| Editor's note: Most of the following information is based on country reports presented at the WFC Assembly, June 14-15, 2005.
|
Greece: Dr. Vasileios Gkolfinopoulos, Ellenic Chiropractic Association president, reported on the ongoing ECA campaign for legislative recognition. In Greece, the practice of chiropractic is legal, but there is no regulation. Achievement of regulation is a particular challenge in Greece, because under Greek law, the government has to fund and provide education for any health care profession that is recognized and regulated.
India: The Indian Association of Chiropractic Doctors (IACD), newly admitted into WFC membership, has 20 members and has established good contacts with government and educational authorities during the past three years. Dr. Amit (Jimmy) Nanda (Life West), IACD president, is establishing three clinics in New Delhi by the end of the year, and Dr. Shailly Prasad (Western States), 1st vice president, practices in Bangalore. The IACD welcomes contact from anyone wishing to support the development of the chiropractic profession in India. (Contact: Dr. Jimmy Nanda,
, or Dr. Shailly Prasad,
.)
Iran: The Iranian Chiropractic Doctors Association (ICDA) now has 21 members and, in what may well be a first internationally, Dr. Hossein Sabbagh, ICDA past president, has recently been appointed to the Medical Council. The Ministry of Education is currently reviewing two proposals for university-based chiropractic education in Iran, a country in which patients generally have to wait more than a month to see a chiropractor.
Israel: Dr. Ofer Baruch, president of the Israeli Chiropractic Society, representing 73 of the 85 chiropractors in Israel, explained that Israel illustrates the growing international difficulties with laws that limit right to practice to "graduates of CCE-accredited colleges." Several chiropractors in Israel are graduates of the South African schools, which are accredited by the government but have no existing chiropractic accreditation agency. A similar situation arises for schools in Asia (Japan) and Latin America (Brazil and Mexico). There is an argument for saying "CCE or equivalent" in future legislation, giving licensing authorities the discretion to recognize graduates from schools such as those in South Africa - of international standard, but without an available CCE.
Italy: Dr. John Williams, president of the Association of Italian Chiropractors (AIC), was only one of leaders from several countries (others included Australia, Singapore and the United Kingdom) who reported that efforts to advance the profession being undermined by those few but visible chiropractors who promote prepackaged, high-volume unethical care.
Japan: The Japanese Association of Chiropractors (JAC), which represents 263 of the 414 duly-qualified chiropractors in Japan, announced at the WFC Assembly that it plans to combat the problem of many unqualified individuals practicing as chiropractors (there is no law regulating practice in Japan) by establishing a JAC Registration Board. This will provide two levels of examination: the first for recognition as a chiropractor, the second for recognition as a chiropractic technician. This is seen as the best possible way to protect the profession's standards and identity during the next decade or more, until government recognition is finally achieved.
New Zealand: New NZCA President Dr. Steve Morse reported solid growth (New Zealand now has approximately 225 chiropractors for a population of four million), new licensing legislation (the Health Practitioners' Competency Act) and NZCA positioning of chiropractors as "the leading profession in spinal health care."
Norway: In a two-year trial project (2002-2003), there was direct government funding for chiropractic services, including diagnostic imaging, together with rights to refer patients directly to medical specialists and PTs, and to authorize sick leave for patients for up to eight weeks. Evaluation showed impressive results in terms of finance and quality of care. Only 3% of DC patients with back pain had sick leave, versus 75% of MD patients, and 90% of patients preferred chiropractic care over medical or other care for musculoskeletal problems. As a result, the government announced in May 2005 that the above rights would be continued on a permanent basis.
The Norwegian Parliament has also voted in favor of the commencement of a government-funded, university-based chiropractic school in Norway. Reporting on these achievements at the WFC Assembly, NCA President Dr. ¯ystein Ogre highlighted these key factors in the rapid advancement of chiropractic in Norway, where the profession was only first regulated in 1988.
In terms of unity in the country, almost 100% of Norway's 340 chiropractors belong to the national association, which has an attitude welcoming integration into the mainstream health care system (the NCA has an active policy of outreach to other health care professions, and the head researcher at the Norwegian National Back Pain Association is a chiropractor); avoidance of practice management schemes; avoidance of "a religious approach"; and setting high membership dues so that there are resources available for the work that has to be done.
Peru: Dr. Jason Gilbert reported to the WFC Assembly that only three of the 20 chiropractors in practice are Peruvian nationals, and that the country has many pseudo-chiropractors. However, in a recent victory for the Peruvian Chiropractors' Association (APQ), a major health plan has provided benefits for chiropractic treatment as long as services are provided by an APQ member.
Portugal: Portugal has recently doubled its number of chiropractors to 30, but there are hundreds of pseudo-chiropractors. In August 2003, the government passed law to provide for the recognition of six "alternative medical professions" and a Regulatory Commission is currently working on the full legislative framework. Dr. Antonio Alves, president of the Chiropractic Association of Portugal, represents the profession on that commission. One problem, however, is that chiropractic is at a significantly higher educational and professional level than other disciplines such as osteopathy and naturopathy, which are absorbing all practitioners and adopting much lower standards. The WFC and the ECU are assisting the association in its government relations, and it is hoped that the next WFC Congress - to be held at Vilamoura in The Algarve, Portugal, May 15-19, 2007 - will help to promote full recognition of the profession in Portugal by that time.
Singapore: Dr. Janet Ruth Sosna, association president, reports a recent doubling of chiropractors and members to 18, and much advancement for the profession. However, a large new problem has come with the arrival of two new chiropractors who are quickly damaging the reputation of the profession - they have not joined the association, have poor ethics, and promote large prepayment treatment packages.
South Africa: The Chiropractors' Association of South Africa (CASA) reports that the two government-funded, university-based education programs are progressing strongly. They are at the University of Johannesburg and the Durban Institute of Technology, and both have a model of five years of full-time undergraduate education, followed by a one-year associateship before eligibility for independent registration and practice.
South Korea: Korean Chiropractic Association President, Dr. Taegsu Choi (Life College, 1998), reports that there are approximately 150 duly-qualified chiropractors in Korea, with 120 being KCA members. Independent chiropractic practice is illegal, with the ever-present threat of prosecution and imprisonment. However, a recent appeal court decision has recommended that the government pass a law to resolve the current situation. The effort to establish chiropractic education at Hanseo University has had limited success, partly because of the university's location some three hours from Seoul, and the KCA is currently investigating a proposal to start a second college at a university in Seoul. A difficulty in Korea is that many MDs and Oriental MDs have taken limited courses in chiropractic, claim to offer chiropractic services, and have a major lobby against duly-qualified chiropractors.
United Kingdom: Dr. Barry Lewis, president of the British Chiropractic Association, reports that the BCA currently has 1,140 members plus 600 student members. There are now 2,200 registered chiropractors in the U.K. (England, Scotland, Wales and Northern Ireland). A practice-based study of the safety of chiropractic neck manipulation, involving 420 BCA members and just completed, has data on approximately 70,000 consecutive neck manipulations without a single serious incident of harm. Lead researcher Dr. Haymo Thiel is currently preparing the paper.
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