Oppositional Defiant Disorder and Colorado

What is Oppositional Defiant Disorder or ODD? Why is it so tricky to get licensure passed in Colorado? What made Dr. Michael Cronin, AANP President, look "trout-like" on his recent trip to Keystone? Is the deadline for abstract submission going to be extended? Dr. Jacob Schor, AANP Conference Speaker Selection Committee Chair, explains it all and more.

In preparing you for next summer's AANP conference in Keystone, Colorado, I continue to ponder how best to explain how unique Colorado is. Sometimes it seems as if the entire state suffers from oppositional defiant disorder (ODD).

ODD is described in the Diagnostic and Statistical Manual of Mental Disorders – 4th edition (DSM-IV) as a “repetitive and persistent pattern of opposition, defiant, disobedient and disruptive behaviors towards authority figures.” That is so us.

The State of New Hampshire's motto may be “Don't Tread on Me,” but if any state could be said to have ODD, it has got to be Colorado.

Last November, two states, Washington and Colorado, voted to legalize marijuana. Washington did so because a majority of inhabitants like the idea of getting high whenever they want to. Here in Colorado most of us aren't that interested in using marijuana, we just don't like being told what to do or what not to do.

Take motorcycle helmets as another example. Twenty-one states and the District of Columbia actually require bicyclists to wear helmets. Colorado not only does not require bicyclists to wear a helmet, we don't ask motorcycle riders to wear a helmet either (except for children). (There's a morbid joke in Colorado medical circles referring to motorcycles as “Donorcycles.”) We just don't like being told what to do.

The Colorado Medical Practice Acts, by the way, do not require continuing education for MDs who practice here. Why? We don't like being told what to do.

This ODD gets particularly bad when it comes to paying taxes. In 1992, Colorado citizens, by popular vote, amended the state constitution taking away the authority to raise taxes or increase state revenue beyond what was spent that year from our elected officials. Known as the Taxpayer Bill of Rights or Tabor Amendment, this has put our state government in a bind not faced by any other state. While it is true that we don't like being told what to do, this has reached the point of absurdity. Yet even ardent opponents will speak of TABOR with a kind of perverse pride, aghast at what this law has done to public safety, public services and education, but still with pride at how whacky and independent our state is.

Built into the law is a ratchet-down effect. When state tax revenue drops during a recession, and we've had a few, that reduced budget level becomes the new ceiling, state income cannot be increased above that level back to pre-recession levels.

As a result, Colorado now ranks 48th in the nation for higher education funding (per personal income level), the lowest ranking in 40 years, a drop from 34th place in 1992. Colorado now ranks 44th in what it spends to repair its roads. If you've wondered why everyone here drives 4 x 4 trucks or SUVs, this is your answer; it's not the snow, it's the roads.

These tax laws have their implications on all political activities as the legislature has had to continually slash yearly budgets for two decades. But it actually got worse a few years back; a second constitutional amendment was passed to rectify the education budget that requires funding for schools, K-12, to increase each year so that education gets a bigger chunk of the state's budget every year.

Forget about that fiscal cliff in Washington, our state has lived in a fiscal Visegrip™ for two decades.

These interesting amendments to our constitution cause havoc for your colleagues here in Colorado who are interested in passing legislation that will regulate our profession. Regulation of pretty much any sort, even registration, costs money. While non-Coloradans assume that because implementation would be self-funded through fees, those of us who have lived with TABOR know different. Fees, whether for drivers' licenses, or naturopathic licenses, go into the state's general fund, a fund that cannot increase due to TABOR. So the costs of regulating our profession will need to be pulled from some other part of the budget.

Thus if it seems like Colorado's naturopathic physicians seem hesitant to accept the political advise coming from other states, it's not just that we don't like being told what to do. It's because we live in a unique state.

These thoughts are on my mind because I had the pleasure of spending last weekend with Dr. Michael Cronin, AANP President, and got to see firsthand his disbelief when I explained TABOR to him. Here in Colorado, we call the facial expression he had while listening a “trout-face.” You know, kind of openmouthed, with eyes glazing over.

Michael grew up in the Commonwealth of Massachusetts. The concept of a Commonwealth is not an idea familiar to people in Colorado; the very thought sounds like Socialism, a word commonly spoken with repugnance here.

Last Friday, Dr. Denise Clark, president of our state association, and my dog Poppy, took Michael on a hike up to Herman Lake. Two weeks before bad weather had forced me to turn back at tree line, but we were having a warm spell the day Michael was here and so we made it to the lake with no problem. This warm spell has lasted most of the month. Colorado's snow pack is half of the 30-year average for this date. Having seen the movie Chasing Icerecently, my thoughts have been of global warming.

After our hike we drove up and over Loveland Pass and down to Keystone Resort, the site of next summer's AANP Conference to get a tour. It's a spacious conference center set in a grove of pine trees just across the street from the hotel and condominiums we will stay in. The air there has that fresh quality to it that one really only finds in the mountains, one knows instantly that breathing it is good for you. There are mountains in every direction.

We are fast approaching the deadline for you to submit speaking abstracts for the conference. The official deadline is December 15th.

I would like to extend it officially to the 21st. This is partly because people don't like to be rushed and here in Colorado we don't like to tell people what to do. Also, because there are always some people who submit their materials a few days late and we let them get away with it. So this year, let's be honest and fair. We want abstracts in by December 15th but will continue to accept abstracts until the 21st of December.