Should naturopaths be allowed to perform sports physicals?

Maya Sugarman/KPCC

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A bill in the California legislature would authorize chiropractors and naturopathic physicians to conduct physicals for aspiring student athletes. 

Current law authorizes physicians, surgeons and physician assistants to do the exams, which involve taking a student's medical history and looking for any cardiovascular, respiratory or neurological conditions that could make it unsafe for him to play sports.

Chiropractors have legally been doing sports physicals in California for more than 30 years, according to the bill's author, Sen. Anthony Portantino (D-La Canada Flintridge). He says the bill, SB 746, is needed because an outdated section of the education code does not list all health care providers qualified to perform the tests.

Some school districts are only accepting these physicals when performed by a health care provider listed in the education code, according to an analysis by the State Senate's Education Committee.

The California Chiropractic Association sponsored Portantino's measure, which would also add nurse practitioners to the list of those permitted to perform sports physicals.

The legislation marks the latest round in an ongoing battle between the medical establishment and chiropractors and naturopaths.

Several medical groups oppose the bill, including the California Medical Association, the California Academy of Family Physicians, the California Academy of Pediatrics and the California chapter of the American College of Emergency Physicians.

"Athletic pre-participation exams protect students by reviewing their medical history, as well as assessing cardiovascular, respiratory and neurological risks," says CMA spokeswoman Joanne Adams. "Unlike medical doctors, chiropractors and naturopaths receive limited training that doesn't equip them to completely assess a student's risk." 

Naturopathic doctors can conduct physical exams and "this bill does not increase or change the scope of practice for any of the providers listed," says Jennifer Bahr, president of the Naturopathic Association. "It simply removes an administrative barrier for California's parents and children, and improves access to and choice in care." 

Naturopaths are trained in four-year "post graduate naturopathic medical schools that are comparable to that of an MD or [Doctor of Osteopathy,]" says Bahr. "This training includes the same diagnostic skills and tools as medical doctors, including physical exams."

Chiropractors are also trained through four-year, doctoral graduate programs, according to the American Chiropractic Association. 

Dr. Dennis Buckley, a chiropractor and the co-owner of Health Advantage Physical Medicine in Pasadena, says he's been legally conducting sports physicals for more than 20 years. 

Chiropractors are "probably one of the best people to do this type of screening," based on their knowledge of posture, reflexes, strength, movement, range of motion and joint stability, he says.