SB641

Dear House Executive Departments and Administration, My name is Dr. Daniel Kyparissis and I am the President of the New Hampshire Chiropractic Association (NHCA). I am writing this testimony on behalf of the NHCA, as we do not support SB641. The NHCA Board of Directors recently voted to oppose this legislation after receiving feedback from our members via survey. Our NHCA board and members are Doctors of Chiropractic who practice in the state of New Hampshire. Many members within the NHCA have taken the Part IV National Board of Chiropractic Examiners (NBCE) test and believe it should remain a requirement. Chiropractors have worked hard to elevate the educational standards related to our profession over the past several decades. SB641 raises many concerns. The removal of the NBCE PART IV exam, without a doubt, will lower the credibility of Doctors of Chiropractic throughout our state. Chiropractic students who can not pass the PART IV exam will make their way to New Hampshire. For many people, chiropractors are the first stop someone goes to with a health concern. The PART IV exam makes sure that chiropractic students are proficient in various subjects including clinical decision-making, physical examination skills, diagnostic imaging interpretation, case management/emergency skills, patient interaction/professionalism, and chiropractic technique. There is no reason New Hampshire chiropractors should lower the standard. Please consider all of the repercussions that may follow the approval of SB641. Thank you very much for your time. Sincerely, Daniel Kyparissis, DC President, NHCA

Hello to the honorable committee members, I'm writing to oppose SB 641. As a practicing chiropractor, it is unacceptable for us to lower our standard for new doctors in the field. As primarily hands-on health care providers, the Part 4 of our board examinations is the only place for individual accountability for learning outcomes in people's practical clinical skills. While the supporting parties compare this test to analogs that were removed in other professions, patients of MDs and DOs are not nearly so dependent on their hands-on skills. The other professions also have residency as a supervised proving ground for their practical clinical skills. Part 4 incentivizes graduating chiropractors to firm up their hands on and clinical skills before they start seeing patients on their own, and NH should not become the first and only state to lower this requirement. Thank you for your attention. Sincerely, Brendan McCann, DC Newmarket, NH

Dear Chairman Layon, I'm writing you this morning regarding SB641 relative to licensure requirements for chiropractors. I am the past president and current board member of the New Hampshire Chiropractic Association and had hoped to testify today in opposition to this legislation but am unable to attend . Please consider this letter as written testimony. The NHCA Board of Directors recently voted to oppose this legislation. We are the oldest chiropractic organization in New Hampshire, dating back to the early 1900's, of which I have been a member for 40 years. We have concerns regarding this legislation. Chiropractors have worked hard to elevate the educational standards related to our profession over the past several decades. This has included the formation of organizations such as the National Board of Chiropractic Examiners. Through their efforts we have been able to elevate educational standards across the country and even enabled our own State Board of Chiropractic Examiners to eliminate certain aspects of testing, such as in person examination, a requirement when I received my license to practice in the State of New Hampshire. This legislation effectively eliminates that component of evaluation with no replacement. Proponents of this legislation will argue that federal standards set by the Department of Education for the accreditation of Chiropractic Colleges satisfies the necessary standards for chiropractors. I disagree. These organizations establish "minimum standards" for academic programs. They do not ensure that an institution is living up to standards set, or that their graduates have achieved a level of competence consistent with excellence in practice. There is without a doubt variation in quality and competence in the institutions providing Chiropractic degrees. These testing programs are essential toward ensuring the individuals seeking licensure in New Hampshire are of high caliber. Passage of this legislation may encourage individuals hoping to avoid this testing to seek licensure in New Hampshire whereas we will be the only state in the country that has eliminated this requirement. I do not believe this serves the residents or the Chiropractic profession well in the State of New Hampshire. It is my hope that you will recommend further study in regards to this legislation. Sincerely, Mark W. Stagnone, D.C. Londonderry, NH 603-738-7306