We sit back in an easy chair and pick up the burgundy, half-inch thick, magazine-sized document and notice its weight. A heafty piece of literature indeed. Going back to the end of the Index, we find to our dismay that it is 222 pages, with three more pages graciously placed at the end to allow us to write notes.
We open the document and begin to read; no, I should say scan through all of the names of the VIPs involved in this so-called massive undertaking. Lots of people there, my oh my. Then on to the Preface, the Secretary's Report, the AHCPR communication from the medic in Washington. Next, another medic tells us about the Consensus Process and then the History of the Commission. About halfway through this we sigh, put down the hefty document, then take it up again to page ahead. Ah ha, we notice that soon we might be getting into the meat of the matter. "But gosh I'm tired." We set it down for yet another day or perhaps a gap between patients in the office.
When that day finally comes, we delve into what is the most indigestible discourse that this writer has ever had the occasion to read. Are its contents really comprehensible and cohesive to me, even after reading it twice? Gosh no! I do know that after I read it, it was not really clear to me how I, after 39 years of successful chiropractic practice, could ever fit into this pseudomedical practice profile. I guess I'd have to rate myself "equivocal," although some of my detractors would say I'm "investigational."
I searched long and hard for the term subluxation as, to me, the ultimate reason for a chiropractic examination is to determine if the patient has a subluxation. (Careful now Barge, you're getting philosophical.) By gosh, I found something familiar, yes I found our term analysis on page 95 -- oops -- they forgot to mention the ultimate goal of chiropractic analysis, subluxation. Perhaps it's under diagnosis; nope, can't find it there either. Now, wait a minute, here it is on page 96. Yes, by golly, they quoted JMPT; they stated that in 90 case reports from chiropractors in the past 14 years, subluxation is mentioned in some of these reports "as a portion of the diagnosis." Well, that means those DCs must have referred out a goodly number of cases. If you cannot find a subluxation it's not a chiropractic case, is it? (Shut up Barge, there you go again.)
Ah ha! I found an adjustment on page 103. But what happened to the definition? It is directed to the concept of "removing structural dysfunctions of joints and muscles that are associated with neurologic alterations. What about restoring the juxtaposition of subluxated vertebra? Freeing neuroforaminal encroachment? This definition sounds like something directly borrowed from National College President Dr. Winterstein. (Oops Fred, you're getting nasty.) Now let's look at manipulation; turn again to page 103. This definition actually talks about moving a joint "into the (its) paraphysiologic range." Hmm, this sounds more like adjustment than the adjustment definition.
Woe is me, my neurocalometer is useless, full spine x-rays are valid only for scoliosis (fortunately more cases are). Subluxation analysis is not really addressed -- and before and after x-rays? Oh well, I'll take them anyway. I've only got a good 10 years to practice yet, so let's let the young fellers with their black bags and stethoscopes figure out just where we fit into some sort of subordinate niche of medical practice. I'll just be the old quack I have always been, diagnosing and analyzing (whichever one you prefer) subluxations, taking x-rays to determine subluxations, taking after x-rays to see subluxation reduction and/or correction, taking the blood pressure to see if it's going up or down, checking the urine and blood to monitor physiology, etc. Yes, I'll continue to accept all cases regardless of their dis-ease or named disease, as long as they have a subluxation.
But do you realize that this document places all type of (organic) disorders in the equivocal class chiropractically? Guess what this means to insurance companies. Oh well, chiropractic works in all dis-ease regardless of the Murky, (oops) Document, or what Dr. Keating has to say. I will continue to practice as a chiropractor regardless of what this document decrees, and if the chiropractoids initiate disciplinary action against me, I may have to revert back to the GPC collection box days; some remember what I mean.
The Mercy Document? Have You Read It? Bah humbug! But one final note. I will not, and I hope you will not, role over and accept this pseudointellectual medipractic attempt to relegate us into the musculoskeletal domain. "Hail the Storm." It is your Antagonist Come to Develop You. (B.J.P.) Let us once and for all declare our independence from the "Enemy Within," Reject the Mercy Conference!
Fred H. Barge, D.C., Ph.C.
La Crosse, Wisconsin
P.S. Don't worry about throwing out the baby with the bath water, it is an oxymoron we could not live with.