New AMA Guidelines Violate Wilk Injunction, Says ACA
Invoking the court decision in the landmark Wilk
vs. AMA lawsuit, the American Chiropractic
Association (ACA) has asked for an immediate
withdrawal of restrictive language in the
American Medical Association’s "Guides to the
Evaluation of Permanent Impairment, 6th Edition"
that limits evaluations by doctors of chiropractic
to the spine only. ACA has also contacted the
Federal Trade Commission and the U.S. Department of
Justice regarding concerns about the new guidelines.
"In our view, the action of the AMA in issuing this
standard unlawfully restricts competition and
excludes a competitive rival, i.e. doctors of
chiropractic from the provision of impairment
ratings," writes ACA General Counsel Thomas R. Daly
in a Feb. 13 letter to AMA Executive Vice President
Michael D. Mabes, M.D. "We note that neither the ACA,
nor any other major chiropractic group, was
approached or provided input in the standard setting
process that established this new restriction."
The language in question is published on page 20 of
the AMA guide in a section titled "Fundamental
Principles of the Guides." Specifically, Item 6 of
Table 2-1- states: "A licensed physician must
perform impairment evaluations. Chiropractic
doctors, if authorized by the appropriate
jurisdictional authority to perform ratings under
the Guide, should restrict rating to the spine."
"This new standard has a devastating effect on
doctors of chiropractic in that it will be used to
prevent doctors of chiropractic from performing
adequate and complete ratings," ACA’s letter to the
AMA states. "It targets doctors of chiropractic for
exclusion or elimination from this important service
which they currently provide under state law in
competition with medical doctors."
ACA’s letter also reminds the AMA of the Wilk
decision and states that the "recent action which
implements a new and onerous restrictive standard on
the practice of doctors of chiropractic violates
existing antitrust law as well as the provision of
the permanent Wilk injunction."
ACA’s legal team is also seeking meetings with
representatives of the Federal Trade Commission and
the anti-trust division of the Department of Justice
to outline the association’s concerns. In addition,
ACA is identifying members of Congress who might be
willing to assist the association in its efforts to
redress the problem.
for a full copy of ACA’s letter to