Chiropractic In Your World

The following has been provided by Dr. Gerry Clum and is a report from the recently concluded World Federation of Chiropractic (WFC) annual Council meeting, biannual assembly meeting and biannual Congress that were all held in Paris from May 20-May 26, 2001. Please contact Life West at the address provided below and thank Dr. Clum for providing this content.

The Latest Stuff from Gerry – Volume 6, Number 8
In This Issue:

World Federation of Chiropractic Annual Assembly
Status of Chiropractic Presented to the Assembly by the Following Nations:

Australia – Mexico – Bolivia – New Zealand – Brazil – Norway – Canada – Peru – Cyprus – Portugal – Egypt – Saudi Arabia – Finland – Singapore – France – Slovakia – Germany – Slovenia – Ghana – South Africa – Holland – Spain – Hong Kong – Sweden – Iceland – Switzerland – Iran – Taiwan – Ireland – Turkey – Israel – Uganda – Japan – United Kingdom – Korea – United States – Lebanon – Zimbabwe – Malaysia

Dear Colleagues,
Let me begin with the end and work my way back:

The Congress
Jointly sponsored by the WFC, the European Chiropractors Union and the French Chiropractors Association, the 2001 Congress enjoyed the participation of approximately 750 chiropractors from the corners of the globe who came together to participate in the largest chiropractic gathering ever held in Europe.

Set at the famous Palais de Congres in Paris, the educational offering was represented by a 700 page proceedings that can be purchased from the WFC by contacting them at www.wfc.org

The week’s gatherings came to an end with the Congress Gala Dinner. The highlight of the evening was the presentation of the 2001 WFC Honour Awards to John Sweeney, D.C. a WFC past-president and a founding member of the Council of the WFC from Australia, Gordon Waddell, M.D. and Dr. Sid E. Williams, founder and president of Life University and the founder of Life Chiropractic College West. Our congratulations to all of the recipients, especially our founder Dr. Sid.

The Assembly
The Assembly meetings held on May 22-23, 2001 enjoyed the participation from nations all over the globe. The country reports that follow were presented during the Assembly meeting.

The highlight of the Assembly meeting was the adoption of the Association of Chiropractic Colleges (ACC) paradigm on the practice of chiropractic by the Assembly following a similar adoption of the paradigm by the WFC Council. While there were nations that did not support the adoption of the paradigm, it was finally adopted by a margin greater than 2 to 1. Lest you think that this represented the ACA and the ICA carrying the vote–together they hold 14 of the more than 90 votes that were cast on this issue. It is safe to say that the majority of national associations from around the world supported the adoption of the paradigm as a unifying statement for the profession around the globe.

The Congress, the WFC’s Board of Directors, met on May 20-21, 2001 and considered matters ranging from the Council’s budget to the schedule of meetings into the future.

The following are my notes from the Assembly presentation of the country reports of WFC member associations around the world. I tried to capture the details and the spirit of the comments offered by the various representatives. I have attempted to clearly identify my comments and reactions to what was offered.

Australia
Chiropractic is very well developed in Australia. Licensure, reciprocity etc. are available across the country. One unique feature is that the term “Dr.” cannot be used by a D.C. in the state of New South Wales (home of Sydney). There is a move to develop a series of practice guidelines in Australia. In addition, specialty activity is just being developed in the country. Education is attended to by two bodies: the Joint Education Commission (JEC) and the Australasian Council on Chiropractic Education (ACCE). The JEC is more of an outgrowth of the states’ registration boards and the ACCE is a more traditionally organized accrediting agency. The JEC and the ACCE are in discussions and it is expected that one body will emerge.

Q: Will the new body be seeking CCE reciprocity with other CCEs?
A: Yes

Protective legislation is under discussion by the government which is seeking the use of the terms “registered this or that”. There are two educational programs for chiropractors in Australia, one at the Royal Melbourne Institute of Technology and the other at MacQuarie University. A third program has been proposed for Western Australia at Murdoch University (Perth, WA) and is expected begin a chiropractic program in 2002.

Bolivia
Six chiropractors are practicing in Bolivia. The Associacao Boliviana de Quiropracticos has been recognized by the government and, as a result, the association assumes the role of a board of examiners with respect to licensing, discipline, scope etc.

Brazil
There are 34 chiropractors practicing in Brazil. There is no legislation protecting the practice of chiropractic nor the title of chiropractor.

There are two chiropractic educational programs in operation in Brazil. The first at Feevale University in Novo Hamburgo, Brazil has enjoyed a developmental relationship and origin with Palmer University. Northwestern, Western States, LACC and National support the second in Sao Paulo.

Canada
There are approximately 6,000 chiropractors in Canada, of these over 4,500 belong to the Canadian Chiropractors Association (CCA). Chiropractic is regulated in all of the Canadian provinces. There are two educational opportunities in chiropractic in Canada. One in Ontario presented in English at Canadian Memorial Chiropractic College (CMCC) and the other at University Quebec at Trois-Riveries presented in French.

Canada has recently experienced a flurry of negative publicity from the death of a young woman 17 days after receiving a chiropractic adjustment. The evidence in the case indicates that chiropractic care played no role in the unfortunate situation. The matter has been “tried” in the press through the efforts of a chiropractic antagonist in Canada. An inquest will be held in the fall regarding the matter.

Cyprus
Chiropractic legislation has existed since 1991. A National Health Insurance law is coming into effect. Chiropractic care is not a part of the system but the GP may refer if he/she sees fit. Chiropractors are viewed as specialists. The first “Spinal Health Day” was held earlier this year with spinal exams and ergonomics discussions presented. Cyprus has a problem involving MDs from Eastern Europe, especially the former Soviet Union practicing manipulation. Chinese physicians are also doing this. Six students are enrolled in chiropractic educational programs; one or two are expected to come back.

(GWC note: 75% of Spanish chiropractors come from the U.S., 75% of Cypriot chiropractors don’t leave the U.S., the quality of life issue looms large)

Egypt
The Egyptian Chiropractic Association was formed in 1991 and presently represents 14 chiropractors. There is no legislation, nor insurance recognition in the Land of the Pharaohs. There has been a strong relationship between Ain Shams University (Cairo) and Life University (Atlanta) for many years and there has been a chiropractic unit within a large Egyptian hospital for a number of years. Since 1998, consultations have been underway between Egyptian military authorities and Life University. These discussions have resulted in the establishment of a facility to provide chiropractic services to members of the Egyptian military. Further plans are underway for three Egyptian officers to be educated as chiropractors in the U.S. with the intent of having them return to Egypt to establish a permanent chiropractic service within their military health care system. Finally, there is the possibility of an educational offering in Egypt together with Life University in the next three years.

Finland
The profession was legally recognized in 1994. Chiropractic does not have separate legislation, rather it is recognized under a 30 profession-wide legislative act that includes everyone from medicine to chiropractic. The term “chiropractor” is not protected, but the term “qualified chiropractor” is recognized. In early May 2001, the Minister of Health held meetings with various providers and one outcome of the discussions was an agreement to develop legislation for the protection of the title of “chiropractor.” This is expected to be implemented early next year. National health insurance funding is expected to flow from the additional recognition. This recognition is also viewed as a potential springboard for the development of an education al offering in chiropractic in Finland.

Q: What will happen to the unqualified chiropractors when the protection of the title chiropractor is implemented?
A: If title protection comes through, those not qualified to use the title will need to call themselves “traditional healers” or something similar.

France
There are 390 DCs in France and they view their circumstance as one of “tolerated illegality”. Occasionally, there are prosecutions of chiropractors, but aside from personal trauma for the defendant, they usually resolve without incident. In 1999, a committee was suggested by the Minister of Health to explore recognition of chiropractic, osteopathy and manual care. No significant movement has been made in this regard to date.

In conversations with persons practicing in France, I learned that a medic under their health care system is paid 110 francs as a GP and 150 francs as a specialist per patient visit. In the Paris area, DCs are receiving a fee of 350 francs per visit. (GWC comment: Let’s think about this: one third the money and all the government you can take, sure I’d want legislation!!!)

The IFEC (Institute Franco-European de Chiropratique) is growing and played a significant part in the organization and presentation of the WFC Congress in Paris. Congratulations to everyone involved from the IFEC especially Mr. Charles Martin and Dr. Catherine Parodi.

Q: Has an osteo-medical group been recognized in France?
A: An MD who wishes to practice as an osteopath can be recognized. It is estimated that there are 30,000 persons practicing some form of osteopathy. They are predominantly PTs. MDs are taking weekend programs on manipulation and mobilization and calling themselves osteopaths.

Germany
There are 37 qualified chiropractors in Germany. In 1980, there were 8 DCs practicing in Germany. Chiropractic is legal in Germany and is recognized under a 1939 act as a “heilpraktiker” as opposed to chiropractor. A license issued to a “heilpraktiker” affords a person the authority to perform acupuncture, homeopathy, chiropractic even minor surgery. MDs have an unlimited license and can provide the same without any education in a discipline such as acupuncture or chiropractic.

Q: I understand that a DC from Life has been recognized as a heilpraktiker but only to practice chiropractic?
A: Two persons were licensed by a single state without examination with a chiropractic limitation to practice chiropractic. This practice has been discontinued.

Ghana
One of the highlights of the WFC Assembly meeting was the chance to meet and welcome the first chiropractor to practice in Ghana. Dr. Eno Sefar-Tawiah, a graduate of the University of Bridgeport, School of Chiropractic who is practicing in Aburi-Akwapim.

Educated as a nurse, the mother of four children by birth and five by adoption traveled to the United States, worked as a nurse and domestic worker to educate her children. The last graduated from Columbia University in the mids 90s. She had an encounter with chiropractic along the way and after graduating her children, she attended the University of Bridgeport, College of Chiropractic. She graduated in 1999 and returned to her homeland of Ghana. She was immediately offered a faculty positioning in nursing which she turned down, advising the authorities that it was her plan and mission to establish the chiropractic profession in her country. She moved to some of the poorer areas away from the city, is having electricity brought to her area and while her daughter secured a computer for her, she will need to get a generator to use it.

The opportunity to meet Dr. Eno Sefar-Tawiah and her colleague Dr. Charles Sebwana of Uganda was inspiring. Each of these persons is single handedly establishing the profession in their respective nations. Be sure and see the comments relative to Dr. Sebwana from Uganda.

A special thanks is due the folks at BackTalk Systems for their generous funding of the travel and accommodations of Dr. Sefar Tawiah and Dr. Sebwana who would have otherwise been unable to attend the WFC meetings in Paris.

Holland
The profession in Holland has no legal professional status. Chiropractors are allowed to practice but legal recognition is dependent on educational offering in chiropractic being available in the Netherlands. Chiropractors use x-ray on a regular basis.

There are 160 DCs in the Netherlands and 150 of them belong to the Netherlands Chiropractic Association (NCA). The remaining 10 DCs have formed the Dutch Chiropractic Federation (DCF) and they represent mainly ICA members. DCs of both organizations are eligible to receive funding through private and national insurance programs.

Hong Kong
The Hong Kong chiropractic registration ordinance was passed in 1993. The legislation serves to protect title but not scope. It is expected that registration will be open within a month and that chiropractors will soon begin to benefit from the registration process.

Iceland
There are 5 chiropractors practicing in Iceland. The profession has been licensed since 1989 and legal recognition to practice chiropractic requires approval of the Icelandic Chiropractic Association and the minister of health.

The law in Iceland requires an MD referral to see a DC. DCs and government ignore this requirement, but it remains a potential stumbling block in the future.

A complementary and alternative medicine bill is due to be introduced in 2002. This legislation may impact the chiropractic community. Malpractice insurance is mandatory for all forms of health care providers and premium costs are viewed as high.

Iran
In 1991, an Executive Order was issued detailing the requirements to practice in Iran. This afforded title protection. In the mid 90s, chiropractors were routinely accused by medicine of practicing medicine without a license. For the period 1994-1999, chiropractors were not allowed to practice, offices were closed and fines were levied. In 2000, the medical practices act was amended and chiropractic was included, there was a nine-month delay in the signing of the amended act. The first license for a chiropractor to function in Iran is less than one month old! Chiropractors enjoy primary contact status in Iran.

Ireland
The Chiropractic Association of Ireland recently defeated a bill seeking to restrict x-ray use by chiropractors. The inconsistency this represents has created an opportunity for legislation to be more fully explored. The view of the CAI is that chiropractic is not a form of alternative or complementary medicine and should stand on its own right.

Israel
There are 75 licensed chiropractors practicing in Israel, of these, 55 are members of the Israel Chiropractic Association. Chiropractors have been defined as para-medical; x-ray use is assured and the title Dr. is also used. Educational requirements embrace CCE standards for licensure

The questions of diagnosis and primary care are still being evaluated.
All NHI programs include chiropractic care on a referral basis under the heading of alternative care. Approximately 50% of DCs want to work under NHI and the others want the present terms of participation enhanced.

Israeli Defense Forces have utilized chiropractic care for years. They now have an internal chiropractic clinic under the IDF. A summary report dated September 2000 on the role of chiropractors in the IDF has been released. Some data from the report includes a study of 120 low back patients, results indicate that they were seen for 12-14 visits on average with 86.7% reporting improvement for 2 months following care, 75% reported improved functions. Length of care, no cessation of care when results are lacking and concerns about records in general were concerns expressed by the report. The conclusion of the report was to continue the IDF chiropractic services.

2002 Council June 3-5, 2002 seminar the week before in Israel and in Egypt the following weekend.

Japan
There are approximately 65 U.S. style trained chiropractors in Japan and there are 10,000 untrained or lesser-trained persons calling themselves chiropractors in Japan. No legislation exists to protect any aspect of the practice of chiropractic or the profession in general in Japan. In an attempt to bring some order to this chaotic situation, the Japanese Association of Chiropractors (JAC) developed the Japanese Council of Chiropractic Colleges (JCCC) in 2000. They were also the force behind the development of the first Chiropractic Standardization Course (CSC) started in 1996. Since then, 145 persons have graduated from this program. JAC was also the force behind the development of RMIT-Japan. RMIT-Japan has had 18 students complete the 6-year program. Current enrollment is 152.

Challenges in Japan include the lack of licensing regulations and authorities and lack of ability to control education and practice.

Korea
There is and educational program in chiropractic offered by Hansei University. The Korean Chiropractors Association was founded in 1993. At present, 62 persons hold the “D.C.” degree, 24 hold another degree in medicine, acupuncture, oriental medicine etc.

Chiropractic is viewed as illegal in Korea. Government has recognized the Chuna Association as the manipulators in Korea. The Chuna group is composed of predominantly oriental medicine practitioners who have fabricated a 6,000-year history of spinal care and portrayed themselves to the public as the true spinal care folks.

Lebanon
Chiropractors are in practice in Lebanon but no legislation and no further information was presented.

Malaysia
Fifteen chiropractors belong to the Malaysian Chiropractic Physicians’ Association. The “D.C.” is not a protected title. No other legislation relative to the practice of chiropractic exists. There is a possible university based program under consideration.

Mexico
The licensure of chiropractors was achieved in 1988. Licensure is dependent on a CCE style education and also being a Mexican citizen. There is a professional body known as the Collegio de Quiropracticos, it is not a regulatory board but membership is dependent on being licensed.

New Zealand
The profession in New Zealand is represented by approximately 200 practicing chiropractors. Of these practitioners, 70% belong to the New Zealand Chiropractors’ Association. The profession is registered and well regulated in New Zealand. PTs, DOs and MDs can manipulate in New Zealand. Chiropractors enjoy primary contact status under NZ’s worker’s compensation and personal injury schemes.

The New Zealand School of Chiropractic has graduated three classes of chiropractors to date. Their campus is located in Auckland and they have achieved student loan funding through the New Zealand Qualifications Authority and they are seeking recognition from the JEC of Australia.

Norway
There are 256 DCs practicing in Norway at this time and another 140 students attending various chiropractic colleges around the world. Legislation addressing the chiropractic profession has been in place for 10 years. In Norway, as of this year, there are ten licensed health care professions grouped under one law. Each of the ten disciplines must regulate itself under the law.

In January 2002, a two-year trial in three countries will evaluate the practice of chiropractors prescribing sick leaves and patient referrals to other providers will be started. Chiropractors and manual therapists will be involved in the study.

Government is supporting the development and implementation of practice guidelines related to the low back. Norway perceives a need for more chiropractors that are qualified to do research at the same level as the other professions.

An Introduction to Chiropractic Management, a brochure developed by the Norwegian Chiropractors’ Association, is available in English. Copies can be obtained by contacting [email protected]

Peru
The Associacion Peruana de Quiropractica advised that the profession is very well known in the major cities of Peru but remains unlegislated and unregulated.

Concern was expressed about student groups visiting Peru for vacations and “mission” type activities in concert with some of the local chiropractors. It was felt that government was concerned about these activities as well.

Portugal
The Portuguese Chiropractic Association was formed in 1999. Chiropractors have been practicing in Portugal since 1985. The PCA prefers the use of the terms “adjustment” and “subluxation” to other appellations. The PCA has adopted the ACC paradigm. At the present time, no legislation exists regarding the practice of chiropractic. There are government contacts in place at this time and legislation is expected in 2002. Practice is primarily cash with some private third party compensation. Plans to open a school in Portugal are being explored.

Saudi Arabia
There are four or five chiropractors practicing in Saudi Arabia. A law was proposed that included chiropractors under the rubric of complementary and alternative medicine but the chiropractors chose to opt out of the legislation.

Singapore
Nine chiropractors are registered in Singapore and 2 registrations pending. Four Singapore students are overseas studying. The Ministry of Health is focusing on complementary and alternative medicine and they are registering 2,000-3,000 traditional practitioners generally acupuncturists, massage practitioners, moxibustionists, and Chinese medicine practitioners.

The order of registration will be based on the numbers in each group. Traditional Chinese practitioners will be registered first, followed by physiotherapists and followed by chiropractors. Work permits now require vetting of candidates by the Singapore Chiropractors’ Association.

No protection of title exists, except that the “Dr.” title is degree dependent and may be used if the person holds a doctorate degree.

Slovakia
There is one chiropractor practicing in Slovakia. There is no legislation related to the practice of chiropractic in Slovakia.

Slovenia
The first chiropractor to practice in Slovenia opened an office in 1995. There is a remarkable level of public awareness due to extensive media coverage secured by a chiropractor practicing in Slovenia. “Chiropractor” is now a listed profession in Slovenia. Permission to work as a chiropractor is granted by the Minister of Health. No legislation related to scope of practice, protection of title, nor x-ray use exists and insurance rights are pending. The representative of the Slovenian Chiropractic Association requested to receive sample chiropractic laws and educational standards from anyone willing to provide the same.

South Africa
The 164 members of the Chiropractic Association of South Africa represent 87% of the profession in the land of Mr. Mandela. There are two educational institutions granting a master’s degree in chiropractic. Upon completion of a chiropractic degree, a one-year internship is mandatory for licensure. Eighteen continuing education development credits are required annually to renew a license. It was indicated that faculty are desperately needed at the two “Technikon” programs in South Africa (Wittwatersrand and Natal).

Spain
There are approximately 100 chiropractors practicing in Spain. The membership of the Associacion Espanola de Quiropractica (AEQ) is headquartered in Madrid and enjoys the membership of 85% of chiropractors practicing in Spain. An “Association of Patients” has been formed recently and the AEQ is offering lectures to the public through this patient advocacy group. In Spain, chiropractic is not legal and it is not illegal. There is a 16% tax on chiropractic care as compared to a 7% tax on physiotherapy care. Chiropractors have been prosecuted for practicing chiropractic and it is conceivable that someone could be incarcerated for practicing chiropractic. Two cases have recently been won and one person was deported in the recent past for practicing chiropractic.

There is hope for a chiropractic college to be developed in Spain. Twenty-five percent of the practicing chiropractors in Spain are Spanish nationals. The majority of Spanish chiropractors has been and continues to be educated in the United States.

Sweden
There are 130-140 members of the Swedish Chiropractic Association. Chiropractic practice has been authorized under law since 1989. Recently, the requirements for education have changed from an international standard (CCE) to a lesser one. Sweden has the unique circumstance of having an educational institution in Sweden that is recognized by the government, but is NOT recognized or accepted by the Swedish Chiropractic Association. As a result, there is the desire to require a university level education for chiropractors in Sweden. There is no protection of title. The term “authorized chiropractor” is recognized by the government. There are 300-400 people who call themselves “chiropractors” as opposed to “authorized chiropractor”. The former being unprotected, the latter protected.

Insurance reimbursement varies by county and continuing education is required. To acquire a work permit and thereby work in Sweden, you must have a family tie to Sweden. The Swedish representatives were quite blunt about this–if you have no family in Sweden, then don’t come here!

Switzerland
New legislation regarding the chiropractic profession as well as other professions has recently been developed. This legislation will replace the basis under which chiropractors have functioned for decades. Chiropractors, dentists and medics all train together for their first three years and then each splits off into a specialized program. Insurance coverages are changing, chiropractors are considered specialists and therefore patients will require a referral from a GP for payment of the visit.

Q: Only selected chiropractic colleges have been approved for their graduates to practice in Switzerland, what about accredited programs (AECC, Glamorgan, Surrey, McTimoney, IFEC, Sherman, Bridgeport, Life, Parker, Life West, RMIT, Macquarie) whose graduates are not eligible to practice in Switzerland?
A: Wait!

Taiwan
Legislation exists in Taiwan providing title and scope protection. Less than 20 chiropractors practice in Taiwan. Chiropractic is considered “non-medical,” and things non-medical are all common domain, therefore anyone can do anything “non-medical” regardless of training. They can’t however call themselves chiropractors.

The profession in Taiwan is seeking an agreement with a major Taiwanese charity to develop a chiropractic school.

Turkey
For the past four to five years, chiropractors have been practicing in Turkey.

Uganda
The story of Dr. Charles Sebwana, the first and only chiropractor is exciting. Dr. Sebwana is a 1995 graduate of the Anglo-European College of Chiropractic. Before returning to Uganda, he practiced for a number of years in the UK. He maintains a private practice and also sees patients at one of Uganda’s largest hospitals–Mulago Hospital in Kampala.

This was a blow-your-mind moment to listen to Dr. Sebwana and Dr. Sefar-Tawiah (Ghana). I am writing much of this from memory, as they were too spellbinding to take notes!

United Kingdom
The president of the British Chiropractors Association advised that they have a membership of 840 members. He advised of the Act of Parliament that created the General Chiropractic Council (Board of Examiners) and established a “registry” for chiropractors. To date, nearly 1,500 persons have sought to be registered by the GCC, a majority are registered by the GCC. The “register” will close on June 14 and the grandfathering window will be over. After June 14, it will be illegal to call yourself a chiropractor unless you are registered under the GCC. Additionally, the term “chiropractic assistant” will not be available for use in any way. After June 14, 2001, for anyone graduating from a chiropractic college other than the Anglo-European College of Chiropractic, the University of Glamorgan, the McTimoney College of Chiropractic or the University of Surrey, they will be required to sit for an examination similar to the NBCE Part IV exam.

The GCC has imposed a number of requirements on practitioners (they are already in “Board” mode) that will require a cost estimate as a patient begins care and the development and presentation of a diagnosis and care plan.

The recent Health and Social Care Act proposed limited prescribing rights for chiropractors and the same was passed on May 10. It was asserted that no dialogue with the chiropractic profession nor the GCC nor with any other impacted discipline preceded the introduction of the Act. The Act is an enabling Act. It provides the authority for certain prescribing rights to be granted to chiropractors and osteopaths. At some time in the future, another Act will have to be enacted to identify the exact rights involved and activate the same. The action was defended because it was expressed as including vitamins, minerals, cervical collars, knee braces etc. It was further asserted that the chiropractic profession of the UK would not accept prescribing rights of medicine without consultation involving all members of the GCC. The main value of the prescription of medicine aspect was argued to be ‘if we are without these rights we cannot recommend a patient be removed from prescribed drugs. If we do have those rights, we will be able to take people off those prescriptions’. (GWC Comment: I thought I had been given two spoonfuls of syrup of ipecac.)

Q: Regarding limited prescribing rights…the Chiropractic Association of South Africa received this same offer and they refused. What impact might this have on education in the UK and what will happen relative to persons coming from outside the UK?
A: The vast majority of the membership of the BCA has these concerns, the issue is foundational, and it is the current thinking that the chiropractic fraternity will not accept the bill.

Q: I would like to see the GCC come forward and assert that they would deny the rights.
A: No one has the authority to make such a declaration at this moment.

Q: 1500 DCs in the UK, about 1,000 are registered, would you tell more about the profession other than the BCA.
A: There are an estimated 1600 DCs in the UK, 850 BCA, the Scottish Chiropractic Association has 100 members and the McTimoney Chiropractic Association has about 550.

United States-ACA
The American Chiropractic Association discussed the recent developments with chiropractic services in the United States military. In addition, the lawsuit against the Health Care Financing Administration (HCFA) was reviewed. In addition, the legal action against Blue Cross/Blue Shield was discussed.

United States-ICA
A thirteen-page report was presented to the Assembly detailing ICA’s activity relative to chiropractic services involving the military and their dependents and the development and publication of the Recommended Guidelines for Chiropractic Practice. Copies of the proceedings of the Lisbon Conference from 2000 were also distributed.

Concern was expressed by ICA regarding the developments in the United Kingdom and the possibility of prescribing rights for chiropractors.

The report of the ICA can be received by contacting [email protected] or by calling 703-528-5000.

Zimbabwe
The chiropractic profession has been legislated in Zimbabwe since 1975 and there are presently five chiropractors practicing in the country. Ten percent of the population is employed and one percent has some form of health insurance coverage.

The staggering impact of AIDS in Zimbabwe was related as the nation’s most pressing health concern. There are 2,000 AIDS deaths per week in Zimbabwe alone, 30%-45% of the population is thought to be infected with HIV. Life expectancy for the population as a whole has declined from 69 years to 45 years.

—Gerry Clum, D.C.

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Comment: Thank you to Dr. Gerry Clum and Life West College for providing this information. Send Gerry and Life West some students to fill the new campus, he would like that.

Congratulations to Dr. Clums daughter Lauren on her recent graduation from Sonoma State University.

The Latest Stuff from Gerry Online, a FREE newsletter from Dr. Gerry Clum, President of Life Chiropractic West (http://www.lifewest.edu).

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