President's Message — Dr. Pat Bickert, BCCA president
I would like to focus on three issues that the Association Board is currently addressing: the Health Profession's Council (HPC) scope of practice review, ICBC, and the BCCA's public relations initiatives.
The Health Professions Council
The Council is well into its process of reviewing the scopes of practice
for all health professions. This process offers opportunities for our
profession as well as some risks. Regardless, bypassing the process is
not optional, since all health professions are involved. Our primary focus
has been to capitalize on securing exclusivity of adjustment for chiropractors.
If successful, this legislation would make it illegal for other health
practitioners to employ spinal manipulation in their practices. This legislation
currently exists in several states across the U.S. We want to ensure that
practitioners with inadequate training such as medical doctors, physiotherapists
and naturopaths are not granted this procedure in BC.
Undergoing this scope of practice review also introduces the possibility of new limitations imposed on chiropractic practice. Whenever government opens up discussion on scope, presentations from other practitioner groups (as well as council member personal biases) can influence recommendations to government in a way that may not be impartial or based on facts. The BCMA's recent edict on treating children under the age of 12 is a classic example of issues our profession has to relegate. Whatever the outcome, I am confident that throughout the process, presentations by our profession have been articulate, comprehensive, and rational. I believe they adequately reflect the best interests of everyone in the profession.
ICBC
I would like to ask members to begin to take a serious look at how you
interact with ICBC adjusters. As most practitioners are aware, many adjusters
have increased their efforts to limit chiropractic involvement in whiplash
cases. Far too many of us are rolling over and playing dead, accepting
the inappropriate actions of adjusters. This tends to undermine the efforts
of your colleagues who are fighting for the rights of their patients to
receive necessary care, as well as the Association's efforts to troubleshoot
adjusters or Claims Centres.
We strongly suggest that when you initiate an ICBC case, that you have your COA immediately contact the adjuster and find out the "end date" for the claim. As offensive as it sounds, ICBC's procedure is to automatically key in this date when a practitioner initiates care. In reality, the date was designed as a review date for physio and massage therapists, not chiropractors. ICBC maintains that computer programming administratively lumps chiropractors with PTs and RMTs, even though adjusters are instructed that D.C.s do not require a medical referral to initiate or continue care.
In addition, you should contact adjusters prior to the end date and provide an estimate of future needs of care so that end dates are extended and visits are not refused. ICBC is acutely interested in when the patient's treatment will end. Although this remains a difficult clinical judgement for practitioners, adjusters will be far more reasonable if provided with an estimate of when treatment objectives will be obtained (Maximum Medical Improvement), than if you are non-committal. Evasiveness only serves to prompt the adjuster to seek other opinions, which may ultimately result in termination of chiropractic coverage.
Be sure to separate simple administrative obstructions like these from actual inappropriate activity of adjusters, such as requiring GP approval of care. If the adjuster's immediate supervisor (B.I. Claims Manager) does not resolve the problem, immediately document and report the event to the Association so that we can initiate action.
Public Relations
The Association is currently reviewing its vision for the message we wish
to convey through media advertising, particularly T.V. I am personally
pleased to see that here, as well as in other provinces, there is a shift
toward emphasizing the wellness concept of chiropractic care, including
reference to subluxation. If you open your local Yellow Pages directory
and compare physiotherapy ads to those in the chiropractic section, the
messages we are communicating are the same. Is there any wonder the public
is confused? Chiropractors need to begin to clearly define our unique
health care niche.
I want to thank members who have expressed their concerns regarding our response to ongoing attacks in the media. While at times it may appear that we "sit back" and don't respond to these attacks, the very opposite is true. Defensive, knee-jerk responses that focus on our indignation do not further the long-term objectives of the profession or reflect our confidence in the status that we have obtained. Chiropractors need to get over their professional inferiority complexes. Not every single cheap shot that appears in the media is worth a rebuttal. Often, this only gives our detractors a forum to open up debate in an uncontrolled environment. It is better that we create our own positive news that constantly assumes a defensive posture to bogus information.
Doctors, remember that as chiropractors you are great. Great not because you are chiropractors, but because you dedicate your life to providing chiropractic care to a great humanity. Chiropractic is not a career - it is a cause. Please, do what you must to keep yourselves healthy, stress free, committed and successful. Plug in, be a team player and get involved. Help advance this profession as you capitalize on the rewards it provides you.
It is an honour to be your colleague and spend this year helping serve you in my capacity within the BCCA.
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