Northwestern chiropractors recognized for making state history

Liala Helal | May 18, 2015

Seven years in the making, their work to update Minnesota’s chiropractic scope of practice reaches far


A special award announced by the Minnesota Chiropractic Association (MCA) recognized seven years of work by Northwestern Health Sciences University thought leaders to achieve a historic moment for chiropractors and their patients across the state.

The 2015 Champions of Chiropractic award in late April this year went to Dr. Joseph Sweere, Dr. Chuck Sawyer, and David Kunz who is a government lobbyist for Northwestern through the Center for Healthcare Innovation and Policy, for modernizing the scope of chiropractic practice in Minnesota, which was signed into law last year.

Dr. Sweere, a doctor of chiropractic and 1961 alumnus of Northwestern’s College of Chiropractic, is the founder and advisor to the H.C. Sweere Center for Clinical Biomechanics and Applied Ergonomics at Northwestern Health Sciences University.

Dr. Sweere led the Scope of Practice subcommittee of the MCA during the process, which included Dr. Sawyer, Vice President for Innovation at Northwestern and 1977 alumnus of Northwestern’s College of Chiropractic, nine other doctors from outside Northwestern, and Kevin Goodno, who is the lead lobbyist for the association, as well as Kunz.

Original language in state law defining chiropractors’ scope of practice had existed since 1919, but no major changes had been made since. The modifications were important to the future of the profession because the new language, which Dr. Sweere assisted in crafting, helps avoid possible disagreements about interpretations of chiropractic scope of practice. It clarified ambiguous language and strengthened the legal authority supporting current chiropractic practices, and modernized the language used in the statute.

 “Clearly articulating and enacting into law what chiropractors are trained in and practice on a daily basis was long overdue”, Dr. Sweere said.

The seven-year process presented many hurdles.

“We were often confronted by conservative members of the profession who feared we were expanding the scope of practice too far, and they would come to the capitol and protest what we were doing,” Dr. Sweere said. “They would literally follow us after meetings with legislators to express their concern. It took a lot of work to gradually neutralize those attitudes to get this in place. Over a period of time and many local and statewide meetings, we were able to bring them to the table and go around, listen, hear them out and sufficiently modify the language to satisfy their concerns.”

Dr. Sweere led the efforts to mediate and get people on board.

“I was particularly grateful to have that opportunity — it’s somewhat historic after all these years, and all these struggles, to have this important legislation pass,” Dr. Sweere said.

Dr. Sweere and his team also worked with members of other health care professions to show chiropractors were not invading on their scope of practice with this new language.

“We had to satisfy the concerns of other practitioners who provide care ― medical doctors, nurses, physical therapists, nutritionists, etc…over what our scope and authority was going to be and whether it was going to invade their authority,” Dr. Sweere said.

The main changes define “diagnosis” in the scope of chiropractic and “chiropractic services.” It also introduced changes to the language linking “therapeutic services” and “chiropractic adjustment.”

“The language of the new law contributes to many mutual causes between professions, and most importantly, it benefits our patients since we are now able to provide them with more optimal care with our training,” Dr. Sweere said.

Many individuals, organizations and government officials were involved in the efforts, and Dr. Sweere was responsible for bringing people together in agreement.

“Under Dr. Sweere’s calm, steady leadership, working alongside our lobby team, we had a very successful outcome,” said Dr. Sawyer. “Getting that bill to pass and ultimately signed by the governor was a big accomplishment. Dr. Sweere’s leadership was critical, especially his ability to bring various thoughts and factions of the profession together. His skillful diplomacy and his persistence and steadfast commitment to pursuing those changes was something that I and many others admired.”

An effective lobby team is also critical when pursuing legislation, and Kunz assisted the team representing the Minnesota Chiropractic Association.

“Dave is a great asset to the chiropractic profession in Minnesota,” Dr. Sawyer said. “He is very bipartisan and we have many friends from both parties as a result of his constant presence at the Capitol. He works hard and over the years he has helped me understand the complexities of state politics.”

Minnesota Governor Mark Dayton signed the updated scope of practice into law in August 2014, updating Minnesota law to reflect current chiropractic practice.

“It was truly a historic event,” Dr. Sweere said. “95 years is a lot of years to not be grounded.”

Chiropractors were always able to diagnose patients’ conditions through the training they received for the doctor of chiropractor degree, but by law, their authority to do so could be questioned because it was not clearly spelled out in the state’s scope of practice.

“It was a double-edged sword,” Dr. Sweere said. “Now we’ve defined our diagnostic privileges. The original law was unclear on diagnostic privilege and authority.”

Dr. Sweere felt honored to work on the language in the Minnesota statutes.

“Words are critical, that’s how I felt,” Dr. Sweere said. “The language had to be such that it had to have no opposition from other care providers as well as satisfy the concerns of all of our chiropractors. As the story unfolded, I found that I played a greater role in the latter challenge.”

There are about 2,400 licensed chiropractors in the state who are now protected by the new language, and can more clearly treat patients, Dr. Sweere said.

“A lot of this was motivated by wanting our graduates to practice at the top of their license,” Dr. Sweere said. “This puts us in a better position as we move toward an integrative healthcare system.”

Beyond the legal aspect, the far-reaching accomplishment also corrects public misconceptions about chiropractic care only being “alternative” treatment.

“It finally defines us with clarity to the world, similar to other practitioners,” Dr. Sweere said.

A History of Service

Northwestern’s contribution to this successful effort is a recent example of the collaborative relationship between the University and the Minnesota Chiropractic Association.

“It’s important that we do this work because our involvement can have an impact on the future of our graduates,” Dr. Sawyer said. “It also provides an important opportunity to involve students in the political process and creates an awareness of the importance of advocacy.”

Dr. Sweere, who was president of the Minnesota Chiropractic Association in 1976, and Dr. Sawyer have contributed other major advancements to the profession across Minnesota and the world. Among other awards, they have both been recognized by their colleagues in the association as MCA Chiropractor of Year; Dr. Sweere in 1979 and Dr. Sawyer in 2011.

Dr. Sawyer was named to the MNsure advisory committee in 2013, advising and making recommendations to the MNsure Board of Directors.

 In 2012, Minnesota Physician Magazine named Dr. Sawyer in its list of 100 Influential Health Care Leaders.

As a leading authority on occupational health, Dr. Sweere served for 34 years as chairman of the Rehabilitation Review Panel for the Minnesota Department of Labor and Industry and has served on the Workers’ Compensation Advisory Board for the state department of labor. He practiced chiropractic for 25 years and has been a full-time educator since 1986, before recently becoming founder and advisor of Northwestern’s Sweere Center for Clinical Biomechanics and Applied Ergonomics in 2011.

Dr. Sweere is also the Minnesota Chiropractic Representative to the Workers’ Compensation Research Institute in Cambridge, Mass. In addition, he is the founder, current president and member of the Board of Directors of the International Academy of Chiropractic Occupational Health Consultants.

Dr. Sweere wrote a book on health and wellness, published in 2004, Golden Rules for Vibrant Health in Body, Mind and Spirit: A Holistic Approach to Health and Wellness and a chiropractic clinical manual in 1992. He has given presentations about chiropractic and health topics around the world.

In 1999, Dr. Sweere was selected to serve as the chiropractic spokesperson at the federal (OSHA) stakeholder’s meetings regarding the Proposed Ergonomics Standard for the prevention of neuromusculoskeletal disorders. From 1980 through 1986, he was the principal investigator for the Viracon Project, an industrial spinal injury prevention program. He is also the developer of the Biomechanical Stress Index (BSI), involving physical and biomechanical screening for the prevention of work-related lower spinal injuries.

Dr. Sweere says an important defining component of a profession is the collective activity of a group of similarly-trained, like-minded individuals working toward a common cause.

“I have always found great satisfaction in working with my colleagues in the gradual attainment of chiropractic’s primary cause: that of serving as a beacon of hope for suffering humanity,” Dr. Sweere said.

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