The original article can be found in: Virgin Islands Daily News
ST. CROIX – A medical doctor voiced concerns at a Senate committee hearing Wednesday about a bill that would expand the scope of practice for chiropractors in the territory, while local chiropractors testified in support of the measure.
The Senate Committee on Health, Hospitals, Human Services and Veterans Affairs listened to the testimony and ultimately voted to forward the bill to the Rules Committee for further consideration.
Plans are to fine-tune the bill through amendments while it is in the Rules Committee, said Sen. Sammuel Sanes. Sanes, who sponsored the bill, made the motion Wednesday to forward it to Rules; he also is the chairman of the Rules Committee.
He said the Rules Committee hearing about the bill will include time for further testimony and to address concerns raised at Wednesday’s hearing.
At Wednesday’s Health Committee meeting, Dr. Frank Odlum, a St. Thomas surgeon who heads the V.I. Board of Medical Examiners, testified by telephone, saying he believes that some sections of the bill are too broad as written.
As it stands now, the bill makes a number of changes in V.I. Code, increasing the scope of practice for chiropractors in several areas and giving them more autonomy to police their own profession.
Odlum said that he had thoroughly reviewed the bill and limited his testimony to areas that raised concerns for him.
Part of the bill was written too broadly and, combined with other language in the bill, would make it OK for a chiropractor to treat fractures and dislocations, Odlum said.
He noted that this may not be the intent of the section – but he said it would be the result based on the language.
“All fractures and dislocations are emergencies and could lead to permanent dysfunction and or limb loss,” Odlum said. “These should be treated in the emergency department and/or by an orthopedic surgeon.”Odlum also took exception to some language in the bill that would enable chiropractors to perform routine physicals.
Chiropractors who testified said that the profession has continued to evolve over the years to encompass areas that include wellness, exercise, nutritional care and stress management, and that V.I. Code should reflect the nature of the changes.
“The chiropractic premise has always been to assist the body by balancing and improving the integrity of its systems, maintaining wellness rather than attempting to treat disease,” said local chiropractor Malcolm MacDonald.
MacDonald said that expanding the scope of what a chiropractor can do under V.I. Code would also, under the Affordable Care Act, allow residents to be reimbursed by insurance for all services rendered by chiropractors.
MacDonald contended that the issue that Odlum noted about the treatment of fractures in the bill was the result of a typo.
Among the things the bill would do is change the definition of “the practice of chiropractic.”
Currently, the definition is “detecting and correcting by manual means of the structural imbalance, distortion or subluxations in the human body for the purpose of removing nerve interference and effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column.”
The bill would change that definition to “the diagnosis and treatment of human ailments,” and then lays out in four sections the elements that are included in that practice.
Odlum noted concern with one of the sections that pertains to taking case histories and examining and evaluating a patient, and another section that pertains to the performance of health promotion and wellness procedures.
He said that for chiropractors, the histories and evaluations should be part of assessing a chiropractic problem.
“If Bill No. 30-0037 is left as is, it would make chiropractic physicians, primary care physicians with the right to perform gynecological and obstetrical exams, rectal exams and children examinations,” Odlum said.
Odlum also urged rejecting a section of the bill that allows chiropractors to perform “scholastic, sports, routine or other physical examinations.”
“Chiropractic physicians are not primary care physicians and should not be doing ‘routine’ physicals,” Odlum said. “There is nothing in medicine that is routine.”The bill also would expand chiropractors’ authority to order X-rays for diagnosis. Currently, they are confined to ordering X-rays of the spinal column and boney articulations, and the bill expands that to include the entire body.
The bill also would allow chiropractors to recommend nutritional, herbal, homeopathic, enzymes or other non-prescription drugs. Chiropractors are not allowed to prescribe prescription medications.
Another section of the bill lifts a few of the restrictions that currently are in place for chiropractors. For instance, the bill would lift the restriction on chiropractors treating diabetes.
Chiropractors who testified said they could treat early diabetes with diet and exercise.
Other measures in the bill include provisions that would:
– Change references to “chiropractor” in V.I. Code to “chiropractic physician.”
– Eliminate medical doctors from the Board of Chiropractic Examiners, the board that licenses and regulates chiropractic in the territory. The bill changes the makeup of the Board of Chiropractic Examiners from two chiropractors, two medical doctors and one member of the public to four chiropractors and one member of the public.
– Allow the Board of Chiropractic Examiners to make nominations for the chiropractor who serves on an advisory committee for Workman’s Compensation.
– Change the terms of the Board of Chiropractic Examiners to three years from four, define a quorum as three members, establish a $75 per day per diem for board members conducting board business and give board members immunity from personal liability for good faith board decisions.
– Changes some of the requirements for licensure.
Health Committee members who voted to move the bill to the Rules Committee for further consideration were Senators Craig Barshinger, Alicia Hansen, committee chairman Clarence Payne, Tregenza Roach, Sanes and Terrence Nelson. Committee member Sen. Kenneth Gittens was absent for the vote.
