Heated committee hearing on chiropractic prescriptive authority draws dozens of witnesses

Representative Greg Oblander introduced House Bill 929 to create an endorsement that would allow doctors of chiropractic who meet board-defined training and continuing-education requirements to prescribe a narrow formulary of noncontrolled medicines for diagnostic and therapeutic treatment of musculoskeletal conditions.

The sponsor said the endorsement would be optional and asserted the intent is to give chiropractors additional treatment tools for short-term symptom relief while patients receive conservative care: “This is a % optional to any doctor of chiropractic in the state,” Oblander said. He described outreach including letters of support from a range of clinicians and stakeholders and emphasized clinical training chiropractors receive in anatomy, diagnostics and radiology.

Proponents included multiple Montana chiropractors and association representatives. Dr. Ryan Oblander (vice president, Montana Chiropractic Association) said the change is “a patient grab,” not a power grab, and described cases where patients sought immediate relief and could not get same-day access to primary care; he told the committee the formulary had been submitted to the licensing board.

Opponents were numerous and included state and out-of-state physicians, medical associations, hospital clinicians, veteran chiropractors and national chiropractic educators. Jean Branscum, CEO of the Montana Medical Association, said the association “respectfully oppose[s] House Bill 9 29,” arguing physicians’ longer clinical education and residency training are critical to safely prescribing and managing medications. Dr. Daniel Brabey, an otolaryngologist, warned of medication interactions and serious side effects from nonsteroidal anti-inflammatories and corticosteroids and emphasized the need for lab monitoring and clinical experience to spot complications.

Witnesses from New Mexico and educators who have worked with jurisdictions that expanded chiropractic formularies said their experience raised caution: one witness said New Mexico later sought broader prescribing rights and that oversight arrangements there differed from the Montana draft. Opponents also warned the bill could increase malpractice insurance costs for all chiropractors, create patient-safety risks outside metropolitan referral centers, and fragment coordinated care without physician collaboration and pharmacist oversight.

Sponsor and proponents repeatedly said the endorsement would be limited to a short-term, narrow list of medicines (noncontrolled anti-inflammatories, muscle relaxants and short steroid courses), and that training and board rules would set safe guardrails. But many panel members and a large set of medical and chiropractic witnesses urged additional interprofessional guardrails such as joint oversight by pharmacy or medical boards, clearer supervised clinical training and stronger formulary governance before granting prescribing rights.

The committee closed the hearing after several hours of testimony. No formal vote or final committee action was recorded during the hearing.