One thing to mention is that over 100 delegates from national associations in 36 countries met in this long consultation and identity process which included several surveys of the profession. We knew as an organization that the identity of the profession lacked clarity and we wanted to find consensus on some core concepts for an international identity of the profession, something the public could relate to. So after a two-year process, the identity of the profession as “the spinal health care experts in the health care system” was agreed to, along with a series of other statements that went into further detail about the identity of the profession.

Is there a need to harmonize not only the identity of chiropractic, but its legal definition and scope of practice, across national boundaries? Or, for that matter, across state boundaries within the United States?

That’s an important question. It’s an issue that we have to grapple with as a profession, both internationally and within the United States. We have 50 different states, and pretty much 50 different state laws. And the profession, sometime soon, will have to mature to a point where we have to come to a uniform agreement as to what is the practice and scope of chiropractic. That won’t be an easy process, but I believe that the Federation of Chiropractic Licensing Boards, the Congress of Chiropractic State Associations, our colleges and national associations will have to take that on at some point in the near future.

Internationally, the profession is growing in leaps and bounds and facing similar issues. Chiropractic colleges will be springing up all over the globe …

There are now more chiropractic colleges outside North America than inside North America.

Many more. Just recently, David Chapman-Smith, the Secretary-General of the WFC, was in Jordan with our previous president Dr. Stathis Papadopoulos of Cyprus. One of the leading medical universities in Jordan is very serious about beginning a chiropractic program, as are other universities in different countries that are saying, “We want a chiropractic department.” As you are aware, Kuala Lumpur, Malaysia, just began its first class a couple of months ago, at the International Medical University. They have nursing, dentistry and medicine, and now they have a chiropractic class as well. Almost all of the new chiropractic programs will be tied into established universities. 

The Council on Chiropractic Education now has an international branch, CCE-I. The National Board of Chiropractic Examiners also has an international branch, IBCE. So we are seeing great efforts to harmonize the standards of the profession, universally. They’re doing a good job with it. They are ahead of the curve, understand the issues and are making great progress. I am very proud of the work going on at those international agencies, which are offshoots of agencies began in the United States.

Internationally, where does the chiropractic profession stand today regarding the inclusion or exclusion of drugs and surgery?

I don’t think surgery comes into the equation. But there seems to be a growing interest in the use of pharmaceuticals. Surveys in North America and in Europe show a minority of DCs interested in some prescription rights. Denmark and Switzerland have prescription rights, and there may be others. So there are pockets of this precedent internationally.  The WFC has a clear policy that was passed by the Assembly in 2003, that states the practice of chiropractic does not include the use of prescription drugs. I don’t see any attempts to change that anytime soon, but I do believe that it’s an issue that in the future, our profession, internationally and in the United States, will have to have a conversation about.

Where does the chiropractic profession stand today internationally with regard to primary contact or primary care status?

Everywhere that chiropractic is practiced and regulated, there is primary contact status, and we should not settle for anything less. A good example is that several months ago, Israel finally received regulation and licensure from the government. Over a period of 15 years before this, they were offered regulation, but with the caveat that they couldn’t diagnose. They walked away from that table, unwilling to accept a substandard regulatory act. They held the high ground and were rewarded years later.

If they weren’t allowed to diagnose, would that mean that chiropractors could only see patients after a medical physician had diagnosed the patient?

Yes, this would create a technician/therapist status rather than a doctor-level status. We can’t allow unacceptable legislation anywhere in the world. The WFC stands strongly for a consistent level of legislation internationally, one that includes diagnostic rights, and that values our skills, training and education.