World Chiropractic Alliance concern with CCE proposals
12-24-02

reply@worldchiropracticalliance.org


1. The premise that CCE style chiropractic education prepares full 
body, primary care diagnosticians is a dangerous farce. The 
absurdity of claiming a person is qualified to perform rectal and 
vaginal exams after poking a mannequin is obvious on its face. So is 
the claim of ability to screen for a wide array of diseases that have 
never been seen.
The claim that requiring 7, or 14, or 35 different clinical encounters 
fosters adequate competency to serve as a „primary care physician¾ 
is ridiculous. Which of the thousands of diseases in ICDA or Cecil are 
we to know? Which may we ignore?
However, we can rationally argue that chiropractic education does 
an excellent job of preparing DCs to determine the safety and 
appropriateness of chiropractic care.
2. Many fully accredited CCE colleges do not teach ANY form of 
spinographic analysis, despite favorable reliability studies for a 
variety of systems.
3. Many fully accredited CCE colleges do not teach ANY form of 
instrumentation to monitor neurological function, despite evidence 
of reliability and clinical utility.
4. The technique instruction in some of the CCE accredited colleges 
appears abysmal.
5. The orthopedic and neurological tests relied upon for patient 
assessment have not (with few exceptions) been shown to be 
reliable and valid indicators of the medical conditions they purport 
to evaluate, much less aid in subluxation assessment.
6. Many CCE colleges teach and promote the use of physical therapy 
modalities that have been shown to be either no better than a 
placebo, or actually harmful. There is a mandate to teach PT pending.
7. Questions have been raised concerning CCE's corporate 
restructuring.
8. It has been alleged that accreditation was granted to the U of 
Bridgeport in "record time" to maintain a balance of power, when 
Sherman's accreditation was about to be granted.
9. CCE is proposing a takeover of Continuing Education, in 
association with FCLB.
10. CCE is seeking to mandate use of the term "physician" by 
colleges, although law in many licensed jurisdictions prohibits use 
of this term by DCs.
FCLB has released their PACE proposal on the web site 
<http://www.fclb.org/>
The most disturbing material may be found by clicking on Criteria. 
Deeply buried in this document are 2 major problems:
Criterion 17. Second to last paragraph: "Continuing education 
programs must address topics and subject matter areas that are 
pertinent to the contemporary practice of chiropractic and well 
balanced in presentation. Subject matter must be evidence-based, 
professionally credible, and educationally sound."
Criterion 26. "An evaluation mechanism must be provided at each 
program for the purpose of allowing all participants to assess their 
achievement in accord with the program's learning objectives."
So there you have it. CCE will determine what "evidence-based" 
content is permissible. There must be an "assessment" provided at 
each program. In case you didn't know the FCLB offices are inside the 
NBCE headquarters in Colorado! 
Does anyone see what could happen here? You must take a 
medipractic program and pass an exam in it to renew your license. 
You'd better answer the questions the right way. This would then 
become the standard of care.
CCE already has control of the educational process and who gets 
licensed. Their only barrier to total domination is the field. Now 
they will be imposing their will through the license renewal 
mechanism.
If we let it happen, we deserve the result.
It is imperative that join the <http://www.dece.org/> and protest 
the CCE's actions including:
1. Use of physiotherapy is prohibited in some jurisdictions. In 
addition, it's use is discretionary where permitted. It should not be a 
mandatory part of a DC program.
2. Use of the title "physician" by a chiropractor is prohibited in many 
jurisdictions. It is also potentially misleading to the public.
3. Approval of Continuing Education programs is within the 
discretion of the individual states. The CCE/FCLB proposal could 
potentially increase the costs of CE programs to the end user. 
Furthermore, content requirements vary from state to state. The 
proposal could impinge on academic freedom by imposing content 
restrictions.
I have and will continue to voice my strong protest against the 
proposed revisions to the CCE Standards for Chiropractic Programs 
and Institutions.
These provisions could have extremely serious ramifications for the 
entire profession, and allow the CCE to interfere in state regulatory 
functions. They could change the way chiropractic is taught, and how 
the public perceives it. Most critical, however, is that they clearly 
over reach the authority of the CCE to set accreditation standards.
Section G - This proposal is an attempt to control continuing 
education by providing accreditation requirements for use by the 
FCLB for certification of CE courses. This proposal, as a prelude to 
the PACE project, could impinge on academic freedom by imposing 
content restrictions. CCE and FCLB leadership is dominated at this 
time by medically oriented doctors who could easily use this power 
to deny approval to subluxation-based CE courses. In addition, the 
proposal denies the states the right and discretion to approve their 
own CE programs, and could potentially increase the costs of CE 
programs for doctors. This proposal extends the authority of the CCE 
without the consent and approval of the profession.  
<http://www.chiroweb.com/archives/21/02/19.html 
Section C - The change of the designation from doctors of 
chiropractic to „physicians¾ would be interpreted as an „official¾ 
chiropractic designation and as a mandate to chiropractic colleges. 
This is an extremely ill-advised proposal, since several state 
statutes prohibit the use of the word „physician¾ by chiropractors. 
In addition, the terminology has no relevance to educational 
standards and is not therefore an issue to be decided by the CCE. 
Finally, use of the term would confuse the public and further blur 
the distinction between medical physicians and chiropractic doctors.
Section H - The requirement that ALL chiropractic colleges include 
physiotherapy in the D.C. degree requirement and in clinical 
competencies denies autonomy to the colleges and could interfere 
with their mission. The task of the CCE is to ensure that colleges 
fulfill their mission - not to dictate what that mission will be. 
Further, the use of physiotherapy is prohibited in some jurisdictions 
and, where it is permitted, its use is discretionary, not mandatory. 
Colleges should be permitted this same freedom to include 
physiotherapy as an option, not a requirement. The mandatory 
inclusion of physiotherapy could change the basic character of a 
college's educational direction, shifting the emphasis from 
subluxation correction to treatment therapy.
The proposed revisions are totally unacceptable and must be 
rejected.
In addition, I want to voice my protest over the lack of time given to 
the profession to respond to these proposals. The CCE made no 
attempt to distribute information on these proposals to the entire 
profession in a timely manner that would enable doctors to study the 
proposals and respond in full. By releasing the information shortly 
before the Christmas holiday season, the CCE denied doctors the 
chance to participate fully in the process.