Where Have We Been?
I know it's not the most original subject to write about and there have been many articles in the past, but I wanted to give my perspective after being involved in the profession for 58 years.My tenure in chiropractic began in 1950 when I enrolled at Palmer School of Chiropractic. B.J. was in complete control and we were taught one technique: hole-in-one (HIO) upper cervical. The neurocalometer (NCM) was used on all patients before they were adjusted. You went into clinic six months into what was then an 18-month curriculum.
The International Chiropractors Association (ICA) was headquartered at Palmer, where B.J. was the president and in complete control of the conservative voice within the profession. Conversely, Joe Janse from the National College of Chiropractic was the voice of the National Chiropractic Association (NCA), representing the liberal aspect of chiropractic. There was then, just as there is today, constant verbalization between the "straights" and the "mixers." I have learned one thing during my many years in this profession: Probably 90 percent of all chiropractors use some type of "mixing" procedure in their practices. But at the same time, 95 percent of all practitioners use the spine as their primary portal of entry.
In 1950, approximately 12 states did not have a chiropractic board of examiners and consequently, chiropractors practiced illegally and under threat of prosecution and incarceration. After I graduated in 1955, I bought a practice in Rock Island, Ill., and practiced five years without a license. Many of my friends were jailed. The Illinois Medical Practice Act had been passed in 1923 and eventually included chiropractic in the law, but Palmer was not a recognized school in the state of Illinois until 1960. Palmer graduates (about 600 of them in Illinois) were allowed to sit for the examination after legislation was passed recognizing Palmer and other colleges. Illinois is still the only state that does not have a chiropractic board of examiners. For years, legislation was introduced to establish a board and define chiropractic, but was never passed because the profession was split on whether this type of legislation was necessary. Many felt the medical board was a haven for the profession.
One advantage to being licensed in Illinois is the ease of obtaining a license. All that is necessary is a diploma and evidence that you've passed the national boards. This information is sent to the Department of Registration and Education and a license is issued. More states need to follow this pattern. The amount of time and money students must spend passing the boards should prove their ability to practice in any state. State boards of examiners should become regulatory and possibly policing bodies, and forget about testing procedures.
Physiotherapy and Chiropractic
For years, there has been an alarm going off about the PTs "stealing" chiropractic and trying to obtain legislation which would allow them to adjust or manipulate the spine. However, chiropractors encroach on PTs constantly by utilizing their modalities. Most chiropractic colleges endorse and/or teach the use of PT equipment and procedures in the curriculum, so who is stealing from whom? One negative thing is that many ads for modalities stress the income that can be derived from their use, as opposed to the health benefits.
Gidgets, Gadgets and Gizmos
Over the years, chiropractors have been exposed to and "bitten" on so many of the above that it is close to shameful. Go back to the 1920s. The NCM was a high-priced instrument that "every chiropractor had to have." B.J. tried to mandate its usage and caused a split in the profession. In the '60s, the Ellis Micro-Dynameter was another hot item until the FDA declared that it had no scientific value. I inherited one in the practice that I bought, and the FDA came to my office and confiscated it, with no remuneration, of course.
The big gadget for the liberal practitioner in the '50s and '60s was the colonic irrigator or, in actuality, a super-duper enema. But it was a big item and there is no way to tell how many of them were sold to chiropractors. I am not sure, but I think the FDA had something to do with their demise. I imagine the premise for using the instrument was that a normal bowel movement did not eliminate all the waste in the colon. Ho-hum - a little Ex-Lax probably could have solved the so-called problem. And we must not overlook the "electroencephaloneuromentimpograph" that B.J. used in his research clinic. I interned in the B.J. clinic my senior quarter and was assigned to the room where the patients were tested with this instrument. I never figured out what it accomplished.
Today, there are so many adjusting and testing "gadgets" around that it is mind-boggling to determine which one is the most proficient.
The "gurus" in chiropractic have been involved in all aspects of the profession. B.J. wrote books on "salesmanship," as did Roy Lemond and Jim Parker, the latter of whom probably had the largest following of anyone during his time as a practice-building icon. He has been called the granddaddy of practice-building and after him; there have been a host of others. Most are charismatic, good speakers and know their topic from A to Z. But many times the DCs taking the classes cannot duplicate the gurus in practice.
I would say the philosophy gurus have the largest following among the more conservative chiropractors. They all have the same basic message and their primary aim is to get their audience "pumped" up by expounding on the merits and benefits of chiropractic. Some have a religious fervor in their presentations. These gurus help balance out the liberal aspect of the profession.
Where Are We Going?
Now, where do we go from here and what does the future hold for the chiropractic profession? I think that thanks to the pioneers who fought so hard for the profession in the areas of licensure and public recognition, we are on solid ground. The question that dangles out there is, will we remain an independent health care provider or be engulfed into the medical profession?
Can the ACA and the ICA ever unite into one strong organization? For that to happen, there needs to be more grassroots support. Whatever the future holds, chiropractic must present a united front and that will come from the individual chiropractors pulling together for each other. In my experience, the average DC wants to stay in their office, do their thing and be left alone. Chiropractors will be members of their state association because they need CME hours, they might join a national association, and (last on the list) they might support their alma mater.
Let's not forget the question that's been on the table since 1895, when D.D. Palmer discovered chiropractic: Will the profession become more conservative or broader in its approach to health care? I think time and research will answer that one.
Service to patients must rule over money. We must stop fighting each other and present a united front. One national organization representing conservatives and liberals would help achieve this. In short, chiropractic must be first and chiropractors must be second.