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The Joint Commission Now Recognizes Chiropractors as Physicians
By William Morgan, DC
The Joint Commission, the largest credentialing body for hospitals and health care organizations in North America, has recently changed its stance on the recognition of chiropractors. This organization now recognizes chiropractors as physicians.¹-² This is a major policy change from decades ago, when the commission published an article entitled “The Right and Duty of Hospitals to Exclude Doctors of Chiropractic.”³
The Joint Commission (JC) was one of the organizations named in the Wilk antitrust lawsuit for allegedly restricting the profession of chiropractic. It has grown in maturity since those days and is now a major force for good in the provision of health care in the United States and in Department of Defense (DOD) medical facilities worldwide. JC is no longer simply a private policeman for the health care industry; it now considers itself a partner in health care. This is evident in its new motto: Helping Health Care Organizations Help Patients.4
The current list of JC-recognized physicians includes medical doctors, dentists, podiatrists, optometrists and chiropractors. Chiropractors and optometrists are recent additions.
What Is the Joint Commission?
The Joint Commission, formerly the Joint Commission on Accreditation of Health Care Organizations (JCAHO, pronounced jay-co), is a non-profit private organization that accredits health care organizations. JC credentials 17,000 different health care entities. It provides a fee-based credentialing process, in which hospitals participate. Even though submitting an application to this private organization for credentialing is technically voluntary, from a practical perspective, failure to have JC accreditation would very likely lead to the closure of a hospital. Joint Commission credentialing is the standard that all successful hospitals, including government facilities, attain.
JC has changed in recent years from being an inspection and credentialing institution to being a proactive partner in improving health care. The new JC identifies particular patient safety needs and educates participating organizations about how to optimize treatment and to prevent sentinel events, prescription errors, wrong-side surgeries, nosocomial infections and a variety of patient safety concerns. It now provides leadership, guidance and education to the hospitals it credentials.
Every hospital-based chiropractor can tell you about the impact that JC has on clinic standards, record keeping and policy. Hospital-based chiropractic clinics write their policy with JC in mind. Fortunately, JC values interdisciplinary collaboration greatly and likes to see evidence of patient-focused teamwork.
Not Everyone Is Happy With This Change
Even though JC clearly stated this change will in no way diminish the authority of medical doctors, there has still been an outcry from certain medical organizations5 that do not want chiropractors (and optometrists) added to the list of physicians. These organizations are lobbying JC in an attempt to have DCs and optometrists removed from physician status.
Why Is Physician Status Important?
The reason that we should be concerned about JC’s physician designation is the wide-sweeping impact JC has on health care in North America. JC influences Medicare, Medicaid, the DOD, the Veterans Administration, the Public Health Service and virtually every hospital in the United States. This private organization will have a monumental impact on how all of the other players in health care perceive and treat chiropractors in the future. Being designated as a physician by a prestigious organization lends far more credibility to chiropractic than being categorized as technicians.
Dr. Morgan splits his clinical time between a hospital-based chiropractic clinic and two Washington, D.C., executive health clinics. He is adjunct faculty for F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences and New York College of Chiropractic. He can be reached through his Web site, www.drmorgan.info.
1. Joint Commission Perspectives, June 2009. Volume 28, Issue 6.