(No subject)

[Guest guest]

OR DCs,

FYI…sent to the OBCE.

A. Simpson, DC

A. Simpson, DC,

DABCO

3990

SW Lafollett Road

Cornelius,

OR 97113

March 13, 2006

Oregon

Board of Chiropractic Examiners

3218

Pringle Road SE, Suite 150

Salem,

Oregon 97302-6311

RE: Public Hearing on the Clinical Justification

Rule

Ladies and Gentlemen of the Board;

I wish to express my continued support for the current Clinical

Justification Rule. The basic intent of the rule in my view is to tie the

justification of chiropractic practice to the evidence. “Evidence”

means the whole body of professional knowledge. This includes the spectrum of

evidence from the highest standard of randomized controlled clinical trials

(RCT-the so-called “gold standard” of evidence) to

“lesser” forms of evidence like case reports, basic science that

provide a “biological rationale” for clinical practice and

professional consensus for those things that may lack more formal

“proof” published in peer reviewed and referenced journals. This

last critical piece about consensus seems to have been lost by many who oppose

the rule.

What makes a profession a profession

and not just a trade group, is a collective set of values and performance

expectations. As a health care professions regulatory agency, your job is a

tough one. For one thing, a layman cannot effectively evaluate the quality of

chiropractic practice and more importantly, there is a significant negative

impact to the general public from incompetent practice.

Both of these of these features of professionalism demand the highest

levels of integrity. The public rightfully expects that its health care

providers render care that is safe and effective. As health care

professionals, we must be willing to accept that responsibility. And as the

regulatory agency, I would expect that the Board reflects the highest levels of

professionalism and operate by the light of the best evidence available. Board

policy must be informed not by the prejudices of the board members, but by the

best evidence.

Abandoning the Clinical Justification Rule, particularly language that

is related to “evidence based” practice sends the wrong signal to

those in whose stead you act, the public.

Sincerely,

A. Simpson, DC, DABCO

Via Fax 03.13.06