Chiropractors wage delicate battle States derail AVCA's attempts at separate licensure; veterinarians say chiropractic lacks scientific proof

The American Veterinary Chiropractic Association (AVCA) will continue its attempt to regulate animal chiropractors despite another disapproval at the state level.

The Colorado agency dealt the association its latest blow, dismissinga proposal to distinguish animal chiropractors from human chiropractorsand veterinarians, by creating, in essence, a third profession. A 25-pagereport from the Department of Regulatory Agencies (DORA) claimed the AVCA'sproposal failed to fully demonstrate regulations would benefit the pet-owningpublic.

To date, no states have permitted AVCA to move forward with such a proposal.

Never give up

Paul Rowan, DVM, legislative chair and author of the AVCA proposal, sayshe won't surrender.

"We completed it and they rejected it. It's the end of the story- for now. I take exception to some of their conclusions, but that's theirprivilege," the doctor of chiropractic says.

The AVCA, in accord with its Model Animal Chiropractic Practice Act,seeks regulation on behalf of animal chiropractors that is independent ofveterinary and human chiropractic rules. Chiropractors and veterinarianswould be eligible to practice animal chiropractic upon completion of a 150-to 200-hour certification program.

The initiative didn't influence DORA, which chose to uphold existingregulations that require veterinarians to supervise and be held liable forchiropractic work performed on animals.

"I don't think that's a safe position for us to put ourselves in,"Rowan argues. "If I've got to supervise somebody (as a veterinarian)and I don't even know what he's doing that's kind of fraudulent. It's adisaster that's going to set us up for so many legal problems."

Ralph Johnson, executive director of the Colorado Veterinary MedicalAssociation (CVMA), disagrees. When DORA was soliciting input, the CVMAissued a position statement in outright opposition to the AVCA's proposal.

"Broadly, with any complementary or alternative modality, we thinkit is vital that veterinarians be kept in their trained role for diagnosis,"says Johnson. "They're the ones who are educated to watch for diseasethat could be transmitted to other animals or to humans."

A source of contention for CVMA was that the proposal would have allowedan AVCA-certified chiropractor to be a "gatekeeper" for animalcare.

"We think the veterinarians are the ones who have the skills andeducation to be that gatekeeper so we advocate for retaining that,"says Johnson.

Neighboring views

In Oklahoma, governing officials passed a statute that allows chiropractorsin the state to practice on animals if referred by a veterinarian or certifiedby the chiropractic board.

Meanwhile state veterinary and chiropractic examining boards are enactingrules establishing certification procedures for chiropractors to practicemedicine on humans and animals. (No accredited chiropractors practice onanimals at this time.)

"The real value that we saw in it was that we did not have a lotof veterinarians that were trained in spinal manipulation or animal chiropractic,"says Dr. Charles Helwig, executive director of the Oklahoma Veterinary MedicalAssociation. "The purpose of this legislation is actually to have thetwo professions work together."

In Nevada, the arrangement is slightly different in that animal chiropracticis recognized as a licensed endeavor for a chiropractor who has met AVCAcertification requirements. The veterinary board would then license theperson as an animal chiropractor. Although veterinary referral is unnecessary,the animal chiropractor must contact a veterinarian within 10 days of chiropractictreatment.

In Texas, the guidelines in place since 1994, are straightforward: chiropractorsmust be referred, should be supervised.

Rowan says he fails to see the logic behind referrals.

"How is somebody who has no clue about chiropractic going to lookat a patient and say you need to go see a chiropractor? That's limitingthe choices of an animal owner."

AVMA quiet

Although an AVMA task force finalized Guidelines on Complementary andAlternative Veterinary Medicine in 2001, the veterinary organization haskept a low profile on the issue ever since.

"After the guidelines were approved and published, we heard verylittle comment on them. If we would have done a bad job, we would've heardabout it," responds Dr. Craig Smith, AVMA consultant. The guidelineswill be reviewed again in 2006.

As a member of the now-defunct AVMA taskforce that created the guidelines,Dr. Harmon Rogers says veterinarians have an obligation to remain open-minded,but only for consideration of new forms of medical therapy.

"The scientific method provides the only realistic approach to determinethe effectiveness of any particular therapy including manipulative therapysuch as chiropractic," says Rogers. "I believe that such proofis generally lacking for manipulative therapy in animals."

Dr. David Ramey, who practices in Southern California, adds, "Inthe past 20 years (of AVCA's existence), there is not one shred of evidencethat any of what they're doing makes any difference as far as the healthand welfare of animals go. They're trying to succeed by inference and anecdote.

"What they're trying to do is to grant themselves legislativelywhat they can't accomplish scientifically," he says.

Do the homework

Rowan passes off the medically biased views as blatant ignorance.

"Why is chiropractic legal in all 50 states? If there is no scientificproof that it works, then why is it licensed?" he queries. "Manypeople have never taken the time to read anything in terms of journal articles,scientific papers-there's a myriad of information available."

He cites three texts that provide scientific evidence supporting humanchiropractic with ample research on animal studies. However, he concedesthe research on animal chiropractic is still scant.

AVCA is responding by recently establishing a research foundation tobegin searching for funding for clinical research.

Still, Rogers of AVMA cautions, "If manipulative therapies are offeredas primary approaches to general animal medical problems by doctors of chiropracticwithout the involvement of licensed veterinarians I believe that there willbe high risk of inadequate diagnosis and care."

Wish list

Aside from the Colorado setback, AVCA plans to establish goals that definebasic academic requirements for future chiropractors or veterinarians whoperform chiropractic on animals, set up CE requirements, and obtain accreditationfor its certification.

"Down the road we would like to see the establishment of an animalchiropractic degree program," Rowan says. "Without licensure,without legality, you've got all kinds of people who have an ability todo something but are a.) afraid to make it known or b.) can't advertiseto the public because there is no access."