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Chiropractor upset over change in sports physicals policy
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Bruce Lutes has been performing sports physicals for Ceres high school athletes for 20 years.

Now that the Ceres Unified School District's policy no longer allows students to seek medical clearance to play sports from chiropractors, Lutes is upset. He went so far as to call CUSD superintendent Dr. Scott Siegel an "overpaid authoritarian" in a recent letter to the editor.

Siegel said CUSD personnel have repeatedly explained the matter to Lutes, who isn't taking the matter lying down.

"I know he's upset. I had staff sit down with him and tried to explain it's not personal but it's something we probably should not have done in the first place," said Siegel. "What we had been doing for a number of years was not wise."

The superintendent explained that Ceres school athletic directors attended a California Interscholastic Federation (CIF) conference where the matter of chiropractors performing physicals was addressed by an attorney. According to Siegel, the CIF requires sports physicals before a student can join a team. The state education code, Siegel said, requires those physicals to be done by medical practitioners. While the decision remains a local one, he said, the CIF attorney "strongly advised districts against having chiropractors doing physicals for a number of reasons."

Ceres principals passed the recommendation onto their athletic directors. Siegel also asked the executive director of the Central Region School Insurance Group (CRSIG), a Joint Powers Authority which group buys workers compensation and property liability insurance, to weigh in. Susan Adams is in charge of risk management for the districts involved in CRSIG and was "astounded that we were using chiropractic physicals," said Siegel.

Siegel said the former practice was a "bad practice but one that could get the chiropractor in legal trouble and the district in trouble and it's unsafe for kids."

"Our primary concern is for the students of our students and if there's something wrong we need to catch it," said Siegel.

The scope of a medical assessment of students goes "way beyond" what chiropractors are legally allowed to practice, Siegel notes, such as heart and lung assessment. He said Lutes could get into legal trouble if he didn't catch something seriously wrong with a student and he signed off for them to play.

"He would be liable and he could lose his license," said Siegel.

Lutes said that a number of athletes have also been blind-sided by the change since they often cannot get appointments for physicals from medical doctors because of a backlogged that has disqualified them from playing this fall.

"A lot of these coaches send kids over that can't afford it so I do it for them for free and now I'm getting hecka kids coming in who can't get an appointment with a medical doctor because it's going to take a couple of months to get in so they can't play sports," said Lutes.

Lutes said in years past he has done about 75 physicals on Ceres and Central Valley High athletes each year as well as Pop Warner football teams. He has also performed physicals on neighboring high school districts, including Hughson, Modesto and Turlock.

"Now they're just saying Ceres can't do it - and Waterford too - because they're tied into the same insurance carrier," said Lutes.

Lutes feels that it's a conflict of interest that Siegel sits on the CRSIG board of directors. However, Siegel said he has no financial interests in the non-profit JPA and the CRSIG board didn't take a vote to change policy.

According to the Schools Insurance Authority, the CIF has never stated that chiropractors may legally execute sports physical forms or serve as team doctors. The CIF rejected a request by the California Chiropractic Association to change its rules and recognize chiropractors as authorized to conduct such activities. The NCAA, the CIF (Southern Section), the Los Angeles Unified School District and other groups have limited or rejected the use of chiropractors in these roles.

In addition, Schools Insurance Authority stated on its website that: "Having a chiropractor serve as a "team doctor" then potentially places the individual, and the district, at potential violation of law." Chiropractors are authorized to perform certain types of limited examinations and evaluations, however, there is no statutory authorization for a chiropractor to perform sports physicals.

Siegel said athletes at the junior high school level are now also being required to get sports physicals. Lutes, however, said the district has been accepting physicals from him and a competitor chiropractor in Ceres. Siegel said, however, blamed the acceptance on clerical errors.