The chiropractic profession and the patients it serves scored a major legal victory in 1987 when Federal District Judge Susan Getzendanner ruled in favor of four plaintiff chiropractors and against the American Medical Association (AMA) and several co-conspirators (Table 1).1,2 Those brave DCs stood up against the Goliaths of health care and, after 11 years and two trials, were victorious. (A number of the defendants dropped out along the way, preferring to settle with plaintiff DCs.) The decision opened doors and lowered artificial barriers between doctors of chiropractic and medical doctors.
|
|
|
|
|
Although impediments to teamwork between these professional groups remain, it's hard to think patient care hasn't improved at least a little because of the slightly greater cooperation. Nowadays, we take for granted that MDs will accept referrals from DCs, although referrals in the opposite direction are probably still far fewer than they should be. We are much less frequently surprised when good research conducted by DCs is published in prestigious medical journals - based on its quality rather than the credentials of the authors. In the aftermath of the Wilk decision, patients are less fearful of telling their allopathic physicians they also are receiving treatment from chiropractic physicians. There still is much room for improvement in DC-MD relations, but the path to better cooperation has been illuminated by the judicial outcome of the Wilk, et al. case.
| Table 1: Original plaintiffs and defendants in Wilk et al. v AMA et al., October 1976. Plaintiffs Chester A. Wilk, DC James W. Bryden, DC Patricia B. Arthur, DC Steven G. Lumsden, DC Michael D. Pedigo, DC Defendants American Medical Association American Hospital Association American College of Surgeons American College of Physicians Joint Commission on Accreditation of Hospitals American College of Radiology American Academy of Orthopedic Surgeons American Osteopathic Association American Academy of Physical Medicine & Rehabilitation Illinois State Medical Society Chicago Medical Society Medical Society of Cook County H. Doyl Taylor Joseph A. Sabatier Jr., MD H. Thomas Ballantine, MD James H. Sammons, MD |
Less well-remembered by chiropractors today is England, et al. v the Louisiana State Board of Medical Examiners, a conflict reported by Texas Chiropractic College (TCC) alumnus Paul J. Adams, DC.3-5 The case riveted the attention of DCs for several years in the late 1950s and early 1960s. Jerry England, DC, and several other chiropractic physicians battled the allopathic establishment in state and federal courts in a quest for permission to practice chiropractic in the Pelican State. Chiropractors in Louisiana had been oppressed by organized medicine for years,6,7 a consequence of statutes that defined any professional effort to care for the sick as the practice of medicine. Only those licensed to practice medicine, it was contended, should be allowed to practice chiropractic. The chiropractors engaged attorney J. Minos Simon to devise their battle plan and to represent them in court. Simon's strategy was to argue that the medical board's stranglehold on licensure denied the benefits of chiropractic care to the citizens of the state.
|
|
|
The England case, as it was known, was settled in 1965 when a three-judge panel convened in New Orleans, heard evidence from both sides and ruled in favor of the medical board. Their decision was reached after dramatic testimony by two renowned chiropractors: Joseph Janse, DC, ND, president of the National College of Chiropractic (NCC) in Lombard, Ill., and William D. Harper, Jr., MS, DC, president of the TCC in Pasadena, Texas. Dr. Janse was humiliated on the stand by counsel for the defendant medical board who hammered away at the lack of federally recognized accreditation for chiropractic schools and at chiropractors' treatment for non-musculoskeletal disorders, such as stepping on a rusty nail. Janse departed the state, determined to establish federal accreditation for the NCC or leave the profession.8-10 He accomplished this goal six years later when the NCC achieved regional accreditation.11 Recognition of the Council on Chiropractic Education (CCE-USA) as a professional accrediting body for chiropractic colleges followed in 1974.12
Despite Dr. Harper's presentation, the plaintiff DCs' judicial gambit was lost.15 The federal tribunal ruled that the proper venue for seeking change in the laws governing licensure was not the judiciary but the legislature. Arrests of DCs for unlicensed practice, which had been suspended during the eight-year legal battle, were now resumed. Chiropractors were forced to return to the lawmakers (who had several times rejected their request for a licensing law). Not until 1974 was the practice of chiropractic authorized by statute in Louisiana.16
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
