Chiropractic Care.
I might add Mr. McAndrews helped me immensely by directing me to the Seventh Circuit Court of Appeals, a legal opinion every chiropractic leader and academician should read. I used this court’s decision throughout my paper, which are antitrust issues the public and press need to hear because they’re still being violated. It’s time to bring these issues to the light of day in this era of healthcare reform.
Mr. McAndrews reviewed my Air Force complaint. As I learned, he has an “eagle eye” for grammar, a talent he developed while editor of the Notre Dame Law Review. Upon reviewing my paper, he phoned me with numerous corrections and added, “This paper is outstanding. You should have been an attorney.”
Although I was flattered, I replied, “It’s a bit late for that career move since I am 70 years old now.” I have to admit without his advice, my complaint would never have passed the initial OIG review standards. I have not yet heard any final decision.
I also have gotten much needed advice from my reluctant mentor, Dr. Lou Sportelli, who has battered my ears many times over the years with his tongue-lashings. He also has taught me that “leaders are readers” to broaden my perspective, a trait lost in our post-literate profession where DCs choose not to read. I also appreciated Dr. Sportelli’s ironic description of my work when he wrote, “Like him, dislike him, disagree or support him, one thing you will have difficulty doing is ignoring him.”
I hope all DCs, academicians, political leaders, and students will not ignore these two papers. Indeed, let me say these issues and supportive documentation should be included in the poli-sci classes at every chiropractic college to give them a taste of the medical war they are entering. This information will empower our profession with the latest evidence-based data showing DCs have vaulted from last to first as an option in spine care but still face huge political battles for market share in this medical war.
The problem remains: the public and press are unaware of our progress, and we know damn well the MDs will never tell them. As I’ve learned, MDs don’t follow the guidelines, they follow the money. Plus, the SBWC isn’t interested in the cheapest mousetrap because the more they pay, the more they charge in this ‘cost-plus’ system, so “there’s more money for everyone.”
As Donald Trump would say, “the system is rigged.” Incidentally, you ought to read the Trump Report that recommends government controls in healthcare to create a free enterprise environment. Imagine that — instituting the principles of a free market in healthcare, an idea the AMA would oppose just as strongly as the NRA opposes gun control. Maybe that’s why no one has heard of the Trump Report.
The Trump administration report was remarkable despite the lack of media attention. In fact, it may have been the most disruptive treatise on healthcare since the Affordable Care Act. The 119-page report, Reforming America’s Healthcare System Through Choice and Competition, was written by Cabinet members Alex M. Azar II, Secretary U.S. Department of Health and Human Services, Steven T. Mnuchin, Secretary U.S. Department of the Treasury, and Alexander Acosta, Secretary U.S. Department of Labor.
It’s now time to ascend over the tipping point. This comes at a time in this era of opioid abuse and failed back surgeries when research clearly supports conservative care over usual medical care – drugs, shots, and surgery. We can do this if we have a plan and my two documents will lead the way with the evidence and the law behind us. We have never been so empowered if we act up and assert our rights. Indeed, being ‘nice’ will not work; we need to be disruptive and go on the offense for the first time since the Wilk decision.