American DC Angers Profession in Germany

Should DCs Be Teaching Chiropractic to Non-DCs?

By Editorial Staff

The chiropractic profession in Germany and throughout Europe is up in arms over the actions of a young American DC, Dr. Mark Styers, who has commenced a 432-hour, 26-weekend course of chiropractic technique seminars for lay manipulators.

Upon completion of courses at Dr. Styers' American Institute of Chiropractic (AIC) in Hamburg, graduates are encouraged to join a new chiropractic association formed by him and one of his students - as chiropractors. These developments are strenuously opposed by the German Chiropractors Association (GCA), representing most of Germany's 70 DCs, as well as by the European Chiropractors' Union.

Palmer graduate Dr. Gordon Janssen, a GCA member who has investigated the matter, met with Dr. Styers and ultimately contacted Dynamic Chiropractic on behalf of the GCA; he accuses Dr. Styers of "selling out chiropractic." Dr. Janssen insists that "some of our colleagues are not fighting for chiropractic but are even willing to sell out our profession for their own profit" and that "this might be the beginning of the end for our profession in Germany."

According to guidelines currently being developed by the World Health Organization (WHO), a medical doctor would need at least 1,800 hours of education, including 1,000 hours of supervised clinical training, in order to convert to a doctor of chiropractic. Lay manipulators, such as the individuals being taught by Dr. Styers, would be required to take at least 2,500 hours over a three-year period, including at least 1,000 hours of supervised clinical training, before they could call themselves doctors of chiropractic. The additional hours would focus on developing a foundation in the basic sciences and a philosophical foundation.

Unfortunately, the situation in Germany is similar to that in a number of other nations. The German government does not recognize chiropractic as a health care profession. They do recognized lay manipulators known as heilpraktikers. There are already an estimated 30,000 heilpraktikers who have limited formal training. They are required to pass a written and oral test that many fail, although they are able to take a short course designed to help them pass. Many heilpraktikers go to a heilpraktiker school that teaches them manipulation, acupuncture, nutrition and a variety of other therapeutic modalities. Heilpraktikers have been doing various forms of manipulation in Germany for a long time, much longer than doctors of chiropractic have been practicing.

In countries with a large group of lay manipulators, the challenge for the chiropractic profession is to differentiate properly trained DCs so that the public knows the difference between a chiropractor and a lay manipulator. Years ago, a handful of U.S. DCs taught chiropractic to non-DCs in Sweden. The Swedish non-DCs taught the techniques they had learned to other non-DCs, until the many chiropractic techniques were used by lay manipulators without the appropriate science or philosophy foundation. This contributed to the formation of a two-tier system that recognizes two levels of "chiropractic" practitioners: registered chiropractors, and others who can still use the title of chiropractor, but don't really have the education.

Into the situation in Germany comes Dr. Mark Styers, a U.S. doctor of chiropractic who graduated from Life University in 1999. Dr. Styers has created the American Institute of Chiropractic (AIC) in Hamburg and is also president of the WCA - Germany. According to an AIC Web page (no longer accessible) and members of the German Chiropractic Association (GCA), Dr. Styers' Web page advertised the following courses to heilpraktikers over 26 weekends (432 hours):

  • Upper Cervical Specific Techniques I, II, III, and IV
  • Pediatrics I, II, and III
  • Instrument Adjusting (Activator) I & II
  • Chiropractic Biophysics Technique I & II
  • Thompson Drop Technique I & II
  • SOT Basic and Advanced
  • Extremities Techniques
  • Sports Rehabilitation I & II
  • Neurological Re-Balancing Technique I & II
  • Nutrition
  • Basic and Advanced Cranial Techniques
  • CMRT (Chiropractic Manipulative Reflex Technique)
  • Chiropractic Practice and Case Management
  • Network Technique I & II

(It is important to note that there are no basic science or chiropractic philosophy courses listed. It is also important to note that Dr. Styers does not have permission from Activator Methods to teach its technique.)

When contacted, Dr. Styers stated that the curriculum has changed since the Web pages were initially published. He freely admits that "(W)hen we first started out with this program the focus of what we were going to do changed and evolved. Any original advertising does not accurately reflect these changes." According to Dr. Styers, the AIC now teaches "Philosophy of Chiropractic, History of Chiropractic, Chiropractic Neuro-anatomy, Subluxation Theory, Spinal Biomechanics, Spinal Motion and Palpation, Spinal Biodynamics, X-Ray analysis (chiropractic), Physical exam/Instrumentation, Upper Cervical, Toggle Recoil, Office Procedures, Patient Management and Pediatrics."

And while Dr. Styers states, "(T)he Institute does not issue a degree, or certificate to allow them to practice," his graduates are free to join his chiropractic organization and represent themselves as chiropractors, thus blurring the distinction between his graduates and DCs who have graduated from accredited chiropractic colleges.

This can be clearly seen on the Web site of "Markus J. Kuhlmann, Chiropractor" (, one of Dr. Styers' students. On his Web site, Mr. Kuhlmann not only calls himself a chiropractor, but also provides an explanation of chiropractic using photographs of both D.D. Palmer and B.J. Palmer. The site even features the chiropractic caduceus. He cites his attendance at the AIC and his membership in the WCA - Germany.

Members of the GCA insist that Styers' students are beginning to teach other lay manipulators, thus re-enacting the Swedish situation all over again. Needless to say, German chiropractors are very upset.

Dr. Styers states, "(N)ot everyone agrees with what I have done or what I am doing, and I understand that. What I would like people to understand is that no one is learning chiropractic who cannot already practice chiropractic legally under the framework of the health laws currently here in Germany. I do what I am doing out of love for the safety, efficacy and growth of chiropractic and nothing else. If I had started a money institution I would have enrolled more than 22 students in the last 3 years. I have made the decision to keep it small and effective until the time that this becomes a chiropractic school."

Dr. Styers' European colleagues don't agree. They particularly don't agree that people being legally allowed to manipulate is the same as a well-qualified doctor of chiropractic being allowed to "practice chiropractic."

"Frankly, the World Federation of Chiropractic, and particularly its European members, find it unbelievable that Dr. Styers, an individual American chiropractor with no educational qualifications [to teach], would betray German chiropractors and the profession in this manner," commented WFC President Dr. Anthony Metcalfe, of London, England.

"This 432-hour chiropractic technique program for lay manipulators offends not only the hard-won educational standards of the profession in all countries in which it is regulated by law, but also those of the World Health Organization - about to issue chiropractic educational guidelines that would call for a minimum of 2,500 hours of very different and much more demanding education for such students.

"The WFC, the German Chiropractors Association and the European Chiropractors' Union have all pleaded with Dr. Styers not to exploit the lack of regulation of chiropractic in Germany for his own ends, but without success. He is guilty of highly irresponsible behaviour that is placing the future of chiropractic in Germany and neighbouring countries at great risk."

According to Dr. Styers, the AIC will cease offering its current program in July 2005. Instead, it will be "a Continuing Education center where DCs from all over Europe will be able to come and attend lectures from some of the best chiropractors in the world." When pressed, Dr. Styers admitted that his graduates and other lay manipulators will be able to attend these seminars as well; thus, anyone who lectures for Dr. Styers will be teaching chiropractic to lay manipulators.

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