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Dear Bill

You stated in a recent email describing your We Speak Chiropractic poster that “…one of the things that makes chiropractic attractive is that it isn't medicine.” I understand what you mean but the fact is, chiropractic is "medicine." Here is the definition of medicine: The science or practice of the diagnosis, treatment, and prevention of disease (in technical use often taken to exclude surgery).

Chiropractors do diagnosis, treat and prevent disease (or at least they should). Hence, we practice medicine.

I only bring this up because I believe that your use of the term in your article reflects and reinforces one of our problems in chiropractic. That problem is we feel so insecure in our position that we have this tendency to criticize and castigate what the medical doctors do and try so hard to distinguish ourselves from them in any and all aspects, which has never served us well but only succeeded to further isolate us from medical science and the public.

I'm a chiropractor and proud of it but I get concerned that our profession is stuck in the terminology and thinking of the 1890's which today, in some cases sounds too much like mysticism. There is plenty of science to explain and support chiropractic, but we are still stuck in the subluxation model, which is archaic. This and other terms are completely nonsensical to Western science and the public. They were used back anciently because that was the best explanations they had then. The original explanations coined by DD and BJ Palmer were based on what they thought was happening according to what was understood back then. Neurological science has progressed somewhat since that time, but we haven't.

Another example is "innate." I don't have a problem with the concept of "innate" when used in the broad sense of the body’s ability to heal itself, but when we use it in chiropractic, it takes on the air of mysticism, and with some DC's, an almost quasi-religious quality. This doesn't help our cause or acceptance at all and only appeals to a very small portion of the public that is hot on metaphysical explanations of everything (maybe that's why we see such a small percentage of the public).

I'm not saying we should not acknowledge our philosophical roots or ignore or disavow our history, but we need to move out of the 19th century and in to the 21st. I encourage you to use your platform to help this great profession move more towards science-based chiropractic "medicine."

Vern Redd, DC-APC
Albuquerque, NM

(Dr. Redd's rebuttal to my response is in red below.)

Hi Dr. Redd,

Thank you for taking the time to write your thoughtful response! Wish all my readers were so engaged.

I’m guessing this is one of those times in which our agreement will be limited to disagreeing. That’s okay. Conflicts clarify, to coin a phrase used by B.J. Palmer for the title of one of his books.

The founder and developer of chiropractic made it clear that chiropractic was NOT the treatment of anything. Instead, the objective of chiropractic is to restore, revive and invoke the ability of an individual to self-heal. Many of the mechanistic-linear bent have tried to shoehorn chiropractic into a symptom/disease/condition-treating model. It is a distinction lost on many who search for a cookbook approach to the recovery of health: do this and the patient will respond thusly. Thankfully, this trap was well known during the herculean task of getting chiropractic licensure. It was accomplished with the promise that chiropractic was not medicine and in fact a separate, distinct and nonduplicative healing art. Trying to blur this distinction has confused many chiropractors who see themselves as mere spinal therapists hamstrung by the inability to prescribe drugs. The result has been struggling practices that have reduced chiropractic to a low-tech approach to headaches, back pain and other spinal conditions. I agree with you. In the early days of chiropractic, they would take on what ever condition and they achieved great things and it is unfortunate that today's doctors seem to have lost that.

True, we know more today than a hundred years ago. And it’s true that the simplistic pressure-on-a-nerve model may be more metaphorical than scientific, but this does not make the principles of chiropractic invalid. No it doesn't but it does nothing to engender respect from the medical and scientific communities. Even more telling are the 33 principles articulated by Stevenson in 1927, which were far ahead of their time. Let’s be careful not to throw out something simply because of its age! Doing so might force us to discard the timeless wisdom of Bible, the breakthrough of the Magna Charta and the brilliance of the Constitution of the United States. All of which are far older than the discipline of chiropractic. I'm not familiar with Stevenson, but I agree that true is truth and when it is revealed is not important. However, we don't speak today in the language of ancient England or even in that of our founding fathers (maybe that's a pity) but again my argument is not with the principles of natural healing (on which chiropractic has no exclusive claim) but with how we choose to state our message to the public.

And as for the metaphysics of chiropractic, the public is clearly hungry for it. Witness the popularity of the Chopra’s, Weil’s, Dyer’s and the rest who have taken the holistic, vitalistic philosophy of chiropractic and made it mainstream. I think metaphysics is more appropriate in the arena of spiritual development and though it may have some place in the healing arts, I do not believe it should take presidence over science. To do so makes our profession take on a religious flavor which only hurts us. As a chiropractor I'm a facilitator of healing, not a priest. The public is increasingly wary of the business of medicine and is drawn to alternatives that honor the person and the inborn wisdom of the body. I have to disagree with you here. We are insecure as a profession and that is powerfully expressed in our isolationist behavior. How may DC's belong to other alternative health groups or attend their meetings and make themselves known? How many even interact with their local MD's or DO's? We are not secure in our knowledge and position and most DC's won't interact with other professions because of it. When you speak of "adding energy to a persons spine" what on earth are you talking about? This is the very thing I'm upset over. We use these nonsensical terms and explanations that have no basis what so ever in anything. Any DC who talks to an MD like this rightly deserves to be laughed at because we have much, much better explanations for why chiropractic works that are based on solid neurological science. Why not use them?

Finally, the utilization of chiropractic isn’t small because of the use of the word “innate” or because a few of the bravest chiropractors share metaphysical constructs with their practice members. When you say "bravest" are you suggesting those who chose to use other language to explain chiropractic are cowards? These is no virtue in being brave but wrong. No, chiropractic is small because:

• Chiropractic care requires greater participation and self-responsibility by the patient. Any natural, alternative system of healing requires this, including nutritional "medicine" and Naturopathy, yet they are growing while we shrink, so I don't accept this argument.
• Chiropractors were seduced by the mechanistic, spine-centric treatment offered by insurance companies. Maybe, but that was a choice and we can walk away from that any time we have the courage to do so. I know too many DC's who have all cash practices (including me) that do just fine.
• Chiropractic doesn’t have the financial backing and promotion of the pharmacological industry. True, but that can't be helped and we will never have their support. However, we can have their respect even if they don't like us and besides, it's the public's support that is really important.
• Chiropractors received what is largely a medical education and emerge confused, fearful and emasculated spinal therapists taught to refer to real doctors. We have already agreed that truth is truth, regardless where it comes from. There is much good and truth in medicine but they miss a great deal. Take any graduate of the neurology diplomate program taught by the Carrick Institute for Graduate Studies and I'll show you a DC that is not confused, fearful or an emasculated spinal therapists who can only refer to "real" doctors. What needs to be taught in chiropractic schools is chiropractic neurology. That will take a doctor much further than quoting BJ or expounding on the metaphysics of chiropractic.
• Chiropractors are unwilling to get out of their practices and tell the chiropractic story and the truth about health and healing. All too true. Maybe they don't feel confident with the language they have been given?
• Chiropractors have neglected to effectively explain chiropractic, True but again, why do you think this is so? set and enforce appropriate boundaries Not sure what you mean here. Are you talking about scope of practice or something else? and taken the credit for the results it so often produces.
• Chiropractors were misled into believing that acceptance by medicine was the key to success. Maybe and maybe not. I don't think most chiropractors really believe we will ever be accepted by the medical profession - nor do I believe they care, but I do believe they want the MD's respect. Even if we had the same license as the MD's they would still not like us. Even the DO's are not fully accepted as equals by some MD's.

The myth that science will save us and that chiropractic would be improved, popularized and validated by discarding its metaphysics, vocabulary or anachronistic principles is just that, a myth. Here we disagree. When I have spoken the language of neurology to medical people they listen and respect me (and maybe even fear me a little), but I would never get that same response talking about subluxations and innate intelligence. The cult of scientism and its sacrament of the double blind randomly controlled clinical trial is not the answer. I agree that some treasured scientific methods do not lend themselves well to the study and validation of many alternative healing methods, but clinical outcome studies are accepted and can be demonstrated very nicely with chiropractic and other natural healing methods of treatment. Referring to science as a cult is a little over the top Bill. This same "cult" has given us a standard of living unmatched in the history of mankind. You may find some virtue in living in a mud hut, scratching out a living with a stick but I'll take science any day, thank you :) Far more promising is making sure everyone understands that…

• The body is a self-healing and self-regulating organism, whose every cell, tissue, organ and system is orchestrated by the nervous system. Right on! But far more than the subluxation causes problems with this magnificent system.
• Interferences and insults to the nervous system from physical trauma, emotional stress or chemical toxins can distort nerve communications between the brain and body. That's right.
• One way the body responds when attempting to accommodate these stressors is a defensive mechanism chiropractors call vertebral subluxation. Maybe so, but that doesn't really describe just what a subluxation is. In neurology we call it functional deafferentation, loss of the central integrative state and hemispheresity for starts.
• If the stressor is no longer present, reducing the bone/nerve/soft tissue involvement via a series of highly targeted and specific chiropractic adjustments allow the body to heal itself. With all do respect all I can say is "baloney". I use general, nonspecific stimulation of joint mechanoreceptors all the time and get wonderful results that not only resolve symptoms, but provide measurable positive neurologic and orthopedic changes. Like old Dr. Parker said, any technique works even if you hit 'em in the butt with a shovel you'll still get 80-10-10. And if specific chiropractic adjustments are the real solution then why do Neuromodulation Technique and other energy techniques work too? They sure aren't treating subluxations the old fashion way.
• Because there are so many variables involved, predicting how long it may take or how the body will use the energy to help “right itself” is impossible. Fine but I'm not clear as to what this has to do with anything except I get a little concerned you might be defending the practice of giving continual adjustments when no clincial improvement is evident. I know of a DC who treated a patient three times a week for two whole years with out fixing them. he patient finally quit in disgust. When do you beleive it's time to stop and try a different approach to the spinal adjustment?

Perhaps that is unscientific. Maybe even simplistic. But the results experienced by millions, regardless of age or condition, for over a century are enough evidence for me. Results is the bottom line Bill, but the fact is half the new DC graduates fail in practice and have to do something else for a living, the remaining half are a mix of success and just getting buy, our profession is loosing market share and others (Naturopaths, alternative MD's and DO's, nutritionists,etc.) are taking over the position of authority in the natural/alternative health arena (Dr. Oz isn't a DC you know) and we are being ignored. We are in danger of losing the art of manipulative therapy to others, we refuse to evolve and insist on living in the past and using arcaic language to tell our story which does nothing to garner respect from the public and other health care professionals but acts to castigate us. We are devided and spend more time fighting with eachother then we do taking a unified message to the world. Some of our members have even joined in legal actions against their fellow chiropraactors, with those who want to destroy our profession in a misguided and misinformed action they think will protect the profession. We're in trouble Bill and reverting to the "good old days" of chiropractic will not save us. We either boldly embrase the future and take our rightful place in the healing arts community or we will be pushed into a position of insignificance. Like I've said before, there is nothing wrong with chiropractic. The problem we have is with the chiropractors.

Comments (5)

Don Handly:

If I told my many patient's that have only graduated from the 8th grade that they have a "functional deafferentation, loss of the central integrative state and hemispheresity" their eyes would glaze over. Getting rid of the term subluxation to get respect from the medical profession sounds more like lack of self esteem then a need to improve the profession. I volunteer on a rescue squad and see on a regular basis patient's with 20 or more prescriptions. I talk to medical doctors and nurses frequently. They are about the drugs. We are insignificant to them. Since being involved with EMS I have totally lost respect for the medical profession and what they do. I have no interest in their respect. I hate to call myself a doctor anymore because I am afraid someone will mistake me for a MD. They are good at emergancy medicine but have no idea on how to help someone become healthier.

If chiropractic is medicine and one claims to practice it without a medical qualification, by definition that person would be classified as a "quack".

I was diagnosed with stage three cancer in April have had fantastic medical treatment. Chiropractic and acupuncture has complemented the treatment I have had. Society needs medicine to treat disease and illness, much of the criticism of the medical profession is misplaced and should be directed at the influence the multi-national pharmaceutical companies have on politicians and health care,rather than doctors themselves. I guess more people would use ice if sales reps were going round to doctors explaining the benefits of frozen water.

When we talk about insecurities in relation to chiropractors, I have always maintained its chiropractors desire to use the Doctor title, that fosters this feeling. I don't use the Doctor title simply because, the public sees doctors as medical people and I am a chiropractor. I dispair at the lack of pride in the chiropractor title.

If ever there was a "chiropractor" who brought this home to me, it is the character Alan Harper in "Two and a Half Men". The way he will announce to people he is a doctor and everyone laughs. Charlie will say, Alan is a chiropractor not a real doctor, the only med school that would have him was in Mexico, so Alan went to chiropractic college. I know so many Alans in our profession its embarrassing. We need to focus on what we are good at and KISS. Regular cardiovascular exercise is good for ones health as is maintaining spinal joint function, that's what chiropractors should be good at, its our USP.

Amyas Kabir:

Dear Bill,

I am writing in response to a post I read last week from Dr Redd and feel inspired to share my thoughts...here we go!

Dr Redd makes reference a few times to Chiropractic "medicine" and that the practice of Chiropractic is the equivalent of the practice of medicine...huh?? With access to the internet, one can invariably find a definition that suits one's intention. I also found a definition of medicine that reads,"Treatment using drugs and/or,"a substance or preparation used in treating disease." I am not sure how that definition fits within the scope of a Chiropractic practice. Last time I checked, any attempt at prescribing or even dissuading a patient from taking their meds would constitute practicing medicine without a license...so, I am a little confused here?

Secondly, Dr Redd refers to using the term "subluxation" as being archaic? Well, a little research will reveal that the allopathic paradigm has as its foundation the germ theory which dates back to the early 1800's; It is quite clear that the allopathic model has no intention of abandoning the holy grail that guides them.

Dr Redd uses the term "medical science"? I would like some clarification...does medical science have authority over other sciences?? And, would there also be a "Chiropractic science" as well in which case they would be distinct and separate entities each measurable according to defined parameters and observable phenomenon within the principles set by each profession.

Lastly, while I respect the viewpoint of all within the profession, I cannot fathom how it is possible to feel nothing but pride at the ability to perform a Chiropractic adjustment and watch miracles unfold in your office. Why NOT feel proud about our unique and distinct vernacular...it is the foundational element found within all tribes and communities of people. To uphold our philosophy only creates strength...it is unfortunate for the people that we serve that there is confusion. We can only be as strong as the weakest link in our chain...we have yet to see where that will lie.

Amyas A Kabir D.C. & PROUD!

Chris Wilkerson, DC:

Kudos to Dr. Redd. Such clarity of thought is not often expressed in our profession.

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From March 13, 2012 6:29 AM

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