Is Chiropractic Part of the Health Care Profession?

Some years ago I presented a paper for discussion at a conference questioning whether chiropractic really is a health care profession. At the time I was not adamant about the idea nor was I crusading for a change in the public viewpoint of chiropractic. I am still not a crusader for the issue but apparently the discussion continues and surprisingly, some who I thought would support my position vehemently and vociferously opposed it. Some just attacked me personally and others said I was a stooge for Spinology. I have decided to present here what I believe to be both the most logical and rational opposing arguments along with my rebuttal to those who disagree. I am not concerned about which side you come down on in the discussion but I hope that analyzing and weighing the arguments will cause you to think clearly and increase your understanding of what chiropractic truly is and is not. The following are the arguments of one very articulate spokesman and my response to him:
Argument #1: If the vertebral subluxation is an anatomical and physiological abnormality and anatomical and physiological abnormalities are the domain of the health care profession, then chiropractic is a health care profession. Medical doctors address anatomical and physiological abnormalities. While there are anatomical and physiological abnormalities that are involved in the vertebral subluxation,
the fourth component of the vertebral subluxation, the interference with the mental impulse, is metaphysical which makes it neither anatomical nor physiological. The medical profession does not acknowledge the metaphysical component of the vertebral subluxation or the metaphysical component of anything for that matter. They address anatomical and physiological problems of the spine which are medical problems. The vertebral subluxation is not a medical problem. Medicine does not formally address it. If they do, they address the physical manifestation only.
Argument #2 (a practical argument): If we major in majors and work hard at making it in health care, we can save the practice of correcting vertebral subluxations. That argument demands knowing the future and that is a gift that no chiropractor has been given. Chiropractic has not been too successful after 118 years as a health care profession with its emphasis on correcting vertebral subluxations. In fact, some might argue that it has held the profession back, after all this time, the majority of the public sees us as some sort of back doctor or musculoskeletal problem treater. The issue is not whether we should do what we do as a health care profession but whether we can do what we do as something else. The best argument for the health care side was Reggie Gold and his attempt at Spinology which most resembled the non-health care model. If Reggie could not pull it off, what makes us think that we can develop that model? No one seems to come as close to grasping and, more important, presenting the Big Idea of non-therapeutic chiropractic than Reggie did. His attempt was short-lived for after just a few years he abandoned it and got back into chiropractic. But perhaps the world was not ready for it in 1980. Perhaps western medicine with its largely outside-in philosophy will never be able to embrace it. No one has the best of this argument. I believe that chiropractic, whether we present it as a health care profession or as a non-therapeutic approach to life and health, will never reach a large percentage of the public. Many believe that if we don’t leave the health care model we will eventually be absorbed by medicine. In many ways we already have.

Argument #3: The reason why chiropractors correct vertebral subluxations is a personal matter and the professional matter should end at that. The “why” should be left up to the individual and not create a debate. If the reason why we correct vertebral subluxation is not important, what have we been fighting for during the last 30 years? The pragmatic argument and this argument have caused us to waste untold hours and untold thousands of dollars fighting for a purpose, a mission, an objective for chiropractors rather than just make the adjustment of the vertebral subluxation merely a personal issue. If reasons were not important, what has the battle for the last 3 decades been about? If there is one thing I have learned it is that it is important where we put the period. Our objective is to correct vertebral subluxation to enable the innate intelligence of the body through its forces to be more fully expressed. Does our objective include that entire sentence or should we put the period after the first seven words? I think “the opposition” says “deep down inside you can have any purpose you want, just make sure that it appears that you are treating a medical condition.” We counter that “appearances are important and we do not choose to appear to be doing something we are not”.

Argument #4: The raison d’etre or reason for being is composed of two things: its central area of interest, the vertebral subluxation, and also its practice objective (correcting vertebral subluxation). The raison d’etre should include something about why you do what you do, not just where you do it and what you do. The term “raison” I understand to mean reason. There are many chiropractors who have a central intent, the vertebral subluxation and a practice objective of correcting it. All of them have a reason for doing that. For most it is to treat a medical condition or treat the symptoms of a medical condition. That is not the straight (NTOSC) reason. Perhaps someday we can show that chiropractic cures a particular disease in every person every time. At that time we can all adopt that as our raison d’etre. Until then, my reason for being is to correct vertebral subluxations because they interfere with the full expression of the innate intelligence of the body.

Argument #5: Logic says that if you are correcting something you have an expected outcome that something is corrected. The outcome of treating a fracture is how well set is the broken bone? This particular argument is circular in its reasoning. We are a health field because we can scientifically measure outcomes. Moving a bone is an outcome.That does not mean you corrected a vertebral subluxation. The outcome for chiropractic is that the innate intelligence of the body is now more fully expressed. That makes us different from all the healing arts because our measurement of outcome cannot be determined by medical criteria. The writer makes an interesting analogy- orthopedics. If that is all we do, we are chiropractic orthopedists/mechanists. Vitalism has nothing to do with the orthopedic objective otherwise M.D.s are holistic…trying to make a better world. I am not excited about the word “vitalism” but we are holistic not because we want to change the world (we don’t, that idea was abandoned years ago) but because we work with a metaphysical phenomenon while the orthopedist is just mechanically putting two bones together. The outcome for the orthopedist, the measure of his success, is whether he put the bones in their proper juxtaposition. Ironically, he usually measures it by an outcome that he has nothing to do with..…whether the patient’s innate intelligence successfully heals the bone. Yet that is not even his outcome because quite often, in fact most of the time, those bones will knit together even if the bones are not set correctly, even if the orthopedist does not have a successful outcome. He completes his objective, measures the success of it and allows the innate intelligence to perform the vitalistic healing. The chiropractor does not measure his outcome by whether he has corrected the misalignment. On the contrary, having a structural or medical outcome is not the measure of chiropractic’s success. Whether there is an improved expression of the innate intelligence of the body through the nerve system is the issue and if our only measurement for the success of that objective is a structural change I think we have done nothing more than achieve a medical objective. Will this issue be resolved in the near future or will it ever be resolved? I doubt it but if it causes all of us to take a closer look at that objective and be more cognizant of what we are really all about, it will have served a valuable purpose and been a worthwhile debate.