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http://chronicle.com/free/v51/i21/21a01001.htm
| From the issue dated January 28, 2005 |
Not in Our Backyard
Doctors at Florida State's new medical college say a proposed chiropractic school would be a pain in the neck
By KATHERINE S. MANGAN
A proposal to open the country's first chiropractic college at a public university has professors at Florida State University bent out of shape.
Hundreds -- including about 70 medical professors -- have reportedly signed petitions against the school, and eight part-time medical professors have threatened to quit if it opens. The controversy has opened an angry debate between chiropractors and more-traditional doctors and raised questions about the way higher-education decisions are made in Florida. Ultimately, the battle is about legitimacy. Supporters hope that a public chiropractic college would give the profession respect, but opponents say such respect isn't deserved.
Last year the state Legislature, led by a well-connected chiropractor, approved $9-million a year for the chiropractic college before either the university or the state's Board of Governors had determined it was needed. Lawmakers have estimated that it will cost more than $60-million over the next five years to build the college. Now professors who view chiropractic medicine as "pseudoscience" are feeling manipulated, and they're fighting back.
They launched an aggressive media campaign to pressure the university's trustees to pull the plug on the proposed college. But instead of voting yes or no, the trustees opted this month to toss the political hot potato to the Board of Governors, which is scheduled to vote on the matter this week. The board could vote to kill the school, or it could toss the matter back to the university for further review, and ultimately a vote. That could delay a decision for months, or even years.
The college's foes called the trustees "cowardly" for sidestepping the decision, while frustrated trustees said the Board of Governors was giving them mixed messages about who was supposed to act first: the university or the statewide board.
Last week Gov. Jeb Bush jumped into the debate, criticizing Florida State's handling of the matter and suggesting that the Legislature slash the $9-million appropriation for the chiropractic college to $1.9-million. He said faculty members had been cut out of the debate, and that the university's trustees should have taken a stand on the college rather than turning to the Board of Governors.
The university's provost, Lawrence G. Abele, defended the trustees' action. "I don't think it's fair to ask our faculty to go through a long debate if the Board of Governors has no intention of approving it," he says.
Some of those board members have expressed strong reservations about the chiropractic college, and there is widespread speculation that they will vote to kill it. If the board does vote in favor of the college, "the normal university processes would kick in, including a full debate by the faculty," Mr. Abele says.
Alien Studies Next?
Critics say a public university is no place for a chiropractic school, and they have been circulating a campus map that pokes fun at the proposal by suggesting that schools of extraterrestrial or past-life studies might come next.
Professors at the four-year-old College of Medicine -- the nation's youngest -- are particularly sensitive about the addition of an alternative-health-care college at a university whose provisionally accredited medical school is still awaiting full accreditation. The two colleges would be separate, but medical professors who oppose the chiropractic school argue that it would taint the reputation of the entire university.
"Most of the faculty I speak to are saying this is absolutely ludicrous and we'd be the laughingstock of the academic world," says Raymond E. Bellamy, an orthopedic surgeon and assistant professor of medicine who is leading the charge against the proposal. "Chiropractic is not science-based. Not one major university in North America has a connection with a chiropractic school. There's a reason for that."
This is not the first time that traditional medical and chiropractic educators have clashed over a proposed school. In 2001 York University, in Toronto, decided against affiliating with the Canadian Memorial Chiropractic College after faculty members objected.
At Florida State, supporters counter that doctors and medical professors are feeling threatened by a practice that is growing in popularity and could cut into their business. Lawmakers who approved the money for the college say it could attract millions of dollars in federal support for alternative medicine and be the nation's pre-eminent chiropractic college.
The Florida chiropractor who has championed the new school in the Legislature, Sen. Dennis L. Jones, has accused professors who oppose the school of fomenting rebellion on the campus by misleading their colleagues about the chiropractic profession. The professors have been joined in their protests by prominent critics of chiropractic medicine from outside of Florida -- doctors who Senator Jones says have a bone to pick with the profession.
"I have no problem with these people quitting," says Senator Jones, a Treasure Island Republican, referring to the eight part-time Florida State professors. "If they're spreading professional bigotry, they shouldn't be teaching students anyway." Despite opponents' claims that manipulating necks and spines can injure patients, he argues that chiropractic care is safer than other forms of medicine, in part because it allows some patients to avoid risky surgery or potentially debilitating medications.
He points out that chiropractors are provided on 44 military bases in the United States, as well as in a growing number of Veterans Affairs hospitals. Some 15 million people in the country regularly visit chiropractors, according to the National Institutes of Health's Center for Complementary and Alternative Medicine.
"If it's good enough for the U.S. military, you'd think it would be good enough for FSU," the senator says.
Another Florida chiropractor is more conciliatory. "I have so much respect for those medical professors; to lose one of them over this issue would be tragic," says Lance Armstrong, a chiropractor in Cocoa Beach, Fla., who serves as president of the Florida Chiropractic Association. He became a chiropractor after a rough landing in a B-52 left him with severe neck pain that medication did not relieve. A chiropractor helped him resume his first career as a flight instructor, he says.
"I work closely with the medical profession, but I strongly believe that there are some issues of musculoskeletal injury where the medical world doesn't know as much as we wish they did."
Scientific Debate
If approved, Florida State's chiropractic school would open at the university's Tallahassee campus in 2007 and eventually enroll up to 500 students, who would be required to have a bachelor's degree. They would spend five years in the program earning both a chiropractic degree and one of five public-health master's degrees -- in aging studies, food and nutrition, public health, movement science, and health-policy research -- currently offered at the university.
Graduates would be at least as qualified as their counterparts in the medical school to treat patients with nagging backaches, chiropractors argue.
Donald J. Krippendorf, president of the American Chiropractic Association, accuses the profession's critics of playing politics and putting the financial interests of physicians ahead of the best interests of patients.
"Doctors of chiropractic are specifically and uniquely qualified to diagnose and treat problems of the musculoskeletal system, with an education that includes more than 2,000 hours of study devoted to the human spine and nervous system," he wrote in a December 16 letter to the St. Petersburg Times. "Conversely, a 2002 study published in The Journal of Bone and Joint Surgery found that 78 percent of medical doctors failed to demonstrate basic competency in musculoskeletal medicine and that medical-school preparation in musculoskeletal medicine is inadequate."
Alan H. Adams, an administrator who was hired to oversee curriculum development at the new school, says critics are misleading the public when they say that chiropractic medicine is not scientific or rigorous. Critics say a research university is no place for chiropractors because the field is not based on science.
"That argument doesn't hold water today," says Mr. Adams, a longtime educator at the Los Angeles College of Chiropractic. "The profession has been active in research for nearly 30 years," he says. "Chiropractors have been publishing articles in more than 70 medical and scientific, peer-reviewed journals."
He says a public chiropractic school would provide an affordable and accessible education for Florida residents, who now have to pay private-school tuition if they want to become chiropractors. Florida has one private chiropractic school, a branch of Palmer College of Chiropractic, in Port Orange. It is one of 16 accredited chiropractic schools in the United States that, combined, enroll about 10,000 students. Many more graduate from unaccredited colleges.
A public school would also open the profession's doors to more black and Hispanic students, supporters say. In Florida those groups represent about a quarter of the patients receiving chiropractic care, but fewer than 2 percent of the chiropractors, according to a study commissioned by the university.
This month a group representing about 500 Tallahassee-area physicians urged university and state officials to drop plans for the school, which David Stewart, president of the Capital Medical Society, an association of Tallahassee-area doctors, said had become "a political football."
Dr. Bellamy says he has nothing against chiropractors. "This isn't a turf battle," he says. "I was leaving well enough alone until they wanted to bring a school on my campus, and that's where I draw the line."
He says hundreds of local doctors and Florida State faculty members, including the university's two Nobel Prize winners, have signed e-mail petitions questioning the proposed chiropractic school. He could not verify that number -- which others say is exaggerated -- because he said the responses were scattered in e-mail boxes around the campus.
Ian W. Rogers, a plastic surgeon, is one of the eight part-time Florida State professors who have said they will no longer teach the university's medical students if the school is approved.
"Members of the Legislature have decided to impose the nation's first public chiropractic school on a university with a nonestablished, fledgling medical school, weakening its yet-to-be-established reputation," he wrote in an e-mail message to The Chronicle. "Are the graduating doctors going to be left vulnerable to future taunts from their colleagues nationwide?"
Edward J. Shahady, a professor of family medicine and rural health at Florida State, also worries that a chiropractic college could damage the reputation of the medical school, even though the schools would be separate. "No one wants to be a graduate of a school that people associate with pseudoscience," he says.
He also complains that faculty members were not consulted adequately or soon enough. "Academics are funny like that," he says. "We like to have some say in what happens at our university. At this point, we're almost at the 11th hour, trying to stay the execution."
Oversight Questions
The school's critics charge that state lawmakers have made veiled threats that they might cut money for the medical school if professors stand in the way of the chiropractic college.
Sen. James E. King Jr., a Jacksonville Republican, has been quoted as saying the Legislature would be "angry" if the chiropractic college were derailed. But he has denied charges that he has threatened to retaliate against medical professors if they succeed in killing the proposed college.
The Florida Board of Governors, which will step into the fray with its vote on the proposed school this week, was created in 2002 to oversee public universities. It replaced the Board of Regents.
A group of educators, lawyers, and politicians sued the state's higher-education system in Leon County Circuit Court last month, arguing that the system had shirked its duties by not exercising its authority to oversee higher education and prevent state lawmakers from pushing pet projects through the Legislature (The Chronicle, January 7). The plaintiffs, including E.T. York, a former chancellor of the state-university system, cited the chiropractic school as an example of a program that was financed by the Legislature without first getting the approval of the Board of Governors.
Lawmakers who support the school counter that plans for a state chiropractic college began long before the Board of Governors was created.
Dr. Armstrong, the Florida chiropractor, says he is still hoping to win over skeptics. Working side by side, doctors and chiropractors could learn more about the strengths and limitations of each profession, he says.
"If you took two Florida State football players who suffered serious injuries to the spine and one wished our care and the other didn't, and you followed their spinal health over the next 30 years, I think we'd come through gleaming," he says. "This is a glass ceiling, and it will be broken at FSU or another school. We hope it will be here."
http://chronicle.com
Section: The Faculty
Volume 51, Issue 21, Page A10
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