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SB 908: Giant Leap Forward

Senate Health Policy Committee Holds Hearing on Scope Restoration

In mid-March, scope restoration in Michigan took a giant leap forward when the Senate Health Policy Committee heard compelling testimony in favor of Senate Bill 908, the Patient Services Restoration Act. MAC President Dr. Kirk Steketee and Life University Dean Dr. Robert Scott, DC, PhD, testified in favor of the bill, and noted Oakland University economist and healthcare expenditures expert Dr. Miron Stano submitted written testimony discussing the economic impact of restoring Michigan’s scope of practice.

Along with Drs. Steketee and Scott, the MAC team included Vice President Dr. Don Reno, Chairman Dr. Tom Klapp, Government Relations Committee Co-Chairs Dr. Jim Gregg and Dr. Chris Dolecki, committee member Dr. Dan Spencer and his wife, Michelle, lobbyist Jim Ryan, attorney Kevin Moody, and Government Relations Director Carl Alden.

Dr. Steketee’s testimony, backed by a number of studies and scientific information, centered on the fact that DCs are highly educated and trained to perform all services outlined in the bill and that scope restoration would improve patient care by:

• Removing conflicts between federal and Michigan law;

• Allowing chiropractic patients in Michigan access to the same treatment available to patients across the country;

• Providing chiropractic patients access to more conservative, cost-effective treatment that meets nationally recognized standards; and,

• Allowing Michigan’s chiropractic physicians to utilize their education and training

Dr. Steketee also stated that SB 908 would allow DCs to determine the need for chiropractic care by:

• Diagnosing subluxations, misalignments, and joint dysfunction of the musculoskeletal system, through examination, evaluation, and imaging technology;

• Performing chiropractic adjusting techniques, physical modalities, and rehabilitative services to correct or reduce subluxations, misalignments and joint dysfunction of the human neuromusculoskeletal system; and,

• Monitoring body physiology to determine the effects of treatment, or the need for a referral to another health provider

He further emphasized that SB 908 is needed to support Michigan’s economy by allowing patients to spend their health care dollars in Michigan, as well as improve Michigan’s health care delivery system by utilizing a proven professional treatment that saves scarce health care dollars

Dr. Scott’s brilliantly conceived and executed testimony centered on the education a DC receives, compared a chiropractic education to a medical education, and explained that everything in the bill is taught extensively in chiropractic colleges, preparing Michigan DCs for the changes in services allowed by the bill.

Dr. Stano’s written testimony centered on the economics of the bill, and concluded: “Michigan chiropractors work under one of the most restrictive scope of practice regulations in the nation. In the United States, there has been a tendency toward broadening the diagnostic and treatment procedures that chiropractors are allowed to perform. I find no basis in terms of access, quality, and cost of care considerations that justifies a continuation of Michigan’s existing regulations.”

The Healthcare Association of Michigan handed in a card in support of the bill, but did not testify.

Groups testifying against Senate Bill 908 included the Michigan State Medical Society, the Economic Alliance of Michigan, Chrysler, the Michigan Physical Therapy Association, and the Michigan Radiological Society. Others in opposition but not testifying included the Insurance Institute of Michigan, the Michigan Osteopathic Association, and Blue Cross Blue Shield of Michigan. These groups trotted out the same old, discredited arguments against chiropractic. Their testimony was largely anecdotal, lacking any basis in scientific study, and much of the Committee seemed to understand the rather subjective nature of their testimony.

While this hearing was “testimony only,” with no vote of the Committee on the agenda, it is hoped that a vote will take place in the very near future.

State Representative Kathy Angerer (D-Dundee), chair of the House Health Policy Committee, recently introduced House Bill 5759, the Patient Services Restoration Act, in the Michigan House of Representatives. A Senate version of the bill was introduced last year by State Senator Wayne Kuipers (R-Holland) (Senate Bill 908).

With scope restoration legislation now introduced in both chambers of the legislature, it is critical that YOU contact your lawmakers TODAY and ask him or her to co-sponsor and support these essential bills.

We’ve made it easy for you to do so. Just go to www.chiromi.com, put your zip code in the "Write Your Legislators" icon on the right-hand side of the page, and click "Go." Once at the site, scroll down to input your address or zip code (to determine your lawmakers), scroll back up to the "Take Action!" section, and click on "DCs – Scope Restoration Bill Introduced in Michigan Senate." Be sure to change the Subject Line to "Please Co-Sponsor Rep. Angerer’s Chiropractic Scope Bill." Then, compose your message (Talking Points are along the right-hand side of the message; click on the individual points you wish to emphasize, or feel free to put them into your own words), fill out the required information, and send an email to your lawmakers. And, don’t forget to ask them once again in the body of the email to co-sponsor the bill.

This is a critical time for our legislation. With both chambers taking up the bill, it is essential that both your senators and representatives know the importance of scope restoration.

The 37 co-sponsors of House Bill 5759, listed in the order they signed on, are:

 Members of the House Health Policy Committee are in bold.

If you live in a district represented by one of the above lawmakers, be sure to contact and thank them for co-sponsoring the bill.

We all know that the need for a restoration of Michigan’s chiropractic scope of practice continues to grow. The rewrite of our public health code in 1978, and subsequent court cases, have left Michigan with one of the most restrictive scopes in the nation. This means that doctors of chiropractic are unable to practice as they are educated and trained, and chiropractic patients are unable to receive the full benefits of chiropractic care. Michigan’s overly restrictive scope also negatively affects the state’s economy. Not only does it drive some chiropractors out of Michigan and discourage newly graduated doctors from moving in, it forces patients to take their health care dollars to our border states, especially Ohio, Indiana, and Wisconsin, in order to receive the full benefits of chiropractic treatment.

The legislation to restore the chiropractic scope of practice will be introduced in the Michigan Legislature this fall.

Grassroots activities are needed NOW to form relationships with legislators and build support to pass this critical legislation. We are asking all doctors to help in this cause.

Contact your state legislators by email, letters, and phone calls using the talking points below to help educate them on the need for scope restoration. You can find your state representative online by going to www.house.michigan.gov/find_a_rep.asp. Your state senator can be found online at: www.senate.michigan.gov/  (Click "Find Your Senator" on the left-hand side of the page). If you do not have access to the Internet, contact the MAC office, and we can look up your elected officials for you.

Restoration of Scope of Practice Talking Points

Call Your State Representative and State Senator

Ask Them to Support the Restoration of Chiropractic Scope in Michigan

• Doctors of Chiropractic are the third largest physician group in Michigan and the United States.
• Completion of a Doctor of Chiropractic degree requires four to five years of professional course work (after the college level prerequisites prior to entering chiropractic college).  An average of 4,822 hours is required in chiropractic schools, compared with 4,667 hours in medical schools.
• Doctors of Chiropractic are concerned with the diagnosis, treatment and prevention of neuromusculoskeletal disorders, and the effect of these disorders on the nervous system and general health.
• Doctors of Chiropractic use natural and conservative methods of treatment and respect the human body’s ability to heal itself.
• Numerous studies have demonstrated the efficacy and cost effectiveness of chiropractic treatment.
• Michigan’s chiropractic scope of practice (Part 164 of the Michigan Public Health Code) is the most restrictive in the nation. These restrictions are the result of a 1978 rewrite of the Public Health Code, and a subsequent Michigan Supreme Court decision that resulted in chiropractors losing the right to practice as they are educated and trained.
• These artificial limits result in a conflict between Michigan law and Federal law and rules.  Michigan laws dictate that a chiropractor can only diagnose “spinal subluxation,” but Medicare requires a chiropractor to diagnose more than just “spinal subluxation” before treating a patient.
• Doctors of Chiropractic are educated and trained to perform differential diagnosis to determine subluxations, misalignments, or joint dysfunction, through examination, evaluation, x-ray and other imaging technology. While Michigan does not allow chiropractors to perform differential diagnosis, the large majority of other states do, greatly benefiting chiropractic patients.
• Doctors of Chiropractic are educated and trained to adjust joint misalignments where they appear, i.e., in the spine, legs, arms, etc.  A recent national survey showed that more than 95% of chiropractors do so.  Michigan, unlike other states, does not allow chiropractors to adjust extremities, to the detriment of the patient.
• Doctors of Chiropractic are educated and trained to perform physical treatment modalities in order to help the patient’s healing.  Most states allow this, but Michigan again severely and unreasonably restricts the chiropractor’s right to practice as they have been educated and trained.
• Michigan’s overly restrictive and unreasonable chiropractic scope of practice has a negative impact on the state’s economy.  Not only does it drive some chiropractors out of Michigan and discourage newly graduated doctors from moving in, it forces some patients to take their health care dollars to our border states, especially Ohio, Indiana, and Wisconsin, in order to receive the full benefits of chiropractic treatment.