As the practice of medicine and the practice of chiropractic become more similar, the profession is either going to lose its identity or be forced to more clearly define itself. Chiropractors are performing more and more medical procedures and medical doctors are incorporating more drugless procedures ordinarily associated with alternative approaches like therapeutic chiropractic. The public will not be able to tell the difference between a chiropractor and a medical doctor unless chiropractic more clearly defines what it does. Although the number is decreasing yearly, I believe most chiropractors still do not want to lose their identity and become “physicians.” They are going to be forced to make a decision. The recent case in California of the chiropractor who gave a vitamin to treat a medical condition raises some serious questions.
The medical profession and the district attorney claimed the vitamin was a drug because it was being used to treat a medical condition. The chiropractic association said that was absurd, that there is no such thing as a medical condition, just conditions or diseases which are common domain so that the treatment of it is determined by state law. In other words, back pain was neither a chiropractic nor a medical condition. Either profession could treat it unless the law forbid it. Similarly, cancer was not a medical or chiropractic condition, either profession could treat it unless the law forbid it. This may seem extreme but that was the legal argument of the state association attorneys. If the law allows chiropractors to use vitamins for the treatment of a disease as long as state law does not strictly forbid the use of vitamins or the treatment of a particular disease, that would be chiropractic. Following this reason, if the law allows chiropractic the right to prescribe over-the-counter drugs, that becomes the practice of chiropractic. Where then are the lines drawn between the practice of medicine and the practice of chiropractic? It simply cannot continue this way especially in light of the government’s desire to protect the consumer even to the point of controlling their lives and limiting their freedom. (I am not free to ride a motorcycle without a helmet because the government is afraid I will hurt myself.)
The logical determination that will have to come from this is that if a vitamin is given to treat a disease, it is a drug. Not only is this the logical thinking, it is also the position of medicine which has the strongest political clout. However, if a vitamin is given to fill a nutritional need and not to treat a disease, it is not considered to be a drug regardless of whether a medical condition is present or not or whether that medical condition is associated with a vitamin deficiency or not. This would seem to be an option that both the billion-dollar vitamin industry and the medical profession can live with. Of course, the vitamin industry would rather make claims to cure diseases and the medical profession would rather not concede any aspect of health care. They would prefer to be the only ones who are involved with peoples’ health. Neither group will be totally happy but that is the nature of compromise. The only alternative to this option would render the practice of medicine non-existent since anyone could practice it, including distributors in a multi-level marketing program. If you are giving a vitamin to treat a disease or its cause, then you would be required to have training in the diagnosis and prognosis of that disease, and to know what alternative treatments are available and perhaps more appropriate. In other words, you will have to be trained as a medical doctor. Basically, that would be defining the use of vitamins by your objective. If it is to treat a disease, you must be a medical doctor. If it is to improve peoples’ nutrition anyone can prescribe them. There does not seem to be any other way to satisfactorily resolve this dilemma.
What does this have to do with chiropractic? Well, a great deal for the chiropractor that prescribes vitamins but it is also applicable to straight chiropractic practices. If the objective is to treat a disease or its cause whether you use vitamins or acupuncture or give an adjustment, it must be viewed as the practice of medicine and restricted to those qualified to do that. It may very well be that one day, in the not too distant future, all chiropractors will be forced to practice our model of chiropractic, to correct subluxations to enable the body to work better regardless of or apart from the presence or absence of a disease entity. There is no other resolution except to be trained as a medical doctor and that involves a great deal more training than chiropractors are currently receiving. v15n1