Last year while teaching at Institut Franco Européen de Chiropractique (IFEC), the French chiropractic program in Toulouse, I was speaking to a student in French – rather poor French.Yet the student apologized for how poor her English was. It was worse than my French. I said I should apologize for how poor my French is; after all, I was in France and had a duty to speak French. She said she should speak English because chiropractic is an American profession, so chiropractors should all speak English.
A U.S.-Centric View of Chiropractic Foreign Policy
However, while the profession was started in the U.S., it is not true that it is an American profession, as if we Americans own it. Chiropractic is a worldwide profession.1 At this time, there are more chiropractic training programs outside of North America than inside of North America. Yet many in the chiropractic profession in the U.S. retain that American-centric view of the profession. This leads to an arrogant attitude about how the profession should develop around the world, similar to the attitude that is common in American foreign policy: Our way is the best way.
Policy With a Purpose
In 1999, the World Federation of Chiropractic approved a policy of Non-Interference and Respect for National Authority.2 The policy states:
"Whereas chiropractic developments in one country may significantly influence neighbouring countries;
"And whereas in countries without an established chiropractic profession new projects may conflict with projects already in train;
"Therefore be it resolved that any chiropractic organization should, prior to the initiation or pursuit of any educational, research, clinical or other chiropractic activity in another country, first contact the World Federation of Chiropractic and its representative for the world region or regions in question, in order to explain the nature of the proposed development, and should maintain communication with the Federation, informing it of progress."
Providing Guidance When None Is Required
Despite the WFC policy, some individual chiropractors, unconstrained by such international rules of behavior for national chiropractic associations, seem to believe they need to export their beliefs into different countries and "save" chiropractic in those countries. They think that they need to protect the Europeans from European thoughts and ideas about chiropractic.
One such person's actions in the Netherlands almost got cervical manipulation banned there. That person then had the audacity to suggest the country needed help to prevent the banning of cervical manipulation, which, in fact, their actions almost caused.
In several countries in Europe, chiropractors are completely integrated into the health care system. Chiropractors have the right to refer to all types of diagnostic imaging, hospitals, medical specialists and physiotherapists. All patients are reimbursed by the state. Chiropractors have access to state research funds and funds for post-graduate education (often called CPD – continuing professional development). Chiropractors are highly respected and chiropractic is a household word.
When Europeans were asked if they have confidence in the chiropractor, more then 80 percent said they have "high" or "very high" confidence. This is a circumstance under which most chiropractors around the world would love to practice. Yet some Americans say there is a crisis for chiropractic in Europe. They are simply wrong.
Of course, not all countries in Europe have the same status or laws I have described above. These countries are more vulnerable and susceptible to attacks from American fundamentalists. Some chiropractors in those countries, rather than getting advice from their neighbors, instead are energized by American agitators, creating division within their country.
The European chiropractic profession is in a position to defend itself. It does not need any outside help to move the profession forward. On the contrary, what Europeans see is that when certain chiropractors or groups of chiropractors from the U.S. visit Europe with their practice-management courses, it results in a greater division of the profession.
Respecting Other Beliefs – Even If You Disagree With Them
Do unto others as you would have others do unto you. Americans wouldn't want Europeans telling them how the profession should function; so Americans shouldn't foist their beliefs on Europe. But then again, neither of the American chiropractic organizations, the ACA and ICA, would do that; only rogues lacking respect for their colleagues and what their appropriate role is as American chiropractors vis a vis European chiropractic.
What Europeans want is a more generous and more respectful approach to fellow colleagues. Leave the politics of chiropractic in Europe to Europeans. But given the fact that some of the same agitators and others have applied this same attitude within the U.S., I guess we can't really expect them to behave any better outside of the U.S. I've seen emails that recommend chiropractors lie to legislators in New Mexico, say they live in the legislator's district and tell the legislator their constituency wants them to vote against expansion of the chiropractic scope of practice.
This utilitarian approach (sort of the ends justifies the means) may be moral when the ends are existential: for example, lying to murder to protect the intended victim. However, expansion of scope of practice won't harm anyone with a more narrow orientation, anymore than gay marriage harms my heterosexual marriage of 32 years. The lack of harm from scope expansion is especially true when that expansion is happening in a different state or country. Hopefully, our profession can mature enough to respect the choices of our colleagues in different states and different countries.
- Phillips RB. The Global Advance Of Chiropractic: The World Federation Of Chiropractic 1988-2013.
- WFC Policy Statement - Non-Interference and Respect for National Authority. Approved by the Council of the World Federation of Chiropractic, September 1999.
Click here for previous articles by Stephen M. Perle, DC, MS.