A commentary on the implications of medication prescription rights for the chiropractic profession

Abstract

There is a growing desire within the chiropractic profession to expand the scope of practice to include limited medication prescription rights for the treatment of spine-related and other musculoskeletal conditions. Such prescribing rights have been successfully incorporated into a number of chiropractic jurisdictions worldwide. If limited to a musculoskeletal scope, medication prescription rights have the potential to change the present role of chiropractors within the healthcare system by paving the way for practitioners to become comprehensive specialists in the conservative management of spine / musculoskeletal disorders. However, if the chiropractic profession wishes to lobby to expand the scope of practice to include limited prescriptive authority, several issues must first be addressed. These would include changes to chiropractic education and legislation, as well as consideration of how such privileges could impact the chiropractic profession on a more theoretical basis. In this commentary, we examine the arguments in favour of and against limited medication prescription rights for chiropractors and discuss the implications of such privileges for the profession.

Attitudes, beliefs, and practices among Swiss chiropractors regarding medication prescribing for musculoskeletal conditions: a national Q-methodology study

“…However, evidence suggests that chiropractors who have medication prescription rights perceive these privileges as an advantage for the profession [4,5]. Moreover, if granted limited prescriptive authority (i.e., limited to prescribing medications for treating spine-related and other musculoskeletal [MSK] conditions), chiropractic clinicians could have a positive influence on public health [2]. This is because, with such privileges, chiropractors would be in a position to counsel patients with MSK pain against overusing or over-relying on medications commonly prescribed to treat their condition.…”

“…The right to prescribe medications is a controversial topic within the chiropractic profession [ 1 , 2 ]. At present, only nine countries, including Switzerland, Liechtenstein, Guatemala, Panama, United Arab Emirates, India, Iran, Namibia, and the United States (New Mexico and Oklahoma, only) allow for such privileges [ 3 ].…”

“…The purpose of this study was to assess Swiss chiropractors’ current attitudes toward, the frequency of, and indications for, medication prescribing for MSK conditions in clinical practice. Based on previous literature [ 1 , 2 , 5 , 9 – 12 ], this study also aimed to explore Swiss chiropractors’ beliefs toward their current pharmacology training, as well as their interest in expanding the current Swiss prescribing formulary to include additional medications for MSK and non-MSK conditions.…”

“…For instance, reports indicate that a growing number of chiropractors from countries outside Switzerland are also interested in expanding their scopes of practice to include similar prescribing privileges [ 10 – 17 ]. However, debate continues over the standards of pharmacology training for chiropractors internationally, as well as the extent to which medication prescribing rights should be expanded within the profession [ 1 , 2 , 9 – 12 ].…”

The schism in chiropractic through the eyes of a 1st year chiropractic student

“…The disparity between these groups has divided the profession and invited ridicule from the both the scientific community [ 3 ] and the public at large [ 4 ]. Additionally, disagreements around scope of practice [ 5 ], vocabulary [ 6 ] and ethics [ 7 ] have negatively affected public opinion [ 8 ], cultural authority [ 6 , 9 ] and inter-professional relations [ 3 ]. Externally chiropractic has been embroiled in conflict with political medicine practically since chiropractic was ‘discovered’ in 1895 [ 6 ].…”