Diagnosing and Prescribing Drugs

As a profession we seem to be up in arms about the desire of some within our profession to add the right to prescribe drugs to the practice of chiropractic. Yet we should not be surprised. We should see it as the normal and natural result of our profession’s developing attitude to the practices of medicine and chiropractic and a desire to blend (mix) the two. The same chiropractors who today deplore the idea of us prescribing drugs, were thirty-five years ago applauding, agreeing with, and in fact were some of our leaders who were criticizing the “super straights“ who saw diagnosis as the first step toward the medicalization of chiropractic. Some still do not see the danger of that first step and feel that we should, as primary care providers, come to a medical diagnosis prior to providing a chiropractic service. Some of you are too young to remember what a respected and now deceased leader of our profession said about the “super straight” chiropractors who felt that diagnosing was stepping over the line, a line that would result in us eventually practicing medicine. Before you judge him too harshly, where would your thinking be if you were around in 1977? Remember that with any right comes a responsibility. The right to prescribe a drug comes with the responsibility of first determining what the drug is supposed to treat and second whether you can reasonably expect a positive outcome in that treatment.
So what is the first step down the slippery slope? Many of us chiropractors maintain that the first step is diagnosing, determining the presence of a medical condition and once that step has been taken, the next logical one is the treatment of that condition in the most effective manner. Some believe that the chiropractor is the person most capable or at least as capable of making that decision as a medical doctor. However, any first step is preceded by a thought that precipitates action. In chiropractic that thought is whether chiropractors address medical issues or the lack of heath issues. If they address medical issues, the lack of health issues, i.e. disease, then diagnosis is a requirement. So their objective determines the need for diagnosis or the lack of a need for diagnosis. There is one final point to be made. At one time in the history of our profession it was thought that vertebral subluxation was the cause of all disease. If that were the case then diagnosing a medical condition was not necessary. As we have begun to better understand the difference between DIS-EASE and disease, our thinking has changed. Addressing the former is the objective of chiropractic and the latter the objective of medicine.