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Dynamic Chiropractic – April 11, 1990, Vol. 08, Issue 08

Chiropractic's Favorite Pastime

By Richard Tyler, DC

Sometimes it seems that in the dark of the night -- when there is nothing else to do -- chiropractic "leaders" decide to end their boredom by indulging in their favorite and most obsessive pastime -- defining. Yes -- defining. Not just any old defining, but chiropractic defining which has become an art and technique in itself.

Few professions spend as much energy trying to put fences around what they do. As I've said many times before, when you define something you put a fence around it and then tend to limit its expansion and progress. But, we're told it's important to the "survival" of the profession that we are defined. It isn't too clear to me, however, why survival of the profession depends on being defined into a professional corner. The defense given for defining chiropractic seems to be some kind of hazy claptrap about being accepted by other professions and the "scientific" community. Or getting respect from government agencies, or acceptance by the insurance companies ad infinitum.

Maybe the definers are right. But let's consider the largest and most respected of the healing arts -- medicine. With all this respect it must be defined -- right? Maybe it has been. If so, what is medicine? Really, what are the dimensions and limits of medicine? There aren't any. A medical practitioner is legally empowered to do just about anything but perform marriages. He can adjust the spine, counsel on nutrition, perform acupuncture, and use physical therapy modalities with little or no training in these disciplines. Why? Because they're MDs. If medicine has ever been defined by the "experts" it's the best form of nondefining ever created. The defining experts must have met for five minutes to come up with the statement, "MDs can do anything."

Apparently, there are a lot of folks in chiropractic who are jealous and are determined that we too must be defined. There are the super-straights with their granite carved definition on what we cannot and must not do, and on the other side, the pseudomeds, who believe that we should be but the handmaidens of organized medicine. Each side is determined to put a fence around the vast majority who want a vital growing profession. Ask yourself, when was the last time a strident group of optometrists worked to limit the practice of optometry to the left eye? Or podiatrists to the treatment of corns only? Crazy? Not to a chiropractic definer. There are some -- as you know -- who will tell the world that we shouldn't be allowed to diagnose because we aren't "qualified" and that all adjustments are but a form of quackery unless that adjustment is limited to the atlas only.

The greatest problem with the definers is that they never sleep and are constantly coming up with new ways to get their way. One of the most effective is apparently not to concentrate on the word "define." The latest deal is now being pushed by the California Chiropractic Association. It's the Chiropractic Standards of Care. According to the CCA journal, "A good standard of care will define (there's that word again) our place in the health care delivery system of the future." They go on to say, "It is no secret that there is a certain lack of scientific evidence for what we, as chiropractors, do." We might well ask what "scientific" evidence there is for what the MDs do. The bureau of statistics in Washington estimates that 90% of what the medical profession does hasn't any scientific validity. If in doubt, just read that "bible" of horrors and indecision, the Physician's Desk Reference.

Yes -- I believe there are some pretty lousy people who practice chiropractic. They give away everything in a mad fight for patients, they promise too much, take too many x-rays, and adjust too often. They should be disciplined. But I wonder who is supposed to set the standards upon which any such discipline should be based.

No one asked me who should be on this commission to decide how we should all practice. Did anyone ask you? And who on earth wants MDs on this panel of "experts"? They admit that the MDs will be on the panel and deplore the fact that we in chiropractic have never been accorded the same respect. Well, I want more than that. It doesn't matter how "friendly" towards chiropractic the medical people might be, they simply are not qualified to tell me or any chiropractic physician how we should practice, since the practice they would be judging is built almost completely upon the failures of their own profession. Okay, maybe some objective PhDs to satisfy the "professional community," but not members of a profession which seeks our demise through restriction.

Maybe it would be better if we had something specific like a Standard of Ethics study that would seek to control such things as outlandish advertising and patient/insurance gouging. That, and such valid research as conducted by the FCER makes more sense.

Maybe I'm wrong -- but I just want what is best for my profession, and panels, commissions and councils that attempt to define and lock what I do into the confines of what others, who may not be qualified to judge believe, worries me. For once you're defined, you have essentially stopped future expansion and something that stops growing, stops living.

You have no idea how I, for the first time, sincerely pray that I am wrong.

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