The National Association of Chiropractic Medicine (NACM), a fringe organization within chiropractic that has sought to divorce itself from "unscientific aspects of chiropractic,"1 and which now plans to "abandon the chiropractic profession entirely and establish a new profession under the individual states 'medical practices acts,'" has established a United States chapter of the Orthopractic Manipulation Society (OMS). The OMS is modeled after the Orthopractic Manipulation Society of North America (OMSNA) of which Dr. Murray Katz is the president.
Dr. Katz is best remembered for his testimony vilifying chiropractic before the New Zealand Commission on Chiropractic. The Commission's report made this comment regarding Dr. Katz's testimony:2
"We think the kindest thing to say is that Dr. Katz has become so emotionally involved in his self-appointed role as a 'concerned advocate of consumer rights' that over a period of some years he has allowed his enthusiasm to override his judgment, his sense of reality, and his sense of what is proper."Dr. Katz is more recently noted for his negative commentary on chiropractic pediatrics in the magazine, Pediatric Management, and on ABC's "20/20" segment.
According to Dr. Katz, 200 DCs have joined the Orthopractic Manipulation Society since its inception in April, and a 23-member board of directors has been established: four DCs; two pediatricians; three from public health; four medical professors; two orthopedic surgeons; two physiatrists; the director of the McKenzie Institute; the director of the Back Institute; Stanley Paris, director of the Orthopedic Manual Group; and two members of a Canadian orthopedic manipulation group.
To become a member of OMS and NACM, a DC must abide by the "Patient Guidelines for Spinal Manipulative Practice." The following are excerpts of those patient guidelines:
"By definition an Orthopractor is a "self-limited specialist" whose discipline does not include general health care. Orthopractic does not offer a 'holistic' approach to your health nor an 'alternative' to scientific medicine.While the OMS Patient Guidelines borrow freely from the OMSNA guidelines, there are a few items that are in the OMSNA guidelines that extend into other areas:"Spinal manipulation consists of the manual movement of the joints of the human body and has a role to play in the delivery of health care in legitimate, scientific medicine.
"For this reason these organizations wish to notify the public that any use of spinal manipulative therapy which is not acceptable to the world body of health science knowledge may constitute health fraud and potential health risk.
"In brief, this practice is limited to joint and muscle pain when therapy is not contraindicated by other existing medical problems and is dedicated to the restoration of biomechanical function of the human locomotor systems.
"As this is a limited scope of practice it is recommended that you have a family doctor acting as a general health consultant who is aware of this treatment.
"Comprehensive medical examination should be done by your general family physician.
"X-RayImaging Examination
- X-Ray has no value in evaluation of the manipulative lesion.
- X-Ray has value as: 1. a negative diagnostic tool; it can show what is not there 2. a positive diagnostic tool revealing a contraindication to treatment
"Do not allow forceful manipulation of any joint which has not been screened radiographically without consent of your family physician."Full spine x-ray has no place in ORTHOPRACTIC practice.
"Multiple x-ray exposure for re-examination is not used in ORTHOPRACTIC practice. Dynamic andor videofluoroscopy may be of value by qualified practitioner.
"CAT or MRI scan reports are made available to your family physician.
"Homeopathy: I will not recommend to my patients homeopathic remedies or treatments as I do not consider them to have a scientific basis."Advice for the health care consumer: You can be easily fooled by personal testimony. Do not accept any sales promotions such as family plans, pre-paid contracts, life-long spinal adjustments, coupons to reduce costs or free x-ray examination. Do not attend elementary school screening programs for spinal scoliosis organized by chiropractors.
"Subluxations: I believe that the term "subluxation" refers to the patient dislocation of two joint surfaces. These are rare and occur almost exclusively in the extremities of the body such as the arm and the leg. To describe what I am treating, I prefer the expression, 'lack of adequate mobility and range of joint motion.'
"Use of X-Ray in Diagnosis: It is not necessary to x-ray infants and children. In the rare instance of a suspected bone fracture or congenital bone defect, I will consult in order to make the proper diagnosis.
"Infants and Children: I do not believe that spinal manipulation therapy can be used to treat or to alter the course in any way of conditions in infants and children such as infantile colic, skin eczema, learning disorders, ear infections, respiratory tract infections, strabismus of the eyes, asthma, any infectious disease process, any state of decreased immunity or any form of learning disorders.
"Reports of Manipulation on the Nervous System of the Body: Whatever effect, if any manipulation of the spine may have on the voluntary or the autonomic nervous system, I do not believe this affects in any specific way conditions or diseases such as bacterial and viral infections, cancer, state of decreased immunity, the common cold, arthritis, bursitis, heart diseases, high blood pressure, pneumonia, menstrual cramps, liver diseases or urinary tract infection.
"Disease Prevention by Spinal Manipulation Therapy: I do not believe that spinal manipulation "adjustments" are necessary as part of general health care. I consider it unethical to manipulate a joint which is essentially normal."
Each member of the OMS is required to join the OMSNA. By joining the OMSNA, a doctor agrees "to abide by all the guidelines of the Orthopractic Society" and "distribute to each new patient an official copy of the guidelines of the Society."
Letters from Dr. R.L. Slaughter, executive director of the NACM (printed here in full), are being mailed to chiropractors in the United States. Dr. Slaughter makes a number of curious statements regarding alleged organized efforts by Dr. Katz and various medical associations around the world. The letters also allude to upcoming reports in the media on chiropractic, the kind of reporting that Dr. Katz has been an anti-chiropractic spokesperson for in the past.
This brings up some serious questions:
If the AMA is "in discussion with Dr. Katz," as the first letter contends, is this yet another medical conspiracy against the chiropractic profession?
What is the contribution from OMS/NACM in the purported upcoming reports on chiropractic in the Wall Street Journal and Consumer's Digest?
What type of "deals" could the NACM be making to create this new profession?
As you read these concerns, Dynamic Chiropractic is trying to uncover the answers to these questions. Look for more information in upcoming issues.
1. National Association for Chiropractic Medicine, 1992, statement of organization's mission.
2. Chiropractic in New Zealand. Report from the 1979 Royal Commission Report.
ORTHOPRACTIC MANIPULATION SOCIETY (USA)
Name __________
Address ________
Name: _________
Things have been moving exceedingly fast. Canadian, New Zealand, and Australian medical organization have voted to adopt the "orthopractic model." The AMA is in discussion with Dr. Katz (OMSNA) at this time for adoption. We are confident that they will wish to open the door for all state medical associations.
Consumer (sic) Report comes out in June, followed closely with Wall Street Journal and Consumer (sic) Digest. It appears Peter Jennings is planning a one hour special re: chiropractic (expose').
Membership voted to accept only the first 1,000 applications at "face value" because we know once the word starts getting out we will be flooded with app's. (sic) Thereafter, all apps (sic) will be tabled pending an investigation/credentialing committee yet to be determined, but we will make criteria much more difficult to join. GET YOUR APP IN NOW! Send $35.00 to OMSNA, address on form, and order some of their pamphlets to show to your local MDs. Send $100.00 to us.
You may currently reach me at 713-483-8090 by voice or after the phone picks up you may press "44" and get my fax/modem to leave a fax message. We are acquiring a separate phone number and will let you know.
By the way the NACM was allowed to register the word "ORTHOPRACTOR" for the USA -- we have SOLE RIGHTS TO THE USE OF THIS TERM. A chiropractic college is being challenged to convert to our first Orthopractor College. Our goal is to totally separate from the chiropractic profession and, with medicine's acceptance, recognition, cooperation, and support, to move under the "medical practices acts" of the individual states, and there, to define a NEW PROFESSION with the scope of practice to functional biomechanics, posture, gait, and rehabilitation of the locomotor systems with emphasis on the manipulative lesions and to include mobilization, distraction, heat, cold, all scientifically acceptable physical medicine modalities and a DEA license to be used diagnostically and therapeutically for NMS conditions.
I think we are going to make it this time!
R.L. Slaughter, M.Sc., D.C.
ORTHOPRACTIC MANIPULATION SOCIETY (USA)
NACM R.L. SLAUGHTER M.Sc.,D.C.
NATIONAL EXECUTIVE DIRECTOR
4/27/94
This model originated in Canada with the medical profession. The NACM was invited to initiate "chiropractic" inclusion here in the USA and indeed, the NACM was allowed to register the "orthopractic" name for the USA. Canadian, Australian and New Zealand medical organizations have already endorsed this model for spinal manipulation practice and, we are informed, the AMA is investigation this model for the USA. We anticipate AMA adoption, as it is in their best interests. Look for the Consumer (sic) Report article in June, followed shortly by Consumer (sic) Digest and the Wall Street Journal, plus medical journal articles. Our vice-president Dr. Dan Futch, will be on the Crusaders, Fox television May 7, 9 p.m. CST Saturday night.
The NACM tried for years to "reform" the chiropractic profession with renunciation of all philosophical tenants and clear definition of NMS scope of practice. They would not do so. This is a medical model for spinal manipulation practitioners of all disciplines. Scope of practice is functional biomechanics, gait, posture and rehabilitation of the locomotor systems with emphasis on the manipulative lesion, but to include physical medicine modalities for which scientific efficacy has been established. Further, DEA license is to be sought. We plan to abandon the chiropractic profession entirely and establish a new profession under the individual states "medical practices acts," with medical acceptance, cooperation and support.
We would welcome your support. We have a 1,000 application limit for acceptance on "face value." Thereafter, we are forming an investigative credentialing committee for subsequent applications. As we have the name "orthopractic" registered, however, and should a member "slip past us" and later have complaint filed for which justification is proven, we have an effective policing" mechanism via forcing them to drop the "orthopractor" designation. We shall be strict about it, mark my word. We shall not let this model for manipulation practice be subverted like the chiropractic profession has been via "practice management," "technique gurus" and the like. Nor shall any "philosophical" tenet ever play any role in the Orthopractic profession.
Sincerely,
R.L. Slaughter, M.Sc.,D.C.
P.S.: Please make note of our new number for the NACM: 713-280-8262 which has an answering machine and fax. Further, you may reach me at 713-488-8090 for voice and/or my pressing "44" after phone pick-up, fax direct into my computer.
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.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
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.
