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Chiropractors want to prohibit PTs from spinal manipulation

State’s physical therapists push for self-governance

JACKSON – When physical therapists approached Mississippi lawmakers to create its own licensing board, they found themselves pitted against chiropractors, who want to prevent the group and others from certain therapeutic activity, such as spinal manipulation.

“We are the experts at spinal adjusting and manipulation,” said Mike Patterson, vice president of the Mississippi Chiropractic Association. “That is our turf.”

Senate Bill 2204, introduced by Sen. Bunky Huggins (R-Greenwood), would prohibit anyone from performing certain spinal manipulation of adjustment without qualifications that would include a minimum of 400 clock hours or 18 semester hours of classroom instruction within a three-year period in spinal manipulation or spinal adjustment, and a minimum of 800 hours or 30 semester hours of supervised clinical training at a facility where spinal manipulation or spinal adjustment is a primary method of treatment – in other words, at a chiropractic school or clinic. There are no chiropractic schools in Mississippi; less than 20 chiropractic schools operate in the U.S.

SB 2204 would protect the public, Patterson said. “This is not a bill to prevent anyone from doing something they are qualified to do,” he said. “We would never prevent anyone from doing anything that’s a part of their profession. Physical therapists can do manipulations. All they have to do is get appropriate hours.”

Educational standards cannot be compared, said Mike Higginbothan, president of the Mississippi Physical Therapy Association, who is on staff at Forrest General Hospital in Hattiesburg.

“They use clock hours,” he said. “All of our education programs are traditional semester hours through medical schools. They want to somehow equate the two.”

The chiropractic profession has been known since its inception in 1895 to focus on spinal manipulation, Patterson said.

“Chiropractors have over 4,000 classroom hours in anatomy, physiology and pathology, which is equivalent to what a medical doctor gets in his medical degree,” he said. “One thing we get that’s different is about 1,500 hours in manipulation, corrective adjustments and physiological therapeutics. We are concerned about the general public receiving manipulation by untrained individuals. We know that adjustment is a procedure that is as scientific as a surgical procedure.”

Physical therapists should refer patients to chiropractors, Patterson said.

“Physical therapists do a superb job and are highly trained, but when a physical therapist sees a patient with fixated vertebral segments who may need manipulation, the chiropractor should be the one the patient is referred to for spinal adjustments and manipulations,” he said.

Higginbothan said chiropractors have introduced similar legislation in 36 states without success. “They have not been able to limit the practice of physical therapy in any state, which is, of course, what they want to do,” he said.

If SB 2204 is passed, it would be illegal to teach students spinal manipulation, which is a small but important part of physical therapists’ practice, said Neva Greenwald, incoming president of the Mississippi Physical Therapy Association, and director of the University of Mississippi Medical Center School of Physical Therapy.

“There are about 230 chiropractors in the state, and between 800 and 900 physical therapists,” Greenwald said. “Physical therapists work in hospitals, clinics, children’s hospitals, V.A. centers, hospices and home health care. One of the questions the bill presents is, ‘Are chiropractors going to go out and do home health care?’ If this bill passes, it would have a big impact on healthcare in the state. If you’re talking about manipulation mobilization, you’re not only talking about the back and neck, but you’re also talking about plain exercise by the way their definition is written.”

HB 197, introduced by Rep. Frances Fredericks (D-Gulfport), which passed the House on Feb. 2 and is in the Senate, would create a new licensing board and transfer current licensure powers from the state board of health.

“The regulation of physical therapists would best be governed by physical therapists,” Higginbothan said. “We could be more efficient than the state health department. Testing wouldn’t be affected because that’s done on a national database.”

Physical therapists had their own licensing board from 1966 until 1990. But control of the board passed to the State Department of Health when Gov. Ray Mabus consolidated smaller boards to save money. “It’s been a struggle ever since,” he said. “We ran an efficient board and kept costs down, so it’s not something unfamiliar to us.”

When control of the board changed, less than 300 physical therapists were practicing in Mississippi. Today, nearly 900 physical therapists are practicing in the state, Higginbothan said.

Contact MBJ contributing writer Lynne Wilbanks Jeter at lwjeter@yahoo.com or (601) 853-3967.


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