Ohio Debates Chiropractors’ Role in Concussion Management

College Football Player Some Ohio medical doctors are unhappy over a state budget provision that would give chiropractors the authority to determine whether or not a student athlete with possible concussions should be allowed back into a game.

In December 2012, the Ohio State Legislature passed House Bill 143, which detailed the management of sports-related concussions. The law mandates removing an athlete suspected of having suffered a concussion from the game, practice, or other activity. Players are not allowed to return until cleared directly or under the guidance of a physician.

Recently, however, a provision was made to Ohio’s budget bill, HB 59, which would allow chiropractors to independently manage concussion and return to play. Republican Rep. John Adams added the amendment to HB 59 in April before the House sent the budget to the U.S. Senate. Currently, the law only gives doctors of medicine or osteopathic medicine the authority to clear a young athlete for a return to sports. Not surprisingly, the provision seeking to include chiropractors did not sit well with many in the traditional medical profession.

Tim Maglione, the Ohio State Medical Association’s senior director insinuated the new provision was reckless, especially because it dealt with children. He argues that any physicians’ training is more extensive than that of any chiropractor. While he acknowledged chiropractors have a place in the overall care of athletes, he does not think it extends to assessing concussions.

In May 2013, Maglione wrote a letter to the Ohio State Senate urging lawmakers to reject the provision. The letter was signed by officials with the Ohio Chapter of the American Academy of Pediatrics, Ohio Children’s Hospital Association, Ohio Athletic Trainers Association, Ohio Hospital Association, and Ohio Osteopathic Association.

But proponents of the provision, however, disagree and point out that chiropractors undergo thorough training in neurology and are indeed qualified to make the assessments. Representative Adams believes doctors of chiropractic are adequately prepared to release concussed athletes back to normal activities. According to the Ohio State Chiropractic Board, chiropractors licensed in the state have been permitted to diagnosis, manage, and clear patients with concussions since 1975.

Chiropractor Kreg Huffer, who is also spokesman for the Ohio State Chiropractic Association (OSCA), testified in favor of the amendment, detailing the long history chiropractors have of working in athletics. In addition, Huffer pointed out that chiropractors in Ohio are only licensed after completing 149 hours in neurology training, 271 hours studying X-rays, and 168 hours of orthopedic course work. In fact, says Nicholas Strata, director of legislative affairs for OSCA, the neurology training chiropractors undergo can actually be more rigorous than for med students.

A final determination will be made soon.

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