After reading Dr. Klapp's answers, I became more convinced than ever that there are no significant differences in what the ICA stands for and what the ACA stands for. I am reminded of a television commercial where the announcer holds up two items that cost very different amounts, points out the similar characteristics and qualities of both items and concludes by yelling: "It's the same thing."
As an ACA governor, I would like to also answer the questions posed to Dr. Klapp so you can see the remarkable (if not striking) similarities of the two national associations.
Q. Why is there an ICA?
Dr. Klapp responded to this question by saying the ICA has historically existed and exists today to represent, promote and protect its members and its view of chiropractic and to advocate for its concerns and issues. He then referred to the ICA's mission statement, which reads:
"The mission of the ICA is to advance chiropractic throughout the world as a distinct health profession predicated upon its unique philosophy, science and art, to improve access to chiropractic services, and to promote the professional excellence of its members."
ACA Answer. There's no disagreement here. The ACA's mission statement is remarkably similar:
"The ACA is a professional organization representing doctors of chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of doctors of chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness."
The ACA bylaws then state: "To protect in every way not contrary to law the philosophy, science, and art of chiropractic, and the professional welfare of its members."
Q. What views, concerns and issues of chiropractic are so important to ICA members that they would maintain another national association to represent them?
Dr. Klapp's response: "The ICA exists to represent, protect and promote the profound and timeless principles of chiropractic. We believe chiropractic is and should remain a nonduplicating, separate, distinct, practice and profession."
ACA Answer. There's no disagreement here. The ACA concurs that the timeless principles of chiropractic should be represented, protected and promoted. And when it comes to remaining an independent healing art, the ACA is steadfast. The objective of the ACA (Article II, ACA bylaws) is "To maintain the science of chiropractic as a separate and distinct healing arts profession." (Emphasis added.)
Q. What are the "profound and timeless principles of chiropractic?"
Dr. Klapp answered this question by referring to ICA policy. It discusses the relationship between the articulations of the skeleton and the nervous system; how the practice of chiropractic consists of the analysis of interference with normal nerve transmission and expression produced by abnormalities of one or more vertebral motor units or other skeletal structures; and the correction thereof by adjustment of these structures for the restoration and maintenance of health without the use of drugs or surgery. He concluded: "These are the principles upon which our profession and practice were founded. And they are the truths that form the foundation of our present and-we believe-future success in the health care marketplace."
ACA Answer. There's no disagreement here. The ACA policy and ICA policy on these "timeless principles" are exactly the same. Here is the official ACA policy:
"With regard to the core chiropractic principle, which holds that the relationship between structure and function in the human body is a significant health factor and that such relationships between the spinal column and the nervous system are highly significant because the normal transmission and expression of nerve energy are essential to the restoration and maintenance of health." "Chiropractic is a drug-free, non-surgical science and, as such, does not include pharmaceuticals or incisive surgery." (Emphasis added.)
The ACA agrees that these are indeed "timeless principles" which should never change. Last November, the ACA responded to a Chicago Tribune article by stating: "The chiropractic profession has espoused this [no drugs-no surgery] philosophy for more than 100 years, and the ACA stands firm in its commitment to ensure that these core principles remain intact for centuries to come." (Emphasis added) You can't be any stronger than that.
Q. "What does the ICA do to represent, protect and promote these principles?"
Dr. Klapp discussed the promotion of the principles in various chiropractic political arenas, national and state legal and legislative activities, continuing education seminars, and their four specialty "councils."
ACA Answer. There's no disagreement here. The ACA believes it is essential to promote these principles and has been extremely successful at it. Recent ACA activities (and victories) include the HCFA lawsuit in defense of subluxation; the resultant admission by HCFA that physical therapists may not deliver chiropractic services; passage of the Veteran's Administration bill; passage of the Department of Defense bill; and removal of the Medicare x-ray mandate. The ACA also promotes these core principles through its education seminars and 10 specialty councils.
Q. Isn't the ICA just a "horse and buggy" organization whose members are mostly elderly DCs?
Dr. Klapp responded by saying: "The ICA is made up of a cross-section of chiropractors across the demographic spectrum. We are united by our view that chiropractic is a unique, non-duplicating, separate and distinct form of health care. We are united by our belief that the practice of chiropractic should, by its history, tradition, science, art and philosophy, be centered on the detection, management and/or correction of the vertebral subluxation complex."
ACA Answer. There's no disagreement here. Although ACA membership is composed of a much wider cross-section of the profession, the leadership of the ACA and the overwhelming majority of ACA membership believe chiropractic should always be a "unique, non-duplicating, separate and distinct form of health care" and should "be centered on the detection, management and/or correction of the vertebral subluxation complex."
Q. Does the ICA oppose the use of "ancillary procedures" in chiropractic practice? Does the ICA oppose diagnosis in chiropractic? Doesn't the ICA oppose referral to other health care providers?
Dr. Klapp firmly answered "no" to all three questions.
ACA Answer. There's no disagreement here. The ACA concurs on all three.
Q. Some people have suggested that the ICA is too small to be relevant. How would you respond?
Dr. Klapp stated: "If by 'small' one means over 7,000 members, then I guess we would be considered small. However, we are certainly relevant!"
ACA Answer. There's no disagreement here. The ICA is small (compared to the ACA). But regardless of size, the memberships of the ACA and ICA would be better served if only one national association represented them.
Dr. Michael Pedigo has a unique perspective on this since he served three years as president of the ICA and two years as president of the ACA. Here's what he thinks (Dynamic Chiropractic, October 18, 1999) about the wastefulness of having two national associations:
"Some argue that it's good to have two associations, like we have Republicans and Democrats. That may sound good to some, until you ask how many presidents we have. We have an election and elect one president, be it a Republican or Democrat, but not both. Can you imagine what it would be like having two presidents of the United States...? That's what our profession has, and we wonder why it is so difficult to get things done.
"The cost factor of maintaining two associations is huge. Both associations have overhead costs of what I call up and down lifting. Those costs must be paid before any productive work is done, i.e., office building costs and everything involved with two staffs, including salaries for duplicate work and the costs of double meetings of each association's respective elected officials.
After those costs, then (and only then) are there funds for doing the work you expect your association to do to protect and advance the profession. The smaller the association, the larger the percentage of the budget goes for the up and down lifting. One of the major reasons I resigned from ICA was because so much of the budget was spent on the up and down lifting, there was very little left to do anything else. That has not changed today."
Q. What is the ICA's vision of the future of chiropractic?
Dr. Klapp answered: "We have an opportunity to change the public perception of chiropractors and chiropractic by focusing on long-term spinal health and the wellness that inevitably results. We at the ICA firmly believe that there has never been a better time to be a doctor of chiropractic! This is the vision the ICA has of what chiropractic is and how it should be practiced."
ACA Answer. There's no disagreement here. The ACA has a staff of 40-full time professionals who are working hard to change the public's perception of chiropractic. The ACA also believes this is a wonderful time to be a doctor of chiropractic, and that the future is bright indeed.
Q. There is a perception in the profession that the ICA, due to its rejection(s) of merger with the ACA in the 1980s, has been-and remains-the main impediment to professional "unity." How would you respond to that perception, [and] is the ICA opposed to unity?
Unfortunately, Dr. Klapp did not answer the question about the ICA being the main impediment to professional unity. Instead, Dr. Klapp discussed how a merger of the two organizations would still only represent 30 percent of the profession. He talked about colleges teaching divergent views of what chiropractic is supposed to be, college presidents not following position papers, and how the National Board of Chiropractic Examiners is testing on the allopathic model. He also criticized the "doctor of chiropractic medicine" (DCM) degree, the Florida law which uses the term "chiropractic medicine," and pointed out the hazards of vaccinations.
ACA Answer. If it's true that the combined memberships of the ICA and ACA only represent 30% of the profession, something needs to be done to change that. A recent survey indicated that many DCs are refusing to join any national association until a merger occurs. Let's give the profession what it wants. Let's combine the ICA's 6% and the ACA's 24% into one large national organization. Once that happens, membership will increase like never before.
What colleges are doing and what the National Board is testing have nothing to do with merger and should not be an impediment to unity. Why? Because the ICA and ACA have the same positions on what chiropractic is and should remain. And as I pointed out in my "Four Biggest Lies in Chiropractic" article (Dynamic Chiropractic, December 1, 1999, www.chiroweb.com/archives/17/25/05.html ), the ACA adopted formal resolutions in opposition to the DCM degree and against mandatory vaccinations. Furthermore, the term "chiropractic medicine" appears nowhere in the ACA bylaws, mission statement, vision statement or master plan!
The only disagreement between the ICA and ACA is on the issue of national unity. The ACA voted in 1988 for merger. Unfortunately, the ICA defeated the merger (even though a majority of ICA members voted in favor of it). The ACA is still in favor of national unity, and the ICA continues to give excuses for why they think it would not be beneficial.
It's time for the ICA to stop opposing unity based on "timeless principles," since the ACA and ICA support and stand for the same things. The two national organizations have the same goals, the same purpose, the same vision, the same mission, the same policies, the same beliefs and the same commitment to the timeless principles of chiropractic. Once we get past all the salesmanship, sizzle and smoke, the ICA and the ACA are truly "the same thing!"
Regardless of the spin, it all comes down to this. Other than the issue of merger, there is no material difference between the ICA and ACA. Both organizations share the same goals, purpose, vision, mission, policies, beliefs and commitment to the "timeless principles."
Maybe it's time for this profession to insist that the ICA and ACA agree on the issue of merger. Maybe it's time for this profession to stop the senseless duplication of services and wasting of resources. Maybe it's time for this profession to tell both national associations that everyone now knows that they are the same thing!
Click here for previous articles by James Edwards, DC.