Chiropractic – from CAM to conventional health care
Chiropractic in Italy is an example of how CAM modalities can get acceptance from medical health authorities.
The classification of professions into medical and non-medical, non-conventional or alternative is somewhat contrived; akin to dividing the Transport into automobile and non-automobile. Health Care is an important and vibrant sector of the economy. Economic agents participating in the clinical field are Health Care Operators. The House of Lords proposed a system of classification based on years of training and competences such as diagnosis (1).
Some professions are available to a majority of citizens and integrated fully into the health care system are considered mainstream. As with any sector of the economy health care is in continuous evolution. EU Flagship Initiatives (2) and OECD Health Workforce Projects (3) promote New Skills and Jobs and innovation. New health care professions emerge, grow in use and acceptance and become mainstream. Chiropractic is following this path in Italy.
The World Federation of Chiropractic defines Chiropractic as: “A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.”
The Italian Republic protects health as a fundamental right of the individual; safeguards the principle of scientific pluralism; and ensures the individual a right to choose in health care. Chiropractic in Italy was first rudimentarily regulated in two Ministerial Circulars in 1982 (4) and 1984 (5). WHO guidelines on basic training and safety (6) were issued in collaboration with the Regione Lombardia in 2005.
In 2007 the Italian Parliament recognized chiropractic in legislation as an autonomous primary health care profession. (7). The FNOMCeO (14), representing the medical profession, in Guidelines for training in Medicine and Practice of Non-Conventional Medicine, 12 December 2009 (8) eliminated chiropractic (and osteopathy) from the list of methods considered CAM for medical doctors and dentists.
Relations with WHO
International agencies, members of the Council on Chiropractic Education International, benchmark and accredit the training and practice of the profession. The US Government recognizes the CCE (USA) and the European Council on Chiropractic Education is a member of European National Quality Assurance (ENQA); a CEN standard for Chiropractic Services is soon to be published; and the World Federation of Chiropractic has official relations with WHO. The European Chiropractors' Union promotes the development of chiropractic in Europe; is included in the EU Transparency Register and is a member of the European Health Forum.
Induction into the Association of Italian Chiropractors requires a chiropractic degree from a college accredited by a CCEI member agency; completion of the Graduate Education Programme coordinated the European Academy of Chiropractic; Continuing Professional Development. At December 2011 AIC membership numbered 240: 82 Italians, 60 other Europeans, and 98 non-Europeans. 78 qualified from European colleges of chiropractic and 168 from non-European colleges.
In the US chiropractic is the third largest primary health care profession after medicine and dentistry (9); in the UK chiropractic is legislated and regulated; in Denmark and Norway chiropractors number over one per 10000 of the population (10-11; 12-13) and are fully integrated into Health Policy and Health Programmes. In Italy the chiropractic profession is an emerging innovation in Patient-Centred, Predictive and Personalized Health Care.
Baiju Khanchandani, Doctor of Chiropractic, Association of Italian Chiropractors.
Public Health Committee, European Chiropractors' Union.
1) Classification of professions. House of Lords, Science and Technology, Sixth Report, 21/11/2000.
2) Europe 2020 Flagship Initiative: Agenda for New for New Skills and jobs
3) OECD: New Skills for New Jobs in Health
4) Italian Health Ministry, Circolare n° 79 del 21 dicembre 1982
5) Italian Health Ministry, Circolare n° 66 del 12 settembre 1984
6) Linee guida OMS su formazione di base e sicurezza in chiropratica
Who Guidelines on Basic Training and Safety in Chiropractic; Geneva 2005
7) Legge 244 del 24 dicembre 2007 art. 2, comma 355, riconoscimento della Chiropratica
8) FNOMCeO: Linee Guida per la formazione nelle Medicine e Pratiche non Convenzionali del 12 dicembre 2009
9) Wikichiro 10.06.2012 ref 58
Establishing a database of U.S. chiropractic health manpower data: furthering the development of research infrastructure. National Library of Medicine, retrieved 2008.
10) Danish Chiropractic Association, 700 Members
11) Wikipedia, demographics of Denmark, 2007
12) Norwegian Chiropractic Association
13) Wikipedia, demographics of Norway, 2010
14) FNOMCeO: Federazione nazionale degli ordini dei medici =
The national federation of medical doctors’ associations (Italy)