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This is how the world looks without a state having an Uncle Vern to represent patient needsand choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model. Sears, DC, IAYT1218 NW 21st AvePortland, Oregon 97209v: 503-225-0255f: 503-525-6902www.docbones.comOn Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote: http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534 I don’t think this logic would fly here in Oregon. : ‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’ s. fuchs dc

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Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Anyway to get the Chiropractor for a Day program back at the capital with Governor Kitzhaber at the helm? I think it's important that legislators Discover Chiropractic one on one. I treated a high ranking decision maker for SAIF. For 18 years she has been making "calls" on Chiropractic care. Her response after the treatment was "Oh... that is what a Chiropractic adjustment is like" Alan , D.C743 Lawrence StEugene, OR 97401-2501 sharronf@...; dm.bones@...CC: From: vsaboe@...Date: Sat, 17 Dec 2011 10:31:54 -0800Subject: Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Yes, the OCA has been working on this for some time and the reality is we just need one more key legislative person to be gone from his current post and then we can go forward with our proposal…..Vern From: [mailto: ] On Behalf Of Alan Sent: Saturday, December 17, 2011 11:40 AMSubject: RE: TBCE Scope of Practice Workshop Report Anyway to get the Chiropractor for a Day program back at the capital with Governor Kitzhaber at the helm? I think it's important that legislators Discover Chiropractic one on one. I treated a high ranking decision maker for SAIF. For 18 years she has been making " calls " on Chiropractic care. Her response after the treatment was " Oh... that is what a Chiropractic adjustment is like " Alan , D.C743 Lawrence StEugene, OR 97401-2501 sharronf@...; dm.bones@...CC: From: vsaboe@...Date: Sat, 17 Dec 2011 10:31:54 -0800Subject: Re: TBCE Scope of Practice Workshop Report Thanks for the kind words ,Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas. The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of " Doctor of Chiropractic. " Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine. Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily! The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the " line in the sand " if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on " Oregon Medical Association " make our day!!!!!!!! Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!! Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528. The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER! TO THE CONTINUED GOOD FIGHT! Vern Saboe.....541-231-4528 PS: See what you went and did ! Re: TBCE Scope of Practice Workshop Report This is how the world looks without a state having an Uncle Vern to represent patient needs and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model. Sears, DC, IAYT1218 NW 21st AvePortland, Oregon 97209v: 503-225-0255f: 503-525-6902www.docbones.com On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote: http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534I don’t think this logic would fly here in Oregon. :‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's " intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment. " The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. " I don't want to argue about when does a dysfunction become a disease. " Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’s. fuchs dc

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The Oregon Medical Board is also trying to ‘regulate’ our profession:

http://egov.oregon.gov/PTBrd/docs/Current.Topics/OMB.Position.Letter.12.11.pdf

s. fuchs dc

From: Vern Saboe

[mailto:vsaboe@...]

Sent: Saturday, December 17, 2011

10:32 AM

Sharron Fuchs; Sears

Cc:

Subject: Re: TBCE

Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is

all over this issue and as your ACA Delegate and member of the ACA's Insurance

Commission we have been discussing this for sometime and now with a sense of

urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education.

Education as per the substantial education doctors of chiropractic receive in

their four year training leading to our degree of " Doctor of

Chiropractic. " Education...as in educating each and every Oregon

Legislative Member as well as the state's other key policy makers both

within Oregon's

governmental agencies and within the private sector. How? ..and What? By giving

them the significant core curriculum at UWS vs OHSU which the OCA has

already put together which by the way (drum roll please) is 1,100

clock hours longer that the 4-year medical degree program at OHSU!

We are also putting together a summary of the substantial post-doctorate

diplomate programs leading to Board Certification status within the

profession as well as the various new (we won't say they are new) advance

degree programs such as the UWS new Masters of Science in Nutrition and

Functional Medicine.

Education to the subsequent clinical skill sets chiropractic

physician posses relative to the above education not the least of which

includes our ability to provide correlative and differential diagnoses and

as such have the clinical ability to act as portal of entry

physicians. As first contact, portal of entry physician types we

have the critical clinical capacity to interpret X-ray and lab findings,

conduct comprehensive physical examinations, conduct and/or order and interpret

ancillary diagnostic studies such as CT, MRIs, nerve conduction studies,

nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical

impression. In short the OCA is educating the key policy

makers that because of these skill sets we have the expert ability to

recognize pathophysiological conditions that may masquerade as simple

musculoskeletal complaints such as low back pain and that which may

require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here

being another example of how the OCA is looking out for

you, will also educate our enemies who would darn attempt to influence or

restrict our scope of practice here in the great state of Oregon

with miss-information or miss-represent to legislators as per our

significant training, clinical skills, and wonderful services (with high

consumer satisfaction, improved safety, and reduce per capita costs....oh did I

mention....you can bet I will to our enemies, that this just happens to be

the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the " line in

the sand " if you darn to cross that line and come to the microphone and

lie to our elected officials in public testimony the OCA will make you

PAY AND MAKE YOUR PAY DEARLY! So bring it on " Oregon

Medical Association " make our day!!!!!!!!

Well that's what your trade organization is doing to protect

our scope of practive and as such help all colleagues by our actions

what are you doing to help doctor? We need your financial help, we need

your input, your ideas, we need your support, we need you to finally

become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes

today you can leave a message for staff to get you signed up ASAP....you can do

so for only $66/month! Or go to the OCA webpage and sign up as a member

its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW!

If you need help, if you have any questions, if you have any ideas call me any

time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has

ever been we are over 500 doctors strong help make us stronger, add your

shoulder to that great stone wheel so many colleagues have been pushing up that

mountain for so very long we are nearing the top which leads to that level

playing field for us all and cultural authority for the profession and we are

going to arrive TOGETHER!

TO THE CONTINUED GOOD

FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did

!

Re: [From

OregonDCs] TBCE Scope of Practice Workshop Report

This is

how the world looks without a state having an Uncle Vern to represent patient

needs

and choices. This is how a state looks where the Guv hasn't had

an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians.

But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist.

What's needed is a

united chiropractic profession that keeps patient well-being as the

prize. Oregon

is such a model.

Sears, DC,

IAYT

1218 NW 21st Ave

Portland,

Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I

don’t think this logic would fly here in Oregon. :

‘Board

members and attendees shared their perspectives. One of the key concepts

stated by TBCE board members related to diagnosis. It was stated by a board

member that the doctor's " intention, as

reflected by documentation, is what determines if treatment is in or out of

scope [of practice]. Diagnosis is reflective of your intention for

treatment. " The board member reflected that if you are

treating an organ you are outside your scope. If you are treating a disease you

are outside scope. " I don't want to

argue about when does a dysfunction become a disease. "

Thus, while it is possible for a patient to have a myriad of

conditions/diseases, it is the viewpoint of

members of the TBCE that the diagnosis is that for which you intend to render

treatment. As the treatment protocols and scope of the chiropractic

profession are limited by legal statute, it is important that doctors of

chiropractic note that their diagnosis should be limited to that for which they

intend to render treatment. It is also important to note that current

members of the TBCE feel that treating an organ or treating a disease is

outside of scope. The committee discussed various types of

diagnosis--definitive, provisional, working, differential, and others--and is

working towards defining the diagnosis types used within the chiropractic

profession.’

s.

fuchs dc

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At the risk of making myself a pariah, the truth is, we don't really have any business invading the territory of other practitioners than they do of invading ours. We have such a wealth of ability with our hands and the instruments we use. While I wouldn't begrudge any person using dry needling but we can't be surprise. We have an excellent scope of practice ..... why endanger it with forays into others territories? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: JBrimhall@...From: sharronf@...Date: Tue, 20 Dec 2011 11:52:28 -0800Subject: FW: TBCE Scope of Practice Workshop Report

Dear Colleagues, Friends,

The PDF below has made it around the

country and back to me which is great. I wish to call to your attention a

related issue that I have been dealing with with the Oregon Naturopathic board.

All of this is public so I do not feel that I am not breaching any

confidentiality.

The Naturopathic school in Portland does not teach

dry needling. Given that dry needling is not taught in the Naturopathic school

I asked the Oregon Board of Naturopathic Examiners (OBNE) how many hours of

post graduate training they required before a Naturopath could practice it. (Remember

I posted a PDF a while back from the OBNE that stated 2 hours of training was

required for trigger point injection.) The OBNE refused to answer my question

directly only saying that dry needling was in their scope of practice and if I had

a complaint about a Naturopath to file one. I then proved to them that it was

not taught in the school and again asked them, given that fact, how many hours

were required in order to practice Dry Needling. Same reply, ‘file a

complaint’.

Finally, as I continued to question them,

the matter was to come before their board in early December. After the board

meeting I asked for their decision on hours required. I was told they were now

considering things with their lawyer. I replied telling them that there were a

number of NDs right now practicing Dry Needling and to leave them in the lurch

without the board stating affirmatively that Dry Needling was in their scope of

practice and that a certain numbers of hours of training was sufficient for

training was to leave NDs in potential jeopardy with health insurers and with

malpractice insurers.

Guess what? No reply. No public document

posted on their website. No formal notice to practicing NDs about any ‘legal’

issues. Nothing. Silence.

I am surprised yet I am not surprised. Are

we doing something wrong?.... If you only knew the merry go round that it took

to get our board to understand and rule on Dry Needling and then to wrestle

over the number of hours required for training your head would split open. Yet

here is a board who rules by just stating it is in our scope and nothing more,

even when asked directly.

I imagine the PDF below made it into their

hands as it is addressed to ‘Executive Director, Health Regulatory Board’.

The OBNE is a ‘Health Regulatory Board’. Assuming they now have the

letter, and my continued communications with them which have been after the

date of the letter, December 7th, 2011, you would think they would

make some sort of statement to their profession. But no.

Back to my question: ‘ Are we doing

something wrong?’ :

My answer – Yes.

My remedy – Review all of our laws

and move to expand our scope of practice to the full extent of our laws so we

can practice state of the art care. This includes OB

and minor surgery. Then when asked in the future about our scope, take the same

position as the OBNE of blind neglect, and go forth. And never, never look

back.

s.fuchs dc

In a message dated 12/19/2011 10:53:55

A.M. Pacific Standard Time, sharronf@...

writes:

The Oregon

Medical Board is also trying to ‘regulate’ our profession:

http://egov.oregon.gov/PTBrd/docs/Current.Topics/OMB.Position.Letter.12.11.pdf

s.

fuchs dc

From: Vern

Saboe [mailto:vsaboe@...]

Sent: Saturday, December 17, 2011

10:32 AM

Sharron Fuchs; Sears

Cc:

Subject: Re: TBCE

Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is

all over this issue and as your ACA Delegate and member of the ACA's Insurance

Commission we have been discussing this for sometime and now with a sense of

urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education.

Education as per the substantial education doctors of chiropractic receive in

their four year training leading to our degree of "Doctor of

Chiropractic." Education...as in educating each and every Oregon

Legislative Member as well as the state's other key policy makers both within Oregon's

governmental agencies and within the private sector. How? ..and What? By giving

them the significant core curriculum at UWS vs OHSU which the OCA has

already put together which by the way (drum roll please) is 1,100

clock hours longer that the 4-year medical degree program at OHSU!

We are also putting together a summary of the substantial post-doctorate

diplomate programs leading to Board Certification status within the

profession as well as the various new (we won't say they are new) advance

degree programs such as the UWS new Masters of Science in Nutrition and

Functional Medicine.

Education to the subsequent clinical skill sets

chiropractic physician posses relative to the above education not the

least of which includes our ability to provide correlative and

differential diagnoses and as such have the clinical ability to act as

portal of entry physicians. As first contact, portal of entry

physician types we have the critical clinical capacity to interpret X-ray

and lab findings, conduct comprehensive physical examinations, conduct and/or

order and interpret ancillary diagnostic studies such as CT, MRIs, nerve

conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and

arrive at a clinical impression. In short the OCA is educating the

key policy makers that because of these skill sets we have the expert

ability to recognize pathophysiological conditions that may masquerade as

simple musculoskeletal complaints such as low back pain and that which may

require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here

being another example of how the OCA is looking out for

you, will also educate our enemies who would darn attempt to influence or

restrict our scope of practice here in the great state of Oregon

with miss-information or miss-represent to legislators as per our

significant training, clinical skills, and wonderful services (with high

consumer satisfaction, improved safety, and reduce per capita costs....oh did I

mention....you can bet I will to our enemies, that this just happens to be

the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that

here is the "line in the sand" if you darn to cross that line and

come to the microphone and lie to our elected officials in public testimony the

OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring

it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to

protect our scope of practive and as such help all colleagues by our

actions what are you doing to help doctor? We need your financial help,

we need your input, your ideas, we need your support, we need you

to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes

today you can leave a message for staff to get you signed up ASAP....you can do

so for only $66/month! Or go to the OCA webpage and sign up as a member

its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW!

If you need help, if you have any questions, if you have any ideas call me any

time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has

ever been we are over 500 doctors strong help make us stronger, add your

shoulder to that great stone wheel so many colleagues have been pushing up that

mountain for so very long we are nearing the top which leads to that level

playing field for us all and cultural authority for the profession and we are

going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did

!

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern

to represent patient needs

and choices. This is how a state looks where the Guv hasn't

had an Uncle Vern to show them

chiropractors are an excellent source of primary

care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a

super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as

the prize. Oregon

is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon

97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon.

:

‘Board members and attendees shared their

perspectives. One of the key concepts stated by TBCE board members

related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what

determines if treatment is in or out of scope [of practice]. Diagnosis is

reflective of your intention for treatment." The board

member reflected that if you are treating an organ you are outside your scope.

If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become

a disease."

Thus, while it is possible for a patient to have a myriad of

conditions/diseases, it is the viewpoint of

members of the TBCE that the diagnosis is that for which you intend to render

treatment. As the treatment protocols and scope of the chiropractic

profession are limited by legal statute, it is important that doctors of

chiropractic note that their diagnosis should be limited to that for which they

intend to render treatment. It is also important to note that current

members of the TBCE feel that treating an organ or treating a disease is

outside of scope. The committee discussed various types of

diagnosis--definitive, provisional, working, differential, and others--and is

working towards defining the diagnosis types used within the chiropractic

profession.’

s. fuchs dc

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Share on other sites

Dry Needling is a physical therapy modality it is not acupuncture. The needle is only a tool.s. fuchs dcSent from my iPhoneOn Dec 20, 2011, at 1:47 PM, "Sunny Kierstyn" <skrndc1@...> wrote:At the risk of making myself a pariah, the truth is, we don't really have any business invading the territory of other practitioners than they do of invading ours. We have such a wealth of ability with our hands and the instruments we use. While I wouldn't begrudge any person using dry needling but we can't be surprise. We have an excellent scope of practice ..... why endanger it with forays into others territories? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: JBrimhall@...From: sharronf@...Date: Tue, 20 Dec 2011 11:52:28 -0800Subject: FW: TBCE Scope of Practice Workshop Report Dear Colleagues, Friends, The PDF below has made it around thecountry and back to me which is great. I wish to call to your attention arelated issue that I have been dealing with with the Oregon Naturopathic board.All of this is public so I do not feel that I am not breaching anyconfidentiality. The Naturopathic school in Portland does not teachdry needling. Given that dry needling is not taught in the Naturopathic schoolI asked the Oregon Board of Naturopathic Examiners (OBNE) how many hours ofpost graduate training they required before a Naturopath could practice it. (RememberI posted a PDF a while back from the OBNE that stated 2 hours of training wasrequired for trigger point injection.) The OBNE refused to answer my questiondirectly only saying that dry needling was in their scope of practice and if I hada complaint about a Naturopath to file one. I then proved to them that it wasnot taught in the school and again asked them, given that fact, how many hourswere required in order to practice Dry Needling. Same reply, ‘file acomplaint’. Finally, as I continued to question them,the matter was to come before their board in early December. After the boardmeeting I asked for their decision on hours required. I was told they were nowconsidering things with their lawyer. I replied telling them that there were anumber of NDs right now practicing Dry Needling and to leave them in the lurchwithout the board stating affirmatively that Dry Needling was in their scope ofpractice and that a certain numbers of hours of training was sufficient fortraining was to leave NDs in potential jeopardy with health insurers and withmalpractice insurers. Guess what? No reply. No public documentposted on their website. No formal notice to practicing NDs about any ‘legal’issues. Nothing. Silence. I am surprised yet I am not surprised. Arewe doing something wrong?.... If you only knew the merry go round that it tookto get our board to understand and rule on Dry Needling and then to wrestleover the number of hours required for training your head would split open. Yethere is a board who rules by just stating it is in our scope and nothing more,even when asked directly. I imagine the PDF below made it into theirhands as it is addressed to ‘Executive Director, Health Regulatory Board’.The OBNE is a ‘Health Regulatory Board’. Assuming they now have theletter, and my continued communications with them which have been after thedate of the letter, December 7th, 2011, you would think they wouldmake some sort of statement to their profession. But no. Back to my question: ‘ Are we doingsomething wrong?’ : My answer – Yes. My remedy – Review all of our lawsand move to expand our scope of practice to the full extent of our laws so wecan practice state of the art care. This includes OBand minor surgery. Then when asked in the future about our scope, take the sameposition as the OBNE of blind neglect, and go forth. And never, never lookback. s.fuchs dc In a message dated 12/19/2011 10:53:55A.M. Pacific Standard Time, sharronf@...writes: The OregonMedical Board is also trying to ‘regulate’ our profession:http://egov.oregon.gov/PTBrd/docs/Current.Topics/OMB.Position.Letter.12.11.pdfs.fuchs dcFrom: VernSaboe [mailto:vsaboe@...] Sent: Saturday, December 17, 201110:32 AMSharron Fuchs; SearsCc: Subject: Re: TBCEScope of Practice Workshop ReportThanks for the kind words ,Yes, colleagues the Oregon Chiropractic Association isall over this issue and as your ACA Delegate and member of the ACA's InsuranceCommission we have been discussing this for sometime and now with a sense ofurgency following the unanticipated defeat in Texas.The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive intheir four year training leading to our degree of "Doctor ofChiropractic." Education...as in educating each and every OregonLegislative Member as well as the state's other key policy makers both within Oregon'sgovernmental agencies and within the private sector. How? ..and What? By givingthem the significant core curriculum at UWS vs OHSU which the OCA hasalready put together which by the way (drum roll please) is 1,100clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctoratediplomate programs leading to Board Certification status within theprofession as well as the various new (we won't say they are new) advancedegree programs such as the UWS new Masters of Science in Nutrition andFunctional Medicine.Education to the subsequent clinical skill setschiropractic physician posses relative to the above education not theleast of which includes our ability to provide correlative anddifferential diagnoses and as such have the clinical ability to act asportal of entry physicians. As first contact, portal of entryphysician types we have the critical clinical capacity to interpret X-rayand lab findings, conduct comprehensive physical examinations, conduct and/ororder and interpret ancillary diagnostic studies such as CT, MRIs, nerveconduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., andarrive at a clinical impression. In short the OCA is educating thekey policy makers that because of these skill sets we have the expertability to recognize pathophysiological conditions that may masquerade assimple musculoskeletal complaints such as low back pain and that which mayrequire immediate or timely attention/referral and we do that daily!The Oregon Chiropractic Association which again herebeing another example of how the OCA is looking out foryou, will also educate our enemies who would darn attempt to influence orrestrict our scope of practice here in the great state of Oregonwith miss-information or miss-represent to legislators as per oursignificant training, clinical skills, and wonderful services (with highconsumer satisfaction, improved safety, and reduce per capita costs....oh did Imention....you can bet I will to our enemies, that this just happens to bethe Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) thathere is the "line in the sand" if you darn to cross that line andcome to the microphone and lie to our elected officials in public testimony theOCA will make you PAY AND MAKE YOUR PAY DEARLY! So bringit on "Oregon Medical Association" make our day!!!!!!!!Well that's what your trade organization is doing toprotect our scope of practive and as such help all colleagues by ouractions what are you doing to help doctor? We need your financial help,we need your input, your ideas, we need your support, we need youto finally become a member of the OCA and WE NEED IT NOW!!!Please call the OCA office at 503-256-1601 call today yestoday you can leave a message for staff to get you signed up ASAP....you can doso for only $66/month! Or go to the OCA webpage and sign up as a memberits easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me anytime on my cell 541-231-4528.The Oregon Chiropractic Association is the strongest it hasever been we are over 500 doctors strong help make us stronger, add yourshoulder to that great stone wheel so many colleagues have been pushing up thatmountain for so very long we are nearing the top which leads to that levelplaying field for us all and cultural authority for the profession and we aregoing to arrive TOGETHER!TO THE CONTINUED GOOD FIGHT!Vern Saboe.....541-231-4528 PS: See what you went and did ! Re: TBCE Scope of Practice Workshop Report This is how the world looks without a state having an Uncle Vernto represent patient needs and choices. This is how a state looks where the Guv hasn'thad an Uncle Vern to show them chiropractors are an excellent source of primarycare physicians. But Rick is no Kitzhaber,so more is needed to avoid this kind of turf war than asuper-lobbyist. What's needed is a united chiropractic profession that keeps patient well-being asthe prize. Oregonis such a model. Sears, DC, IAYT1218 NW 21st AvePortland, Oregon97209v: 503-225-0255f: 503-525-6902www.docbones.comOn Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote: http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534I don’t think this logic would fly here in Oregon.:‘Board members and attendees shared theirperspectives. One of the key concepts stated by TBCE board membersrelated to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is whatdetermines if treatment is in or out of scope [of practice]. Diagnosis isreflective of your intention for treatment." The boardmember reflected that if you are treating an organ you are outside your scope.If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction becomea disease." Thus, while it is possible for a patient to have a myriad ofconditions/diseases, it is the viewpoint ofmembers of the TBCE that the diagnosis is that for which you intend to rendertreatment. As the treatment protocols and scope of the chiropracticprofession are limited by legal statute, it is important that doctors ofchiropractic note that their diagnosis should be limited to that for which theyintend to render treatment. It is also important to note that currentmembers of the TBCE feel that treating an organ or treating a disease isoutside of scope. The committee discussed various types ofdiagnosis--definitive, provisional, working, differential, and others--and isworking towards defining the diagnosis types used within the chiropracticprofession.’s. fuchs dc

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Sunny,

Please don't take this as critisism of your quesiton. I mean this only as my opinion of why our profesison should continue to morph.

Our profession, as welll as all other medical professions are in constant flux. Change is a 'normal' occurance in nature, of which we are a part. Currently, the following professions can use skeletal manipulation as a healing form:

1. MD

2. DO

3. ND

4 Acupuncturists

5 PT

and of course us - DCs.

As DCs, our education is constantly evolving. However, even if we back track 15 years, we still had the education to palpate trigger points, anatomical palpation to a degree that we can identify what's beneath our hands. In order to do Dry Needling, one needs that basic knowledge. The placing of a needle, in Oregon licensed DCs is required for blood draws. I would counter that placing a needle to withdraw blood is a similar skill set to dry needling. It's not a stretch to add this to our scope. It's well within our training. And I would argue that we actually have more training in areas needed to do this than some of the other professions currently practicing it legally.

Beyond that argument, I think it's short-sighted to think that we can remain static in an ever changing environment. Yes, we have a great arsenal to do what we've always done. However, if we all look at national and world trends in health care, our current skill set is being taken by many other professions. I don't have a problem with that as long as there's training to allow it. I say , "What's best for the public?" However, I want my profession to continue to grow with the rest of the medical care fields. To be sustainable. To thrive. To do this, I think we need to evolv and change. If that means increasing our scope in areas that are already well within our educational standards, it's a natural progression.

IMHO

Minga Guerrero DC

abowoman@...

Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease."

Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Hi MInga, Your point is well taken ..... and I don't really disagree with it. It just seems that so many (of us) ignore what is at our fingertips for a machine or tool .... would like to see more development of hands .... but that seems to require getting past a fear of touch. That ol' Puritan ethic still seems, too often, to get in our way. SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com skrndc1@...; sharronf@...; Subject: Re: TBCE Scope of Practice Workshop ReportFrom: abowoman@...CC: jbrimhall@...Date: Tue, 20 Dec 2011 17:37:18 -0500

Sunny,

Please don't take this as critisism of your quesiton. I mean this only as my opinion of why our profesison should continue to morph.

Our profession, as welll as all other medical professions are in constant flux. Change is a 'normal' occurance in nature, of which we are a part. Currently, the following professions can use skeletal manipulation as a healing form:

1. MD

2. DO

3. ND

4 Acupuncturists

5 PT

and of course us - DCs.

As DCs, our education is constantly evolving. However, even if we back track 15 years, we still had the education to palpate trigger points, anatomical palpation to a degree that we can identify what's beneath our hands. In order to do Dry Needling, one needs that basic knowledge. The placing of a needle, in Oregon licensed DCs is required for blood draws. I would counter that placing a needle to withdraw blood is a similar skill set to dry needling. It's not a stretch to add this to our scope. It's well within our training. And I would argue that we actually have more training in areas needed to do this than some of the other professions currently practicing it legally.

Beyond that argument, I think it's short-sighted to think that we can remain static in an ever changing environment. Yes, we have a great arsenal to do what we've always done. However, if we all look at national and world trends in health care, our current skill set is being taken by many other professions. I don't have a problem with that as long as there's training to allow it. I say , "What's best for the public?" However, I want my profession to continue to grow with the rest of the medical care fields. To be sustainable. To thrive. To do this, I think we need to evolv and change. If that means increasing our scope in areas that are already well within our educational standards, it's a natural progression.

IMHO

Minga Guerrero DC

abowoman@...

Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease."

Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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I'll chime in on this. I totally agree with your position, Minga. As a DC who manually adjusts a lot, but also uses instrument assessment and adjusting (PulstarFRAS) and Instrument assisted soft tissue mobilization (SASTM) I am totally on-board with adding another tool to the box. No one size fits all. But underlying it all is palpation skills, and that is where DC's (should) excel! Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724abowoman@...; sharronf@...; CC: jbrimhall@...From: skrndc1@...Date: Tue, 20 Dec 2011 14:52:46 -0800Subject: RE: TBCE Scope of Practice Workshop Report

Hi MInga, Your point is well taken ..... and I don't really disagree with it. It just seems that so many (of us) ignore what is at our fingertips for a machine or tool .... would like to see more development of hands .... but that seems to require getting past a fear of touch. That ol' Puritan ethic still seems, too often, to get in our way. SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com skrndc1@...; sharronf@...; Subject: Re: TBCE Scope of Practice Workshop ReportFrom: abowoman@...CC: jbrimhall@...Date: Tue, 20 Dec 2011 17:37:18 -0500

Sunny,

Please don't take this as critisism of your quesiton. I mean this only as my opinion of why our profesison should continue to morph.

Our profession, as welll as all other medical professions are in constant flux. Change is a 'normal' occurance in nature, of which we are a part. Currently, the following professions can use skeletal manipulation as a healing form:

1. MD

2. DO

3. ND

4 Acupuncturists

5 PT

and of course us - DCs.

As DCs, our education is constantly evolving. However, even if we back track 15 years, we still had the education to palpate trigger points, anatomical palpation to a degree that we can identify what's beneath our hands. In order to do Dry Needling, one needs that basic knowledge. The placing of a needle, in Oregon licensed DCs is required for blood draws. I would counter that placing a needle to withdraw blood is a similar skill set to dry needling. It's not a stretch to add this to our scope. It's well within our training. And I would argue that we actually have more training in areas needed to do this than some of the other professions currently practicing it legally.

Beyond that argument, I think it's short-sighted to think that we can remain static in an ever changing environment. Yes, we have a great arsenal to do what we've always done. However, if we all look at national and world trends in health care, our current skill set is being taken by many other professions. I don't have a problem with that as long as there's training to allow it. I say , "What's best for the public?" However, I want my profession to continue to grow with the rest of the medical care fields. To be sustainable. To thrive. To do this, I think we need to evolv and change. If that means increasing our scope in areas that are already well within our educational standards, it's a natural progression.

IMHO

Minga Guerrero DC

abowoman@...

Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease."

Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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No disrespect to Dr. Kierstyn, but I agree wholeheartedly with Dr. Guerrero.

Bill Hartje, DC, MS

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent

patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern

to show them

chiropractors are an excellent source of primary care physicians. But Rick

is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's

needed is a

united chiropractic profession that keeps patient well-being as the prize.

Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland , Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_Ne\

ws/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key

concepts stated by TBCE board members related to diagnosis. It was stated by a

board member that the doctor's " intention, as reflected by documentation, is

what determines if treatment is in or out of scope [of practice]. Diagnosis is

reflective of your intention for treatment. " The board member reflected that if

you are treating an organ you are outside your scope. If you are treating a

disease you are outside scope. " I don't want to argue about when does a

dysfunction become a disease. "

Thus, while it is possible for a patient to have a myriad of

conditions/diseases, it is the viewpoint of members of the TBCE that the

diagnosis is that for which you intend to render treatment. As the treatment

protocols and scope of the chiropractic profession are limited by legal statute,

it is important that doctors of chiropractic note that their diagnosis should be

limited to that for which they intend to render treatment. It is also important

to note that current members of the TBCE feel that treating an organ or treating

a disease is outside of scope. The committee discussed various types of

diagnosis--definitive, provisional, working, differential, and others--and is

working towards defining the diagnosis types used within the chiropractic

profession.’

s. fuchs dc

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Share on other sites

Yea, my opinion is that it’s futile to attempt to limit our scope and anyone else’s for that matter. I didn’t always feel this way. Our scope is as broad as they come in the country. I think that’s great in the context of doctors being able to choose from a large basin of modalities in order to help their patients appropriately. I also think it’s nice to have some DC’s specializing in certain areas outside of fundamental chiropractic.

Where I cringe is when our toolbox becomes so large that we don’t exactly excel in it’s usage: Hold on Ms. , looks like I need my dry needles for this job,,,,,,now where did I put those,,,,just used em last month.

ph Medlin D.C.

From: AboWoman@...

Sent: Tuesday, December 20, 2011 2:37 PM

skrndc1@... ; sharronf@... ;

Cc: jbrimhall@...

Subject: Re: TBCE Scope of Practice Workshop Report

Sunny,Please don't take this as critisism of your quesiton. I mean this only as my opinion of why our profesison should continue to morph.

Our profession, as welll as all other medical professions are in constant flux. Change is a 'normal' occurance in nature, of which we are a part. Currently, the following professions can use skeletal manipulation as a healing form:

1. MD

2. DO

3. ND

4 Acupuncturists

5 PT

and of course us - DCs.

As DCs, our education is constantly evolving. However, even if we back track 15 years, we still had the education to palpate trigger points, anatomical palpation to a degree that we can identify what's beneath our hands. In order to do Dry Needling, one needs that basic knowledge. The placing of a needle, in Oregon licensed DCs is required for blood draws. I would counter that placing a needle to withdraw blood is a similar skill set to dry needling. It's not a stretch to add this to our scope. It's well within our training. And I would argue that we actually have more training in areas needed to do this than some of the other professions currently practicing it legally.

Beyond that argument, I think it's short-sighted to think that we can remain static in an ever changing environment. Yes, we have a great arsenal to do what we've always done. However, if we all look at national and world trends in health care, our current skill set is being taken by many other professions. I don't have a problem with that as long as there's training to allow it. I say , "What's best for the public?" However, I want my profession to continue to grow with the rest of the medical care fields. To be sustainable. To thrive. To do this, I think we need to evolv and change. If that means increasing our scope in areas that are already well within our educational standards, it's a natural progression.

IMHO

Minga Guerrero DCabowoman@...

FW: TBCE Scope of Practice Workshop Report

Dear Colleagues, Friends,

The PDF below has made it around the country and back to me which is great. I wish to call to your attention a related issue that I have been dealing with with the Oregon Naturopathic board. All of this is public so I do not feel that I am not breaching any confidentiality.

The Naturopathic school in Portland does not teach dry needling. Given that dry needling is not taught in the Naturopathic school I asked the Oregon Board of Naturopathic Examiners (OBNE) how many hours of post graduate training they required before a Naturopath could practice it. (Remember I posted a PDF a while back from the OBNE that stated 2 hours of training was required for trigger point injection.) The OBNE refused to answer my question directly only saying that dry needling was in their scope of practice and if I had a complaint about a Naturopath to file one. I then proved to them that it was not taught in the school and again asked them, given that fact, how many hours were required in order to practice Dry Needling. Same reply, ‘file a complaint’.

Finally, as I continued to question them, the matter was to come before their board in early December. After the board meeting I asked for their decision on hours required. I was told they were now considering things with their lawyer. I replied telling them that there were a number of NDs right now practicing Dry Needling and to leave them in the lurch without the board stating affirmatively that Dry Needling was in their scope of practice and that a certain numbers of hours of training was sufficient for training was to leave NDs in potential jeopardy with health insurers and with malpractice insurers.

Guess what? No reply. No public document posted on their website. No formal notice to practicing NDs about any ‘legal’ issues. Nothing. Silence.

I am surprised yet I am not surprised. Are we doing something wrong?.... If you only knew the merry go round that it took to get our board to understand and rule on Dry Needling and then to wrestle over the number of hours required for training your head would split open. Yet here is a board who rules by just stating it is in our scope and nothing more, even when asked directly.

I imagine the PDF below made it into their hands as it is addressed to ‘Executive Director, Health Regulatory Board’. The OBNE is a ‘Health Regulatory Board’. Assuming they now have the letter, and my continued communications with them which have been after the date of the letter, December 7th, 2011, you would think they would make some sort of statement to their profession. But no.

Back to my question: ‘ Are we doing something wrong?’ :

My answer – Yes.

My remedy – Review all of our laws and move to expand our scope of practice to the full extent of our laws so we can practice state of the art care. This includes OB and minor surgery. Then when asked in the future about our scope, take the same position as the OBNE of blind neglect, and go forth. And never, never look back.

s.fuchs dc

In a message dated 12/19/2011 10:53:55 A.M. Pacific Standard Time, sharronf@... writes:

The Oregon Medical Board is also trying to ‘regulate’ our profession:

http://egov.oregon.gov/PTBrd/docs/Current.Topics/OMB.Position.Letter.12.11.pdf

s. fuchs dc

From: Vern Saboe [mailto:vsaboe@...?] Sent: Saturday, December 17, 2011 10:32 AMSharron Fuchs; SearsCc: Subject: Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Share on other sites

Thanks Joe, that's part of what I am attempting to express. There are so many techiques and abilities at our fingertips....we get seduced by the laser shows (so to speak) of the newest toy on the block and last week's "I gotta have it,,,it will change my practice' is put on the shelf. Seems to me we need to develop what we have. The chiropractic pool is SO rich! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com From: spinetree@...To: skrndc1@...; sharronf@...; ; AboWoman@...CC: jbrimhall@...Subject: Re: TBCE Scope of Practice Workshop ReportDate: Tue, 20 Dec 2011 16:31:06 -0800

Yea, my opinion is that it’s futile to attempt to limit our scope and anyone else’s for that matter. I didn’t always feel this way. Our scope is as broad as they come in the country. I think that’s great in the context of doctors being able to choose from a large basin of modalities in order to help their patients appropriately. I also think it’s nice to have some DC’s specializing in certain areas outside of fundamental chiropractic.

Where I cringe is when our toolbox becomes so large that we don’t exactly excel in it’s usage: Hold on Ms. , looks like I need my dry needles for this job,,,,,,now where did I put those,,,,just used em last month.

ph Medlin D.C.

From: AboWoman@...

Sent: Tuesday, December 20, 2011 2:37 PM

skrndc1@... ; sharronf@... ;

Cc: jbrimhall@...

Subject: Re: TBCE Scope of Practice Workshop Report

Sunny,Please don't take this as critisism of your quesiton. I mean this only as my opinion of why our profesison should continue to morph.

Our profession, as welll as all other medical professions are in constant flux. Change is a 'normal' occurance in nature, of which we are a part. Currently, the following professions can use skeletal manipulation as a healing form:

1. MD

2. DO

3. ND

4 Acupuncturists

5 PT

and of course us - DCs.

As DCs, our education is constantly evolving. However, even if we back track 15 years, we still had the education to palpate trigger points, anatomical palpation to a degree that we can identify what's beneath our hands. In order to do Dry Needling, one needs that basic knowledge. The placing of a needle, in Oregon licensed DCs is required for blood draws. I would counter that placing a needle to withdraw blood is a similar skill set to dry needling. It's not a stretch to add this to our scope. It's well within our training. And I would argue that we actually have more training in areas needed to do this than some of the other professions currently practicing it legally.

Beyond that argument, I think it's short-sighted to think that we can remain static in an ever changing environment. Yes, we have a great arsenal to do what we've always done. However, if we all look at national and world trends in health care, our current skill set is being taken by many other professions. I don't have a problem with that as long as there's training to allow it. I say , "What's best for the public?" However, I want my profession to continue to grow with the rest of the medical care fields. To be sustainable. To thrive. To do this, I think we need to evolv and change. If that means increasing our scope in areas that are already well within our educational standards, it's a natural progression.

IMHO

Minga Guerrero DCabowoman@...

FW: TBCE Scope of Practice Workshop Report

Dear Colleagues, Friends,

The PDF below has made it around the country and back to me which is great. I wish to call to your attention a related issue that I have been dealing with with the Oregon Naturopathic board. All of this is public so I do not feel that I am not breaching any confidentiality.

The Naturopathic school in Portland does not teach dry needling. Given that dry needling is not taught in the Naturopathic school I asked the Oregon Board of Naturopathic Examiners (OBNE) how many hours of post graduate training they required before a Naturopath could practice it. (Remember I posted a PDF a while back from the OBNE that stated 2 hours of training was required for trigger point injection.) The OBNE refused to answer my question directly only saying that dry needling was in their scope of practice and if I had a complaint about a Naturopath to file one. I then proved to them that it was not taught in the school and again asked them, given that fact, how many hours were required in order to practice Dry Needling. Same reply, ‘file a complaint’.

Finally, as I continued to question them, the matter was to come before their board in early December. After the board meeting I asked for their decision on hours required. I was told they were now considering things with their lawyer. I replied telling them that there were a number of NDs right now practicing Dry Needling and to leave them in the lurch without the board stating affirmatively that Dry Needling was in their scope of practice and that a certain numbers of hours of training was sufficient for training was to leave NDs in potential jeopardy with health insurers and with malpractice insurers.

Guess what? No reply. No public document posted on their website. No formal notice to practicing NDs about any ‘legal’ issues. Nothing. Silence.

I am surprised yet I am not surprised. Are we doing something wrong?.... If you only knew the merry go round that it took to get our board to understand and rule on Dry Needling and then to wrestle over the number of hours required for training your head would split open. Yet here is a board who rules by just stating it is in our scope and nothing more, even when asked directly.

I imagine the PDF below made it into their hands as it is addressed to ‘Executive Director, Health Regulatory Board’. The OBNE is a ‘Health Regulatory Board’. Assuming they now have the letter, and my continued communications with them which have been after the date of the letter, December 7th, 2011, you would think they would make some sort of statement to their profession. But no.

Back to my question: ‘ Are we doing something wrong?’ :

My answer – Yes.

My remedy – Review all of our laws and move to expand our scope of practice to the full extent of our laws so we can practice state of the art care. This includes OB and minor surgery. Then when asked in the future about our scope, take the same position as the OBNE of blind neglect, and go forth. And never, never look back.

s.fuchs dc

In a message dated 12/19/2011 10:53:55 A.M. Pacific Standard Time, sharronf@... writes:

The Oregon Medical Board is also trying to ‘regulate’ our profession:

http://egov.oregon.gov/PTBrd/docs/Current.Topics/OMB.Position.Letter.12.11.pdf

s. fuchs dc

From: Vern Saboe [mailto:vsaboe@...?] Sent: Saturday, December 17, 2011 10:32 AMSharron Fuchs; SearsCc: Subject: Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education. Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of "Doctor of Chiropractic." Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU! We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians. As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression. In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the "line in the sand" if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA will make you PAY AND MAKE YOUR PAY DEARLY! So bring it on "Oregon Medical Association" make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor? We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month! Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW! If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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I feel compelled to join this friendly fray over scope of DC Practice.  Count me in Minga's corner 100% on this issue.  I feel the larger the  arsenal of  tools in our proverbial toolbox the more folks we will be able to help.  Who says we cannot master a wide range of tools in serving our patients?  Some may be stymied by such an array of tools but others may thrive with such a diverse array of therapeutic tools.

  As an analogy would we want to limit the tools of our auto mechanics or construction workers?  Would we think less of an auto mechanic who had a diverse and sophisticated array of tools with which to work on our car?  I  certainly would not.   Why should we worry that a similar large array of quality tools in our chiro toolbox could be a liability? 

  I believe many of us are well equipped mentally to handle a larger group of tools without compromising in any way the quality of the care we provide.  Schneider DCPDX

On Tue, Dec 20, 2011 at 4:31 PM, ph Medlin <spinetree@...> wrote:

 

Yea, my opinion is that it’s futile to attempt to limit our scope and anyone else’s for that matter. I didn’t always feel this way.  Our scope is as broad as they come in the country. I think that’s great in the context of doctors being able to choose from a large basin of modalities in order to help their patients appropriately. I also think it’s nice to have some DC’s specializing in certain areas outside of fundamental chiropractic.

 

Where I cringe is when our toolbox becomes so large that we don’t exactly excel in it’s usage:  Hold on Ms. , looks like I need my dry needles for this job,,,,,,now where did I put those,,,,just used em last month. 

 

ph Medlin D.C.

 

From: AboWoman@...

Sent: Tuesday, December 20, 2011 2:37 PM

skrndc1@... ; sharronf@... ;

Cc: jbrimhall@...

Subject: Re: TBCE Scope of Practice Workshop Report

 

 

Sunny,Please don't take this as critisism of your quesiton. I mean this only as my opinion of why our profesison should continue to morph.

Our profession, as welll as all other medical professions are in constant flux. Change is a 'normal' occurance in nature, of which we are a part. Currently, the following professions can use skeletal manipulation as a healing form:

1. MD

2. DO

3. ND

4 Acupuncturists

5 PT

and of course us - DCs.

 

As DCs, our education is constantly evolving. However, even if we back track 15 years, we still had the education to palpate trigger points, anatomical palpation to a degree that we can identify what's beneath our hands. In order to do Dry Needling, one needs that basic knowledge. The placing of a needle, in Oregon licensed DCs is required for blood draws. I would counter that placing a needle to withdraw blood is a similar skill set to dry needling. It's not a stretch to add this to our scope. It's well within our training. And I would argue that we actually have more training in areas needed to do this than some of the other professions currently practicing it legally.

 

Beyond that argument, I think it's short-sighted to think that we can remain static in an ever changing environment. Yes, we have a great arsenal to do what we've always done. However, if we all look at national and world trends in health care, our current skill set is being taken by many other professions. I don't have a problem with that as long as there's training to allow it. I say , " What's best for the public? " However, I want my profession to continue to grow with the rest of the medical care fields. To be sustainable. To thrive. To do this, I think we need to evolv and change. If that means increasing our scope in areas that are already well within our educational standards, it's a natural progression.

IMHO

Minga Guerrero DCabowoman@...

FW: TBCE Scope of Practice Workshop Report 

Dear Colleagues, Friends,

 

The PDF below has made it around the country and back to me which is great. I wish to call to your attention a related issue that I have been dealing with with the Oregon Naturopathic board. All of this is public so I do not feel that I am not breaching any confidentiality.

 

The Naturopathic school in Portland does not teach dry needling. Given that dry needling is not taught in the Naturopathic school I asked the Oregon Board of Naturopathic Examiners (OBNE) how many hours of post graduate training they required before a Naturopath could practice it. (Remember I posted a PDF a while back from the OBNE that stated 2 hours of training was required for trigger point injection.) The OBNE refused to answer my question directly only saying that dry needling was in their scope of practice and if I had a complaint about a Naturopath to file one. I then proved to them that it was not taught in the school and again asked them, given that fact, how many hours were required in order to practice Dry Needling. Same reply, ‘file a complaint’.

 

Finally, as I continued to question them, the matter was to come before their board in early December. After the board meeting I asked for their decision on hours required. I was told they were now considering things with their lawyer. I replied telling them that there were a number of NDs right now practicing Dry Needling and to leave them in the lurch without the board stating affirmatively that Dry Needling was in their scope of practice and that a certain numbers of hours of training was sufficient for training was to leave NDs in potential jeopardy with health insurers and with malpractice insurers.

 

Guess what? No reply. No public document posted on their website. No formal notice to practicing NDs about any ‘legal’ issues. Nothing. Silence.

 

I am surprised yet I am not surprised. Are we doing something wrong?.... If you only knew the merry go round that it took to get our board to understand and rule on Dry Needling and then to wrestle over the number of hours required for training your head would split open. Yet here is a board who rules by just stating it is in our scope and nothing more, even when asked directly.

 

I imagine the PDF below made it into their hands as it is addressed to ‘Executive Director, Health Regulatory Board’. The OBNE is a ‘Health Regulatory Board’. Assuming they now have the letter, and my continued communications with them which have been after the date of the letter, December 7th, 2011, you would think they would make some sort of statement to their profession. But no.

 

Back to my question: ‘ Are we doing something wrong?’ :

 

My answer – Yes.

 

My remedy – Review all of our laws and move to expand our scope of practice to the full extent of our laws so we can practice state of the art care. This includes OB and minor surgery. Then when asked in the future about our scope, take the same position as the OBNE of blind neglect, and go forth. And never, never look back.

 

 

 

s.fuchs dc

 

 

 

 

 

In a message dated 12/19/2011 10:53:55 A.M. Pacific Standard Time, sharronf@... writes:

 

The Oregon Medical Board is also trying to ‘regulate’ our profession:

http://egov.oregon.gov/PTBrd/docs/Current.Topics/OMB.Position.Letter.12.11.pdf

s. fuchs dc

From: Vern Saboe [mailto:vsaboe@...?] Sent: Saturday, December 17, 2011 10:32 AMSharron Fuchs; SearsCc: Subject: Re: TBCE Scope of Practice Workshop Report

Thanks for the kind words ,

Yes, colleagues the Oregon Chiropractic Association is all over this issue and as your ACA Delegate and member of the ACA's Insurance Commission we have been discussing this for sometime and now with a sense of urgency following the unanticipated defeat in Texas.

The basic strategy of the OCA is that of education.  Education as per the substantial education doctors of chiropractic receive in their four year training leading to our degree of " Doctor of Chiropractic. "   Education...as in educating each and every Oregon Legislative Member as well as the state's other key policy makers both within Oregon's governmental agencies and within the private sector. How? ..and What? By giving them the significant core curriculum at UWS vs OHSU which the OCA has already put together which by the way (drum roll please) is 1,100 clock hours longer that the 4-year medical degree program at OHSU!  We are also putting together a summary of the substantial post-doctorate diplomate programs leading to Board Certification status within the profession as well as the various new (we won't say they are new) advance degree programs such as the UWS new Masters of Science in Nutrition and Functional Medicine.

Education to the subsequent clinical skill sets chiropractic physician posses relative to the above education not the least of which includes our ability to provide correlative and differential diagnoses and as such have the clinical ability to act as portal of entry physicians.  As first contact, portal of entry physician types we have the critical clinical capacity to interpret X-ray and lab findings, conduct comprehensive physical examinations, conduct and/or order and interpret ancillary diagnostic studies such as CT, MRIs, nerve conduction studies, nuclear medicine (bone & S.P.E.C.T. scans), ect., and arrive at a clinical impression.  In short the OCA is educating the key policy makers that because of these skill sets we have the expert ability to recognize pathophysiological conditions that may masquerade as simple musculoskeletal complaints such as low back pain and that which may require immediate or timely attention/referral and we do that daily!

The Oregon Chiropractic Association which again here being another example of how the OCA is looking out for you, will also educate our enemies who would darn attempt to influence or restrict our scope of practice here in the great state of Oregon with miss-information or miss-represent to legislators as per our significant training, clinical skills, and wonderful services (with high consumer satisfaction, improved safety, and reduce per capita costs....oh did I mention....you can bet I will to our enemies, that this just happens to be the Triple Aim Governor Kitzhaber wants to achieved here in Oregon!) that here is the " line in the sand " if you darn to cross that line and come to the microphone and lie to our elected officials in public testimony the OCA  will make you PAY AND MAKE YOUR PAY DEARLY!  So bring it on " Oregon Medical Association " make our day!!!!!!!!

Well that's what your trade organization is doing to protect our scope of practive and as such help all colleagues by our actions what are you doing to help doctor?  We need your financial help, we need your input, your ideas, we need your support, we need you to finally become a member of the OCA and WE NEED IT NOW!!!

Please call the OCA office at 503-256-1601 call today yes today you can leave a message for staff to get you signed up ASAP....you can do so for only $66/month!  Or go to the OCA webpage and sign up as a member its easy its the GREAT BIG GREEN BUTTON THAT SAYS JOIN NOW!    If you need help, if you have any questions, if you have any ideas call me any time on my cell 541-231-4528.

The Oregon Chiropractic Association is the strongest it has ever been we are over 500 doctors strong help make us stronger, add your shoulder to that great stone wheel so many colleagues have been pushing up that mountain for so very long we are nearing the top which leads to that level playing field for us all and cultural authority for the profession and we are going to arrive TOGETHER!

TO THE CONTINUED GOOD FIGHT!

Vern Saboe.....541-231-4528 PS: See what you went and did !

Re: TBCE Scope of Practice Workshop Report

 

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices.  This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians.  But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist.  What's needed is a

united chiropractic profession that keeps patient well-being as the prize.  Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

 

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives.  One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's " intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment. " The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. " I don't want to argue about when does a dysfunction become a disease. " Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment.  It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope.  The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

 

-- Schneider DC PDX

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and listmates,

My question is that by adding to the curriculum what gets pushed aside to make room for the new subjects? What facets of a chiropractic education are put on a back burner? Many of us who have been in practice over 20-30 years are still finding aspects of spinal correction that we never knew existed producing remarkable clinical results in cases that were diagnosed as being incurable.

Have we really uncovered all the riches to be found by digging deeper in our search to find new and more potent methods of drugless health care.

I think not,

Herb Freeman D.C.

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Well, the first thing that got "pushed out" by the expanded scope of practice was CHIROPRACTIC PHILOSOPHY! So, now, we have talk of MD/DC...(which is really DO!). (:-)

RR

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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.....except that the DOs have stopped learning adjustive procedures ..... skSunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com Oregondcs From: drbobdc83@...Date: Wed, 21 Dec 2011 09:22:39 -0800Subject: Re: TBCE Scope of Practice Workshop Report

Well, the first thing that got "pushed out" by the expanded scope of practice was CHIROPRACTIC PHILOSOPHY! So, now, we have talk of MD/DC...(which is really DO!). (:-)

RR

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Dr. s and others,

In the late 40's a movement arose within the profession very similar to what is presently being discussed at which point B.J. joined in. He published an essay entitled "Tics and Tors".in which he pointed out different segments of our profession had been and were still divided as to scope of practice.

The "Tors" believed that our laws had to be broadened to include prescriptives because of the limited results their adjusting alone produced.

The "Tics" were of the opinion that with proper analysis and correction a major change could be made in a patient's health and had been doing it for years at the B.J. Palmer clinic. The patients were examined by a staff of M.D.'s and all findings were recorded. Then a careful analysis was done by the D.C."s they would then be adjusted by the chiropractic staff and later reexamined by the M.D's. The changes were remarkable over a wide range of conditions. These results were later published in an album of the clinical results.

One can't help wondering if this isn't a replay of the earlier movement we are faced with?

Is it the "Tics" and "Tors" all over again?

Herb Freeman D.C.

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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HI Herb, Do you by chance know where we might access those research results? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com drbobdc83@...; Oregondcs From: hbf4747@...Date: Wed, 21 Dec 2011 11:44:28 -0800Subject: Re: TBCE Scope of Practice Workshop Report

Dr. s and others,

In the late 40's a movement arose within the profession very similar to what is presently being discussed at which point B.J. joined in. He published an essay entitled "Tics and Tors".in which he pointed out different segments of our profession had been and were still divided as to scope of practice.

The "Tors" believed that our laws had to be broadened to include prescriptives because of the limited results their adjusting alone produced.

The "Tics" were of the opinion that with proper analysis and correction a major change could be made in a patient's health and had been doing it for years at the B.J. Palmer clinic. The patients were examined by a staff of M.D.'s and all findings were recorded. Then a careful analysis was done by the D.C."s they would then be adjusted by the chiropractic staff and later reexamined by the M.D's. The changes were remarkable over a wide range of conditions. These results were later published in an album of the clinical results.

One can't help wondering if this isn't a replay of the earlier movement we are faced with?

Is it the "Tics" and "Tors" all over again?

Herb Freeman D.C.

Re: TBCE Scope of Practice Workshop Report

This is how the world looks without a state having an Uncle Vern to represent patient needs

and choices. This is how a state looks where the Guv hasn't had an Uncle Vern to show them

chiropractors are an excellent source of primary care physicians. But Rick is no Kitzhaber,

so more is needed to avoid this kind of turf war than a super-lobbyist. What's needed is a

united chiropractic profession that keeps patient well-being as the prize. Oregon is such a model.

Sears, DC, IAYT

1218 NW 21st Ave

Portland, Oregon 97209

v: 503-225-0255

f: 503-525-6902

www.docbones.com

On Dec 16, 2011, at 2:35 PM, Sharron Fuchs wrote:

http://texasjournalofchiropractic.eznuz.com/article/Featured_News/Association_News/TBCE_Scope_of_Practice_Workshop_Report/24534

I don’t think this logic would fly here in Oregon. :

‘Board members and attendees shared their perspectives. One of the key concepts stated by TBCE board members related to diagnosis. It was stated by a board member that the doctor's "intention, as reflected by documentation, is what determines if treatment is in or out of scope [of practice]. Diagnosis is reflective of your intention for treatment." The board member reflected that if you are treating an organ you are outside your scope. If you are treating a disease you are outside scope. "I don't want to argue about when does a dysfunction become a disease." Thus, while it is possible for a patient to have a myriad of conditions/diseases, it is the viewpoint of members of the TBCE that the diagnosis is that for which you intend to render treatment. As the treatment protocols and scope of the chiropractic profession are limited by legal statute, it is important that doctors of chiropractic note that their diagnosis should be limited to that for which they intend to render treatment. It is also important to note that current members of the TBCE feel that treating an organ or treating a disease is outside of scope. The committee discussed various types of diagnosis--definitive, provisional, working, differential, and others--and is working towards defining the diagnosis types used within the chiropractic profession.’

s. fuchs dc

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Herb, I agree that too many facets of being a chiropractor get put on the back burner when there are so many adjunctive therapies added to our scope. I think it's fine if there

are outside seminars teaching them, but the schools should be teaching the students more (than they do) about business practices, how to talk to a patient so they understand health, palpation, and where we came from (the history and principles of chiropractic).

They already do a great job of teaching about therapies such as IFC and US that, apparently in studies, have been shown to not really help the patient. I have had many students tell me they want to practice more palpation (in middle and upper quarters).

I do relay this to instructors at times.

Janell Chandler, DC

Chiropractor

7809 NE 94th Avenue

Vancouver, WA 98662

Office: 360-944-1800

Cellular: 360-606-2502

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