Spinal Chat with The PCA

Pennsylvania Chiropractic Association
  • 5.0 (2)
  • NON-PROFIT

The Spinal Chat – A Service of the Pennsylvania Chiropractic Association Welcome to The Spinal Chat, the official podcast of the Pennsylvania Chiropractic Association (PCA), your front-row seat to everything shaping Pennsylvania’s $800 million chiropractic industry. Each episode brings you insights from industry luminaries, conversations with PCA’s Strategic Business Partners, and practical guidance to help chiropractors strengthen their practice, elevate patient care, and thrive in today’s evolving healthcare landscape. From study breakdowns and legislative updates to member spotlights and stories that celebrate the power of chiropractic, The Spinal Chat is your trusted source for connection, knowledge, and advocacy in the Commonwealth and beyond. Tune in, stay informed, and be part of the movement advancing chiropractic in Pennsylvania. Contact the PCA Email: pca@pennchiro.org PCA: https://pennchiro.org/

  1. PCA Deep Dive: Pennsylvania’s Chiropractic Scope Fight; Modern Care vs. Outdated Laws

    6D AGO

    PCA Deep Dive: Pennsylvania’s Chiropractic Scope Fight; Modern Care vs. Outdated Laws

    PCA Deep Dive: Pennsylvania’s Chiropractic Scope Fight; Modern Care vs. Outdated Laws In this episode of PCA Deep Dive, we examine one of the most important questions facing chiropractic in Pennsylvania: What happens when modern chiropractic education, modern patient needs, and conservative care collide with an outdated scope-of-practice law built for another era? Pennsylvania’s chiropractic scope of practice is nearly 50 years old. While the profession, patient expectations, education standards, and healthcare delivery models have changed dramatically, Pennsylvania law has not kept pace. This episode explores the real-world impact of that mismatch, including restricted practice authority, rural access challenges, workforce pressure, delegation barriers, insurance friction, and the hidden cost of limiting conservative, non-pharmacological care. We also discuss research from West Virginia University showing that Pennsylvania ranks among the most restrictive states in the country for chiropractic scope of practice. The result is a paradox: highly trained doctors operating under low autonomy. But this is bigger than one bill. This is the scope fight. It is about whether Pennsylvania’s chiropractic law will finally reflect modern education, modern patient needs, and modern conservative care. In This Episode Why Pennsylvania’s chiropractic scope of practice is nearly 50 years oldHow outdated scope laws affect access, efficiency, and patient choiceWhy does Pennsylvania rank among the most restrictive states for chiropractic scopeHow regulatory ambiguity can function like a practical banWhy rural communities feel these restrictions more sharplyHow workforce shortages and limited training pipelines affect accessWhy HB 1106 matters for delegation and clinic efficiencyHow scope modernization connects to non-opioid care and the future of chiropractic in PennsylvaniaGet Involved Policy does not change from the sidelines. PCA’s Lobby Day is June 9 in Harrisburg, and we need chiropractors from across Pennsylvania to show up, meet with elected officials, and help tell the story of this profession. We know it is a practice day. But this is one of the most important opportunities we have to show the strength, seriousness, and unity of chiropractic in Pennsylvania. If you cannot attend, please consider supporting the PCA PAC. One hundred percent of PCA PAC donations go directly toward supporting chiropractic advocacy and the future of the profession in Pennsylvania. WVU study on Pennsylvania’s outdated scope of practice: Register for PCA Lobby Day on June 9: Support the PCA PAC: Learn more about HB 1106 and delegation restoration: PCA: https://pennchiro.org/ Email the PCA: pca@pennchiro.org

    24 min
  2. PCA Study Spotlight: The Hidden Circuit of Chronic Pain

    APR 16

    PCA Study Spotlight: The Hidden Circuit of Chronic Pain

    PCA Study Spotlight: The Hidden Circuit of Chronic Pain Stanford’s Hidden Chronic Pain Circuit: A Better Framework for Explaining Persistent Mechanical Pain This episode of PCA Study Spotlight reviews a Stanford Nature study describing a “hidden” looping circuit between the spinal cord and brain that appears to selectively drive chronic mechanical pain in mice while remaining distinct from pathways involved in acute, protective pain and normal touch. In mouse models, silencing nodes in the loop reduced injury-induced mechanical hypersensitivity due to inflammation or nerve injury, whereas repeated activation could create lasting hypersensitivity in healthy mice. The host emphasizes this is basic science, not a chiropractic or manipulation study, but argues it offers chiropractors a clearer framework for communicating chronic pain: persistent pain may reflect altered nervous system processing and sensitization rather than ongoing tissue damage, supporting more accurate, respectful patient conversations and reinforcing the value of conservative care without overclaiming mechanisms. 00:00 Series Purpose 00:25 Study Overview 01:09 Important Caveats 01:40 Why Pain Persists 02:22 Mapping The Loop 03:52 Clinical Communication 04:45 Fear And Function 05:34 Beyond Structural Stories 06:00 Touch Versus Pain 06:55 Layered Pain Biology 07:31 Practical Takeaways 08:16 Read And Reflect 08:47 Closing Thoughts Study Citation Wang, Q., Lee, J. H., Nachtrab, G., Yuan, Y., Yuan, L., Qi, W., Mohr, M. A., Xiong, J., Horowitz, M. A., & Chen, X. (2026). Deconstruction of a spino-brain–spinal cord circuit that drives chronic pain. Nature. Published online April 1, 2026. DOI: 10.1038/s41586-026-10296-y. Official article: Suggested Show Notes Format Study discussed in this episode: Wang, Q., Lee, J. H., Nachtrab, G., Yuan, Y., Yuan, L., Qi, W., Mohr, M. A., Xiong, J., Horowitz, M. A., & Chen, X. (2026). Deconstruction of a spino-brain–spinal cord circuit that drives chronic pain. Nature. Published online April 1, 2026. DOI: 10.1038/s41586-026-10296-y. Read the study here: Optional Short Version Wang Q, Lee JH, Nachtrab G, et al. Deconstruction of a spino-brain–spinal cord circuit that drives chronic pain. Nature. Published online April 1, 2026. DOI: 10.1038/s41586-026-10296-y. PCA Contact information: PCA Website: https://pennchiro.org/ PCA Email: pca@pennchiro.org PCA Study Spotlight, Chiropractic Research, Chronic Pain, Pain Science, Central Sensitization, Neuroscience, Musculoskeletal Care, Conservative Care, Patient Communication, Spine Care

    9 min
  3. PCA March President’s Address with Dr. Andrew Heck |

    APR 14

    PCA March President’s Address with Dr. Andrew Heck |

    PCA March President’s Address with Dr. Andrew Heck | Legislative Progress, Advocacy & Northeast Chiro Summit In this special Spinal Chat episode from the Pennsylvania Chiropractic Association, PCA President Dr. Andrew Heck shares the March President’s Address with updates on spring momentum and ongoing legislative, regulatory, and reimbursement challenges. He reports progress on delegation restoration through House Bill 1106, scope modernization, copay reform, and the sports working group’s efforts on return-to-play physicals and sideline care, as well as continued Capitol meetings led by PCA leadership and staff. Dr. Heck thanks nearly 70 members and non-members for supporting the postcard campaign and emphasizes that engagement from doctors, staff, patients, and communities strengthens chiropractic’s voice. He also previews the Northeast Chiro Summit (May 1–3) at the Kalahari Resort, noting record attendance and encouraging participation, membership, PAC support, and advocacy involvement. 00:00 Welcome and Setup 00:39 Springtime Reflection 01:13 Legislative Progress 01:56 Member Advocacy Push 02:27 Northeast Summit Preview 03:08 Conference Details 03:25 Closing Thanks 03:33 Get Involved Call 04:11 Final Sendoff PCA Contact information: PCA Website: https://pennchiro.org/ PCA Email: pca@pennchiro.org Spinal Chat, Pennsylvania Chiropractic Association, Dr. Andrew Heck, President’s Address, Chiropractic Advocacy, HB1106, Scope Modernization, Copay Reform, Sports Chiropractic, PCA PAC, Northeast Chiro Summit, Pennsylvania Chiropractors

    4 min
  4. PCA Deep Dive: Covered but Not Accessible, The Chiropractic Copay Crisis in Pennsylvania

    APR 7

    PCA Deep Dive: Covered but Not Accessible, The Chiropractic Copay Crisis in Pennsylvania

    PCA Deep Dive: Covered but Not Accessible. The Chiropractic Copay Crisis in Pennsylvania This episode argues that rising deductibles, copays, visit caps, and administrative barriers are pricing patients out of conservative musculoskeletal care, reshaping treatment choices, and increasing downstream costs. Citing the RAND Health Insurance Experiment, it notes chiropractic use drops about 50% with 25%+ cost sharing and that chiropractic demand is more price-sensitive than general medical care. Studies on high-deductible health plans show patients reduce spending largely by skipping care, disproportionately harming lower-wage workers. In contrast,e a Johns Hopkins study links higher out-of-pocket costs to reduced non-pharmacologic care without reducing opioid use. Evidence shows that removing copays reduces downstream physician services, surgeries, and injections, and that chiropractic coverage correlates with lower total spending. The script highlights Pennsylvania billing data, federal Medicare parity bills (HR 539/S 106), DOJ comments on ERISA misuse, Massachusetts’ prior-authorization ban for non-opioid pain care, and Pennsylvania’s proposed 20% cost-sharing cap and Medicare fee payment floor, concluding with a call to action. 00:00 Why Care Costs More 00:51 The Bill Fear Factor 01:59 Rand Experiment Lessons 04:35 Smart Shopper Myth 06:25 Deductibles And Visit Caps 08:31 Maintenance Care Gap 10:06 When Patients Switch To Pills 11:05 Proof Reform Saves Money 14:02 Pennsylvania Billing Shock 14:59 Medicare Parity Fight 16:48 State Reforms In Motion 17:44 Pennsylvania Copay Blueprint 19:35 What You Can Do Now 20:35 Final Call To Action References Baicker, K., & Chandra, A. (2015). JAMA Internal Medicine. Johns Hopkins University study evaluating the impact of high deductible health plan enrollment on nonpharmacologic treatments. (2023). Legorreta, A. P., et al. (2004). JAMA Internal Medicine. Also referenced as: Comparative Analysis of Individuals With and Without Chiropractic Coverage. Lentz, T. A., et al.; ATI Physical Therapy and Duke Clinical Research Institute. (October 2025). Physical Therapy & Rehabilitation Journal. RAND Health Insurance Experiment. (1974–1982). Findings later analyzed in: Shekelle, P. G., Rogers, W. H., & Newhouse, J. P. (1996). Medical Care. Smith, M., & Stano, M. (1997). Journal of Manipulative and Physiological Therapeutics. Swedish randomized controlled trial on maintenance care. (2018). Texas A&M study evaluating employee behavior in high deductible health plans. University of California, Berkeley, and Harvard study on high deductible health plans. USC Schaeffer Center study on the financial burden of high deductible health plans. (2023). Whedon, J. M., et al. (2024). Journal of Integrative and Complementary Medicine. JAMA Network Open clinical trial analyzing the addition of chiropractic care to standard military medical care. Government, Legislative, and Policy Documents American Chiropractic Association. Chiropractic Medicare Coverage Modernization Act Talking Points. (2025). Chiropractic Future. Comments submitted to the Department of Justice Anticompetitive Regulations Task Force. (June 2025). Massachusetts Session Law, Chapter 285. (2024). Medicare. 2025 Physician Fee Schedule. PCA Website: https://pennchiro.org/ PCA Email: pca@pennchiro.org

    21 min
  5. PCA Deep Dive: Beyond the Adjustment, Why Functional Nutrition Matters in Modern Conservative Care

    MAR 24

    PCA Deep Dive: Beyond the Adjustment, Why Functional Nutrition Matters in Modern Conservative Care

    PCA Deep Dive: Beyond the Adjustment, Why Functional Nutrition Matters in Modern Conservative Care This episode of PCA Deep Dive introduces the Functional Nutrition Working Group 100-Hour Certification in Functional Nutrition, developed by the Pennsylvania Chiropractic Association in academic partnership with the University of Bridgeport. The conversation makes the case that today’s patients are more inflamed, more metabolically compromised, and more clinically complex, making chronic disease and dietary inflammation central to musculoskeletal recovery and recurrence. Using Pennsylvania obesity data and the concept of cytokine-driven “chemical casts,” the episode explains why a technically sound adjustment may not hold when biology is working against healing. The episode also highlights a profession-wide gap in nutrition counseling. Nearly 90% of chiropractors already provide some form of nutrition guidance, yet 65% of respondents in a New York survey said they did not feel adequately prepared for in-depth nutritional counseling. This program is presented as structured, academically grounded education, not as scope expansion or a supplement sales model. Topics include systems biology, functional blood chemistry trends, gut-immune pathways, cardiometabolic risk, herb-drug interactions, referral awareness, and the program’s two-part design, Phase I foundations and Phase II clinical integration. Episode Timeline 00:00 Welcome and Mission 00:20 Modern Patient Complexity 01:23 Why Mechanics Fail 02:09 Metabolic Dysfunction Explained 04:10 Four Pillars Framework 04:25 Inflammation Locks Joints 06:30 Training Gap in Nutrition 08:35 Not Scope Expansion 11:23 Program Structure and Rigor 12:26 Deep Curriculum Highlights 14:36 Future of Conservative Care 16:25 How to Get Involved Functional Nutrition Working Group 100 Hour Certification in Functional Nutrition: https://fnwg-functional-nutritio-drmknx5.gamma.site/ PCA Website: https://pennchiro.org/ PCA Email: pca@pennchiro.org

    17 min
  6. PCA Deep Dive: Dentists of the Spine; Why Chiropractic Should Be the First Stop

    MAR 17

    PCA Deep Dive: Dentists of the Spine; Why Chiropractic Should Be the First Stop

    PCA Deep Dive: Dentists of the Spine; Why Chiropractic Should Be the First Stop Why does modern healthcare still send so many patients with uncomplicated back and neck pain into the wrong doorway? In this episode, we examine what happens when patients enter the fragmented “spine supermarket” of urgent care, primary care, pain management, imaging, medication, and premature surgical referral, despite guidelines that support reassurance, activity, conservative care, and avoiding early imaging in most uncomplicated cases. We explore how this failure is not just inefficient, but harmful. When the wrong doorway becomes the default, patients may be exposed to unnecessary imaging, fear-based decision-making, escalating interventions, and long-term disability. From there, we unpack the Primary Spine Practitioner model and make the case for chiropractic physicians as the evidence-based, conservative front door to spine care. This episode also examines how that role manifests in real-world systems, including Washington State guidance on traumatic brain injury referral following motor vehicle collisions and the growth of chiropractic services within the Veterans Health Administration. We close by examining a new challenge, consumer AI tools that often reproduce legacy “see your MD first” referral patterns, even when the evidence points elsewhere. This is a conversation about triage, authority, policy, and the future of conservative musculoskeletal care. What We Cover Why spine care often fails before treatment beginsThe “spine supermarket” problem in modern healthcareHow the primary care bottleneck contributes to poor routingWhy early MRI findings can worsen fear avoidance and chronicityThe difference between symptom management and true musculoskeletal triageThe Primary Spine Practitioner modelWhy chiropractors are positioned as first-contact providers for uncomplicated spine painThe importance of diagnosis, care planning, and referral authorityWashington State guidance on post-MVC concussion and TBI recognitionWhat the Veterans Health Administration shows about chiropractic integrationHow consumer AI tools may repeat old bias in new formsWhy policy, payer, and digital routing reform matter Why Spine Care Fails 02:32 The Spine Supermarket 04:44 Primary Care Bottleneck 07:09 MRI Fear Cascade 09:56 Iatrogenic Chronic Pain 10:53 Primary Spine Practitioner 12:11 Chiropractic Authority 14:27 Dentist of the Spine 17:28 Washington TBI Case 21:56 VHA Integration Proof 24:07 AI Repeats Old Bias 27:21 Fixing Digital Gatekeepers 29:21 Wrap Up and Call to Action PCA: https://pennchiro.org/ Email the PCA: pca@pennchiro.org

    33 min
  7. PCA Deep Dive: Cleared for the Pros, Benched for High School

    MAR 9

    PCA Deep Dive: Cleared for the Pros, Benched for High School

    PCA Deep Dive: Cleared for the Pros, Benched for High School Regulatory Clarity in School Athletics: Return-to-Play, Sideline Care, and Statutory Authority in Pennsylvania In this episode of PCA Deep Dive, we examine a policy disconnect affecting student athletes across Pennsylvania. Doctors of chiropractic with advanced sports credentials serve on professional and Olympic medical staffs nationwide. Yet under current Pennsylvania interscholastic athletic policies, those same licensed providers may face restrictions when working with high school athletes. Why? This episode explores: The difference between scope expansion and scope confirmationPre-participation exams and current PIAA barriersReturn-to-play decisions for musculoskeletal injuriesSideline care and advanced sports chiropractic credentials (CCSP, DACBSP)Rural healthcare shortages across PennsylvaniaThe referral loop and cost burden on familiesHow neighboring states like Ohio and West Virginia approach the issueWhether current athletic association policies align with the Pennsylvania Chiropractic Practice ActThis discussion is not about expanding the scope. It is about regulatory alignment. When 60% of Pennsylvania counties are designated as healthcare shortage areas, restricting the availability of trained providers raises serious questions about efficiency, access, and modernization. If licensed professionals are already authorized under statute to diagnose and manage musculoskeletal injuries, should athletic policies reflect that authority? We examine the legal framework, the training standards, and the policy implications for families, schools, and communities. 00:00 Why This Matters 01:19 Friday Night Football Setup 02:18 The Pro vs High School Paradox 03:06 Scope Confirmation Not Expansion 04:23 Three Pillars of Access 04:36 Sports Physicals and PPEs 05:41 Return to Play Authority 06:17 Sideline Care and Credentials 07:48 Rural Shortage Crisis 09:12 The Referral Loop Problem 11:18 Other States and Legal Logic 13:34 Counterarguments and Safety 15:40 What PCA Is Asking For 17:12 Final Take and Call to Action PCA Sports Working Group: https://pca-sports-working-group-vmf8wp8.gamma.site/ PCA: https://pennchiro.org/ Email the PCA: pca@pennchiro.org

    19 min
  8. PCA Deep Dive: From Quackery to Copays; The Structural Battle Over Access

    MAR 2

    PCA Deep Dive: From Quackery to Copays; The Structural Battle Over Access

    PCA Deep Dive: From Quackery to Copays; The Structural Battle Over Access Here’s a tight, high authority summary you can use: In 1963, the American Medical Association formed the Committee on Quackery with a documented mission to contain and eliminate the chiropractic profession. That campaign ultimately led to Wilk v. AMA, a landmark antitrust case that ended the formal boycott in 1987. But removing a ban did not guarantee inclusion. In this episode, we examine how explicit barriers evolved into economic architecture. From accreditation pressure and referral isolation to copay design, network narrowing, vertical integration, and outdated Medicare statutes, the mechanisms changed. The incentives did not. Major clinical guidelines now recommend non-drug, non-surgical care as first-line treatment for most spine pain. Yet payment structures frequently steer patients elsewhere. This episode explores how access is engineered and why professional participation remains essential in shaping the future of conservative care. 00:00 The AMA’s “Committee on Quackery” — Containment & Elimination (Cold Open) 02:15 From Bans to Spreadsheets: How Access Gets Engineered 03:12 Setting the Stage: Chiropractic’s Rise in the Late ’50s 04:05 The Iowa Plan: Robert Throckmorton’s Blueprint to Target a Profession 05:34 Weaponizing Accreditation: JCAH Rules, “Cultist” Labels, and Ethical Isolation 08:08 Real-World Fallout: X-Rays Denied, Practices Closed, Careers Threatened 11:34 The Leak: “Sore Throat,” Scientology Infiltration, and the Smoking-Gun Documents 13:38 Wilk v. AMA Begins: The Antitrust Battle That Drags On for a Decade 13:48 Court Victory: The AMA Boycott Is Ruled Illegal 14:23 Phase Two: Ending the War Didn’t Mean Inclusion 14:53 The VA as a Real-World Control Group for Integration 15:38 What the Data Shows: Explosive Growth & Opioid Alternatives 17:05 The Modern Pivot: From Explicit Bans to the ‘Architecture of Access’ 17:47 Consolidation & Vertical Integration Explained (Follow the Money) 18:43 Downstream Revenue: Why Conservative Care Can Lose the System Money 20:36 Benefit Design ‘Nudges’: Copays, Velvet Ropes, and Channeled Choice 21:57 Network Narrowing: Market Power Pushes Independents Out-of-Network 23:37 Medicare’s ‘Zombie Law’: Paying for the Adjustment but Not the Exam 25:51 Zooming Out: Evidence Says Conservative First, Payments Say Otherwise 27:33 What Patients Can Do: Question the Incentives Behind Your Care Path 28:54 Final Wrap + Call to Action: Advocacy, Policy, and Staying Engaged PCA: https://pennchiro.org/ Email the PCA: pca@pennchiro.org Copyright Notice PCA Deep Dive and Spinal Chat are proprietary productions of the Pennsylvania Chiropractic Association. All episodes, audio recordings, transcripts, graphics, and related materials are protected by applicable copyright laws. No portion of these podcasts may be reproduced, distributed, transmitted, modified, published, or otherwise used in any form without prior written permission from the Pennsylvania Chiropractic Association. Limited quotation for educational or journalistic purposes is permitted with proper attribution. State chiropractic associations are encouraged to share episodes and approved materials directly with their members. Together, organized professions are stronger. For licensing requests, partnership inquiries, or permission to republish content, please get in touch with the Pennsylvania Chiropractic Association directly.

    30 min
See All (38)

Ratings & Reviews

5
out of 5
2 Ratings

About

The Spinal Chat – A Service of the Pennsylvania Chiropractic Association Welcome to The Spinal Chat, the official podcast of the Pennsylvania Chiropractic Association (PCA), your front-row seat to everything shaping Pennsylvania’s $800 million chiropractic industry. Each episode brings you insights from industry luminaries, conversations with PCA’s Strategic Business Partners, and practical guidance to help chiropractors strengthen their practice, elevate patient care, and thrive in today’s evolving healthcare landscape. From study breakdowns and legislative updates to member spotlights and stories that celebrate the power of chiropractic, The Spinal Chat is your trusted source for connection, knowledge, and advocacy in the Commonwealth and beyond. Tune in, stay informed, and be part of the movement advancing chiropractic in Pennsylvania. Contact the PCA Email: pca@pennchiro.org PCA: https://pennchiro.org/

Information

  • Creator
    Pennsylvania Chiropractic Association
  • Years Active
    2025 - 2026
  • Episodes
    38
  • Rating
    Clean
  • Copyright
    © PCA 2025
  • Show Website
    Spinal Chat with The PCA