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.

Click here for a full copy of ACA’s letter to AMA.