There has been a considerable amount of hoopla in the chiropractic publications recently over the Koren Specific Technique. I am not about to get into the pros and cons of the technique and its validity. Apparently, no one else seems concerned about proving its effectiveness, just whether it is chiropractic or not and whether Dr. Koren should be restricted from teaching it to non-chiropractors. The issue I’d like to address is whether the profession should ostracize Dr. Koren for wanting to teach his technique.
If I followed the natural inclination of those in our profession who control the accrediting, educational and political aspects, I would say restrain his right to teach his technique. However, I believe that is an un-American approach. Let the marketplace determine whether his approach has value and should be used by chiropractors. Allow Dr. Koren the freedom to teach his technique to whomever he chooses. What is the matter with our profession? About the only thing we can truly conclude about the state of our profession is that we have no idea who we are or what we do or should do.
In the past, I have written and lectured on the idea that the problem with chiropractic is not that we cannot agree on the definition of chiropractic (which we cannot), and that is because we cannot agree on the definition of medicine. If we decide what the practice of medicine is (therapeutic, disease/diagnosis treatment care), then we can conclude that we either do something different than that or we are practicing medicine without a license, the training, or the legitimate basis to do so. I opt for the former.
The first thing we need to decide is whether Dr. Koren’s technique, which I understand involves both analysis and adjustment/manipulation, is chiropractic. Clearly, it is not chiropractic as the non-therapeutic camp of the profession defines chiropractic. However, we it is chiropractic as the rest of the profession defines chiropractic. Since everything taught to or done by a chiropractor the profession believes is chiropractic. Dr. Koren acknowledges that he “adjusts” other areas of the human anatomy besides the spine. Further, his spinal adjustments are intended for the treatment of medical conditions. Dr. Koren himself states that it is not chiropractic. Of course, that may just be a matter of practicality, because in order to teach it to non-chiropractors, it must be called something else beside chiropractic. It is the Koren Specific Technique.
Here is the confusing part. Those opposing Dr. Koren have no problem with people teaching everything under the sun to chiropractors. Now if they are teaching procedures to chiropractors, by their definition and as previously discussed, it must be chiropractic and not medicine. So orthotics is chiropractic not medicine. Nutrition is chiropractic, not medicine. TMJ procedures, acupuncture, physical therapeutics, weight loss, hyperbaric, neuro-endocrine regulation, detoxification, massage, rehab, as well as analytical approaches to diagnosing diseases too numerous to mention are chiropractic as well. Can all of the above be part of the practice of chiropractic? I guess they can because they are advertised as procedures chiropractors can learn and use (advertised in the same publication condemning Dr. Koren). No wonder all the world is flocking to chiropractors’ offices! It even gets more confusing because apparently nutrition is also being taught to nutritionists, acupuncture to medical doctors and acupuncturists, and physical therapy is not just being taught to chiropractors. Somebody is actually teaching it to physical therapists. Should we not be attacking them also for teaching those procedures to non-chiropractors? They even have schools of physical therapeutics.
We as a profession have embraced so many procedures under the umbrella of chiropractic that not only does the public not know what chiropractic is, but we ourselves as a profession do not know. It is hypocritical of us to want to do all these therapies and procedures as chiropractic and then when another profession attempts to learn something that we chiropractors do and add it to their armamentarium, we try to stop them. We want to do everything we want to do and call it chiropractic, but when someone else wants to do something that relates to the spine or bears a resemblance to adjusting or manipulation we want to enjoin them from doing it, even if they do not call it chiropractic.
If what Dr. Koren is teaching is not chiropractic then he should be left alone. If it is chiropractic then I believe he should be stopped. However, we really cannot do that until we establish what chiropractic is and as a profession we are so mixed up and confused as to what this profession is that there is no way we can establish the parameters of our profession. There is one segment, and only one segment, of the profession that has done anything to define this profession. They have limited themselves to the correction of vertebral subluxation so that the innate intelligence of the body can be expressed more fully. Non-therapeutic straight chiropractors are the only ones in a position to say whether Dr. Koren is teaching chiropractic to non-chiropractors. The rest of the profession by its own admission does not even know what chiropractic is, by its failure to define it or to settle on an objective. It is totally incapable of passing judgment on Dr. Koren’s technique.
In my opinion Dr. Koren is doing exactly what dozens of other people are doing. He is teaching something other than chiropractic to chiropractors and non-chiropractors. If it is worthless to the public, time will tell. If it helps people, from a therapeutic perspective we have no more right to stop it than to stop people from teaching and practicing any other therapy. v24n3