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NCAHF Position Paper on Chiropractic
Chiropractic's Unique Therapy
The Practices of Chiropractic
Super-Straights, Straights, and Spinologists
Treating "Cause" versus "Effect"
State Licensure, Regulation, and Recognition
NCAHF's Description of a Scientific Chiropractor
Chiropractic is a controversial health care delivery system with an estimated
24,000 practitioners in the United States. Chiropractors are licensed in
all states and several foreign countries. According to the American
Chiropractic Association, 9.8 million patients made 135 million office
visits during 1983 and utilization increased by 77% from 1964-74 while
the population grew at only 10.4%.(1) Politically aggressive and
public-relations minded, chiropractors are seeking to expand their legal
scope of practice, and are attempting to establish their methods as suitable
alternatives to conventional medicine. However, most chiropractors
do not share the view of health and disease held by health scientists worldwide.
Most dispute the idea that germs are the primary cause of infectious diseases,
disparage conventional medical practices--particularly drug therapy and
surgery—and oppose various scientifically-based public health measures.
In short, chiropractic has been anti-science in its philosophy and approach
to health care.
NCAHF's recommendations in this paper are based upon extensive study
of materials from within chiropractic itself, inquiries and investigations
by government and consumer agencies, criticisms by scientists and medical
practitioners, insights provided by chiropractors who share NCAHF's principles,
and the Council's own investigations. NCAHF believes that the chiropractic
controversy is best understood when manipulative therapy, chiropractic's
unique theory, and the practices of chiropractors are considered separately.
Manipulative therapy has a history extending back at least to Hippocrates.
Folk healers (i.e. "bonesetters") and early osteopathic physicians used
manipulation as a panacea, believing that many organic disorders were caused
by "displaced" bones. Today manipulative therapy is employed by medical
specialists (e.g. physiatrists, orthopedists, sports medicine practitioners),
osteopathic physicians, physical therapists and athletic trainers as well
There is substantial evidence that manipulative therapy has value in
treating back pain. Although it may not be any more effective than other
modalities in the long term, manipulation may offer short term benefits
when compared to other commonly used modalities. Several studies have found
that about one-third of patients will experience more rapid relief with
manipulation than with other modalities.(2-4) Manipulation is probably
not utilized as fully as it might be in relieving the symptoms of some
chronic disorders. It has been reported to be beneficial in controlling
migraine pain.(5) Because manipulation involves the laying on of
hands, a procedure employed throughout history by folk and faith healers,
it enhances suggestibility and the placebo effect.(6,7) Occasionally,
manipulation produces dramatic results. An example involves immediate recovery
from paraplegia caused by an auto accident.(8) Manipulative therapy
is not without risk. Many cases of serious complications following manipulative
therapy have been reported in the medical literature. (9-15)
Chiropractors probably are more skilled in the art of manipulation than
other practitioners since it constitutes the major emphasis of their training.
Chiropractors are usually the most accessible manipulative therapists in
a community, and some receive referrals from medical doctors. However,
many physicians are reluctant to refer patients to chiropractors. This
may be due to a fear that the chiropractor may attempt to indoctrinate
patients in deviant health beliefs, a disbelief in the value of manipulative
therapy, or an apathy to non-medical practitioners.(5)
A major criticism of chiropractors is that they over utilize manipulation,
both in excessively treating conditions known to be responsive to manipulation
and in applying it to conditions for which there is no known justification.
According to anecdotal reports by chiropractors, and patients who may have
turned to chiropractic when conventional medical treatment failed to provide
relief, manipulation has sometimes produced beneficial results. Such positive
outcomes appear to be unpredictable and unexplained. These reports are
selective, emphasizing positive results, but are common enough to warrant
Chiropractors have demonstrated some degree of clinical success in workmen's
compensation studies.(16-18) Unfortunately, the failure to apply
rigorous scientific methodology has prevented the identification of any
special value chiropractic manipulation might have. This absence of scientific
evidence is due largely to the confidence placed in the validity of chiropractic's
Chiropractic's Unique Therapy
Chiropractic's uniqueness is not its use of manipulative therapy but its
theoretical reason for doing so. Just as early osteopathy found its justification
in the "rule of the artery" (i.e., the belief that manipulation improved
circulation), chiropractic is based upon the "rule of the nerve", which
assumes manipulation exerts important effects upon ''nerve flow ''.
The term ''chiropractic'' literally means "done by hand." The
word was adopted by chiropractic's founder, Daniel D. Palmer, a layman
with an intense personal interest in the metaphysical health philosophies
of his day such as magnetic healing, phrenology, and spiritualism.
In 1895, Palmer claimed to have restored the hearing of a nearly deaf janitor
by manipulating his spine.
Palmer believed that he had discovered the primary cause of disease
and theorized that 95 percent of all disease was caused by spinal subluxation
and the others by luxated bones elsewhere in the body. Palmer was
not employing the term "subluxation" in its medical sense, but with a new
metaphysical meaning. Palmer's "subluxations" supposedly interfered
with the body's expression of the Universal Intelligence (God) which Palmer
dubbed the Innate Intelligence (spark of life or spirit).(19)
Thus, D.D. Palmer invented chiropractic, named it, and established a guild
of practitioners to further its development. For this reason chiropractic
fits the dictionary definition of a cult (i.e. a system for the cure of
disease based upon dogma set forth by its promulgator) (Webster's New
Seventh Collegiate Dictionary).
The Practices of Chiropractors
In practice, chiropractic presents a chaotic picture. Few practitioners
limit themselves to pure chiropractic. Practitioners are divided
into a variety of factions and political battles over which faction deserves
rightful title to the designation of "chiropractor" are still taking place.
These divisions produce such variations that almost any generalization
is inapplicable to some individuals or faction. Thus, any single
description of chiropractic may be challenged as "unrepresentative."
In the following paragraphs are descriptions of a variety of these factions.
Super-Straights, Straights and Spinologists
Chiropractors who restrict their practices to analyzing the spine for "subluxations"
and removing them exclusively by manipulation without regard to a patent's
disease refer to themselves as "straights." They eschew the concept
of diagnosis. Instead, they believe that if they analyze the spine and
eliminate the "subluxations," health will follow. Those who cling to the
metaphysics of Palmer's original theory constitute a persistent minority
who insist that they are the true chiropractors. Such have been referred
to as "radical religious" (20) and "super-straights." Some
innovative chiropractors recently created the term "spinology" in which
"subluxations" are renamed "obstrusions," and allege that keeping the spine
free of obstrusions will enable a person to reach his/her maximum genetic
potential. Reference to disease or treatment is definitely implied
but specifically denied. Spinology is clearly another version of
"super straight" chiropractic.
Treating "Cause" Versus "Effect"
Chiropractors who restrict their practice to manipulation may be correctly
labeled "straights", but whether practitioners believe their manipulation
to be removing "causes" or "effects" is essential when evaluating individuals.
Scientifically oriented manipulative therapists usually see their treatments
as relieving the muscle spasms and nerve irritation (i.e., symptoms or
"effects") of improper body mechanics, psychological stress, trauma, or
some other "primary" cause. Philosophically oriented chiropractors are
loathe to admit that they treat only "effects" or merely relieve symptoms.
Chiropractic students are taught a distorted view which portrays medical
doctors as philosophically committed to the "allopathic" theory of Hippocrates
by which they merely treat the symptoms (i e, "effects") of disease. Chiropractic
is portrayed as superior to medicine because it focuses on "subluxations"
which it regards as the primary causes of disease. In reality, medical
doctors abandoned practicing on the basis of philosophy long ago as they
accepted scientific methodology. Medicine's dedication to the Hippocratic
Oath is due to its acceptance of its code of behavior of physicians; not
Hippocrates' healing theory.
Chiropractors who utilize other modalities in addition to manipulation
are labeled "mixers" by the straights. Unfortunately, these additional
techniques are unscientific. Many mixers are opportunists who readily incorporate
health fads into their practices. Straight chiropractors charge that mixers
are actually "naturopaths" practicing under the guise of chiropractic in
order to circumvent the fact naturopathy is illegal in most states.
NCAHF tends to agree with this assessment.
Naturopathy is a form of "eclecticism" (i e, a school of thought professing
to select from what is best from all systems of medicine) that borrows
from a wide variety of healing philosophies, applying them by subjective
experience. Naturopaths usually mix common sense (e.g., advice against
smoking and drug abuse and the advocacy of exercise and cleanliness) with
bizarre theories about health and disease. Naturopaths employ a wide
variety of questionable methods borrowed from folk medicine, pseudoscience
and discarded medical practices. One is iridology, based upon the
notion that every disease, habit, etc. is reflected directly through the
nervous system to the iris of the eye.(21)
Iridology, like reflexology, scleraglyphics, graphology and a host of
other suspicious diagnostic techniques, utilizes methods common to a technique
known as ''cold reading''.(22) Using a chart as a guide, the clinician
fishes for past and present health problems. The subject may be quizzed,
"Have you had problems with your stomach, liver, back, etc.?" If
the patient acknowledges that he/she has, or ever has had, any kind of
problem in the area in question, a 'hit' is claimed, and the "finding''
is exploited. If the chart indicates a problem that the subject does not
acknowledge, it can be claimed that there is "a weakness and a tendency
for disease in the area" (a finding which opens the door for "preventive"
treatments to keep the alleged disease from occurring). Thus, the practitioner
is never judged as wrong. Such methods are characteristic of fortune-telling,
Naturopathic treatments may include shining colored lights on the patient
(i.e., chromotherapy) on the theory that red "...might be used in ailments
of the blood . . orange is helpful in fevers...yellow rays aid stomach
troubles", and so forth. Patients might be sold "glandular" products
on the theory that pills made from eyes will help the eyes, pancreatic
substances the pancreas, liver extracts the liver, and so forth.
Naturopaths prescribe megavitamins and herbs, either of which may function
as drugs, belying the claim that their therapies are "drugless" or benign.
Naturopaths tend to emphasize colonics based upon the discredited nineteenth
century "intestinal toxicity" theory. The different kinds of treatments
employed by naturopaths and mixer chiropractors are not necessarily any
more "natural'' than those used by medical practitioners, but are simply
non-scientific in nature or application.
Chiropractors complain that they are cut out from the rest of the health
sciences and have even carried this charge to the point of bringing antitrust
suits against a number of professional health organizations. In reality,
it is chiropractic, with its deviant views on health and disease, that
has isolated itself from the health sciences. Chiropractic theory and philosophy
contest with basic anatomy, physiology, neurology, microbiology, pharmacology,
pathology, immunology, and many other basic sciences. Despite their claims
of persecution by organized medicine, chiropractic expends far more effort
attacking conventional medical practice than vice versa. Chiropractors
often play upon patients' natural fears of surgery and confuse patients
by linking responsible therapeutic drug use with drug abuse.
In addition, chiropractors generally oppose public health programs such
as fluoridation, immunization, and sometimes pasteurization of milk.
Those who engage in nutrition counseling commonly attack modern food technology
and promote unscientific ideas. It seems curious that although chiropractic
students use many standard medical textbooks, what they learn deviates
significantly from others schooled in the health sciences. The source
of these problems appears to be faulty schooling where chiropractic philosophy
and pseudoscience are mixed with training in manipulative therapy.
Chiropractic's lack of science has led it to violate the basic Hippocratic
principle of "first of all, do no harm." The conviction held by chiropractic
true-believers that every spine will benefit from an adjustment causes
them to manipulate spines inappropriately.(23,24) Among the
concerns about chiropractic manipulation is the widespread use of the explosive
"dynamic thrust" which takes the patient by surprise, as opposed to more
conservative techniques. This maneuver has a greater potential for
The practice of greatest concern is the rotary neck movement (sometimes
called "Vaster cervical'' or "rotary break"). This type of manipulation
has led to trauma (25-27), paralysis (28,29), strokes (30,31),
and death (32-33) among patents. Even chiropractic's legal
advisors have warned against its use.(34)
The overuse of x-ray by chiropractors poses potential patient harm.
Of primary concern is the 24' x 36' full spine x-ray. This technique exposes
patients to a substantial amount of radiation. (35,38) Exposing
the body trunk to x-rays can have serious long-range consequences (36-37)
and should be avoided. Further, according to NCAHF's chiropractic
advisors, such radiographs have little or no diagnostic value.
The most disturbing feature of chiropractic is the number of ''success
schools" which teach ethically questionable practices and sometimes outright
fraud to be used in practice-building. The methods employed have
been described elsewhere (38-39) and will not be reviewed here in
detail; just three examples will suffice.
First, is the practice of leading people to believe that vague symptoms
common to everyday life are warning signs of serious disease in need of
chiropractic care. Second, is the tactic of selling patients
on a belief that weekly or monthly "preventive" chiropractic care is needed
to insure health. Third, is the rehearsal of explanations to recite
to patients who have become discouraged in order to keep them returning
despite the apparent absence of benefit.
The message, which is clear to NCAHF from its review of such abuses,
is the critical importance of patient trust and practitioner trustworthiness
in health care. Chiropractors pay strong lip service to freedom
of choice in the health marketplace. However, after reviewing many of the
techniques taught by the success promoters in chiropractic, such "freedom"
could easily be construed to mean a license for unethical practitioners
to use their superior position in the doctor/patient relationship for exploitation.
Patients who are deceived or desperate because of sickness, fear or pain
are not choosing freely.
State Licensure, Regulation, and Recognition
Chiropractic claims that the fact it is licensed by the state legitimizes
it. Close examination reveals major flaws in this assertion.
State licensure is the method used to control the scope of practice of
providers. Historically, chiropractors were licensed to restrict
their use of prescription drugs and invasive techniques. At first,
chiropractors were regulated by boards made up primarily of medical doctors,
but in time most states set up boards comprised mainly of chiropractors.
NCAHF finds this situation indefensible.
Representatives on chiropractic examining boards enjoy state authority
to endorse nonscientific practices among chiropractors. NCAHF agrees with
the 1967 Report of The Health Manpower Commission which called for
a reexamination of the basic assumption that the censure of chiropractors
facilitates regulation (40), and the assessment by Consumer's Union
that "current licensing laws, in our opinion, lend a aura of legitimacy
to unscientific practices and serve to protect the chiropractor rather
than the public." (41)
Legislators who review chiropractic practice acts are sometimes confused
by the warring factions within chiropractic. Straights wish to have
chiropractic practice limited to the manipulation of the spine for the
purpose of removing "subluxations." Mixers favor expanding practice
acts to permit them to engage in a broad scope of practice. Mixers outnumber
straights by about four-to-one enabling them to exert more pressure on
legislators. Consumers will benefit if scope-of-practice laws are
designed in terms of proven safety and effectiveness and not the views
of special interest groups.
Malpractice insurers have some power to encourage and enforce rational
practices by chiropractors. These companies may deny insurance coverage
to or withhold payment from non-scientific practitioners. In doing
so they will simultaneously protect the public health and their purse.
There is a small but growing number of chiropractors who recognize the
failings of their profession, but sincerely believe that there is a place
for chiropractic in the health marketplace. It is estimated that
70-80% of people will suffer back pain at some time in their lives.
If, as studies seem to indicate, one third of these can find more rapid
relief by having safe, conservative manipulative therapy, then there appears
to be a large market for the services of scientifically oriented chiropractors.
Further, a national study of health practices found that three-fourths
of chiropractic patients seek relief from musculo-skeletal problems. (42)
This means that a minority seek the type of treatments found in the plethora
of nonsense practiced by the chiropractor/naturopaths. If chiropractic
were to purge itself of its quackery and offer valid back care, it could
expect a substantial increase in physician referrals.
One small faction of reformist chiropractors is conducting and publishing
meaningful research in the field of manipulative therapy. This group
is not openly critical of chiropractic's shortcomings and has not agitated
for outright repudiation of the "subluxation" theory. They apparently
seek to change chiropractic by evolution, bypassing the theory by ignoring
it or applying the term "subluxation" to a number of spinal aberrations
in a general manner. It is NCAHF's view that these chiropractors
are too greatly outnumbered and overshadowed by practitioners profiting
from pseudoscience to effectively change chiropractic in this manner.
A more progressive-minded group has formed the National Association
for Chiropractic Medicine (NACM), a professional association with views
which are in harmony with science and consumer protection. Using
guidelines set forth by the NCAHF Task Force on Chiropractic, NACM has
openly renounced the "subluxation" theory and unscientific practices.
Members limit their scope of practice to neuro musculo-skeletal conditions,
and its modes of treatment to those which have scientific validity. NACM
does not present itself as an alternative health care system to medical
NCAHF'S Description of a Scientific Chiropractor
At the request of a chiropractor, NCAHF established a task force to describe
in practical terms what, in its view, would constitute acceptable chiropractic
practices. The task force is comprised mostly of chiropractors who share
NCAHF's beliefs in science and consumer protection NCAHF's position is
A scientific chiropractor will:
Advance only methods of diagnosis and treatment which have a scientific
Openly disclaim the nonscientific 'subluxation theory'.
Restrict the scope of practice to neuromusculoskeletal problems loosely
defined as Type M conditions (i.e. muscle spasms, strains, sprains, fatigue,
imbalance of strength and flexibility, stretched or irritated nerve tissue,
and so forth) recognizing that some Type M problems will fall outside the
scope of even a scientific chiropractor.
Work closely with medical practitioners, consulting with them on cases
involving possible pathology and readily referring when reasonable and
Use conservative methods of manipulative therapy.
Avoid exposing patients to unnecessary radiation.
Work to increase public awareness about abuses by non-scientific chiropractors.
Help other chiropractors become more scientific in their approaches to
health care delivery.
Work to prohibit unqualified practitioners of all kinds from performing
Aid in the prosecution of alleged malpractice.
Scientific chiropractors will not:
Use the title "doctor" in such a way as to mislead someone to believe the
practitioner is other than a chiropractor.
Induce anyone to believe that a chiropractor should be consulted first in
preference to a medical practitioner in respect to any disease or disorder.
Induce anyone to believe that chiropractic adjustment will cure or alleviate
infectious diseases, arthritis, cancer, diabetes, nutritional deficiencies
or excesses, appendicitis, blood disorders, kidney diseases, gall bladder
problems, hypertension, ulcers, heart disease or other non-Type M conditions.
Fail to take reasonable steps to advise a patient to consult or continue
consulting a medical practitioner when engaged by someone requiring medical
Publish or publicly exhibit any circular extolling non-scientific chiropractic
treatment or preventive care.
Condemn without scientific justification public health measures such as
fluoridation, immunization, pasteurization of milk, etc.
Use their status as a health professional to sell or profit from the sale
of products to patients.
Excessively treat patients.
Present themselves as specialists in pediatrics or claim the ability to
treat children's diseases.
Claim that chiropractic adjustments will help raise resistance to disease
or prolong life without valid evidence.
Claim to be a "(w)holistic" practitioner.
Claim to be qualified as a "family practitioner."
Claim to be qualified to administer mental health care.
Utilize unproven*, disproven, or questionable methods, devices, and products
such as adjusting machines, applied kinesiology, chelation therapy, colonic
irrigation, computerized nutrition deficiency tests, cranial osteopathy,
cytotoxic food allergy testing, DMSO, gerovital, glandular therapy, hair
analysis, herbal crystalization analyses, homeopathy, internal managements,
iridology, laser beam acupuncture, laetrile, magnetic therapy, Moire contourographic
analysis, Neurothermograph, orthomolecular therapy, pendulum divination,
pyramid power, "Reams" test, reflexology, scleraglyphics, Spinal column
stressology, Thermography Thermoscribe, Toffness device, and so forth.
*Except on an approved experimental basis in which patients
are fully-informed about risk-benefits, protocols are monitored by an Independent
Committee, and patients are not charged a fee for services or products.
NCAHF believes that a health care delivery system as confused and poorly
regulated as is chiropractic constitutes a major consumer health problem.
The fact is that practitioners possess useful skills in manipulative therapy,
and the apparent need for such skills provides an opportunity for a constructive
solution. The chiropractic problem is so broad-based that every segment
of the community involved with health care - scientifically, economically,
legally, or educationally - must inject itself into the chiropractic controversy.
Only a comprehensive approach to a solution has any hope of succeeding.
For this reason NCAHF makes the following recommendations:
As consumers you are largely at your own risk when choosing a practitioner
of any kind because the law offers more protection to providers than consumers.
Therefore choose health-care practitioners carefully - particularly a chiropractor.
Distinguish between manipulative therapy per se and treatment based upon
the specious chiropractic theory. Be alert to the fact that, although
manipulatlve therapy has distinct value in the treatment of back pain and
may provide subjective relief on other chronic conditions, and chiropractors
are educated and trained in manipulation, they represent but one source
of this service. If you do choose a chiropractor, ask him/her to
work closely with your medical doctor.
Chiropractic theory is nonscientific, and most chiropractors have not been
taught to practice on the basis of the same body of knowledge about health
and disease recognized by health scientists around the world.
Understand that some chiropractic treatments involve considerable risk.
Manipulation involving the rapid rotation of the head and neck or sudden
movements have greater potential for injury than more conservative types
of therapy. Do not submit to a "full spine" x-ray. This practice
has doubtful diagnostic value, and the radiation exposure may have long
Be aware that many chiropractors engage in nonscientific practices which
can result in unnecessary expense. Also, nonscientific practitioners
may delay the proper treatment of serious disorders causing excessive debility
or needless death.
Beware of chiropractors who advertise about "danger signals that indicate
the need for chiropractic care," make claims about cures, try to get patients
to sign contracts for lengthy treatment, promote regular preventive "adjustments,"
use scare tactics, or disparage conventional health care.
Demand that your legislative representative introduce and/or support laws
that provide greater consumer protection in health care.
To Insurance Carriers and Third-party Payers:
Limit reimbursement to medically necessary services and to those practitioners
who provide appropriate medical documentation that establishes the diagnosis
and justifies treatment.
Establish an independent commission financed by an insurance industry levy
to investigate and curtail fraud and abuse in health care.
Recognize that legislatures have the greatest power to control chiropractic
practices. Regulatory agencies and the courts can only enforce
the laws passed by legislative bodies. Education alone cannot protect
consumers or help people who do not realize that they are being deceived.
Restrict the scope of practice of chiropractors to neuromusculoskeletal
problems. Prohibit their treatment of other conditions unless
under medical referral. Specify the procedures that chiropractors
may NOT perform, such as: Colonies. herbology, hair analysis, cancer therapies,
or any unproven methods unless working on a bonafide experimental project
in cooperation with qualified medical researchers.
Restrict the use of x-ray by chiropractors--particularly prohibit techniques
that involve unnecessary radiation exposure to patients such as the "full
Prohibit chiropractors from using the title 'doctor' in any manner that
doesn't clearly reveal that they are chiropractors.
Incorporate chiropractic training into the same university systems which
teach medical, dental, and other allied health professionals so that instruction
in basic sciences and training in diagnosis and patient screening will
be brought up to the same standards as other primary entry health care
providers. Designate the chiropractic degrees issued by these institutions
"Doctor of Chiropractic Medicine" to distinguish them from previous diplomas.
Establish standards for people holding "Doctor of Chiropractic" diplomas
to upgrade themselves to the standards of the new degree. Set
a time limit (e.g. ten years) in which this upgrading must occur to maintain
Permit Doctors of Chiropractic Medicine to utilize prescription drugs suitable
to the limitations of their practices.
Regulate all health care providers through a single board of quality assurance
constituted by a wide variety of members adept in the methods of scientific
methodology and the bases for consumer protection legislation. Include
on the board representatives from the basic sciences, public health, education
and legitimate consumer groups. Restrict practitioners from the various
health care delivery providers to service in a consultant status.
Make violation of the medical practice act a felony.
Recognize that the chiropractic controversy involves the basic sciences
more than medicine per se. These sciences are chiropractic's intellectual
competitors in a manner similar to flat-earth believers versus astrological
societies; however, chiropractic must be taken more seriously because it
involves health care.
Take chiropractic seriously enough to become knowledgeable about its basis
and conduct basic research to test the validity of its claims.
Use your influence to bring about reform in the health marketplace.
Academicians and Educators
Recognize that the academic community has an obligation to the communities
at large to help resolve controversial issues which bear upon public health
and well being.
Recognize that chiropractic promotes itself as an alternative to conventional
scientifically-based health care, and that it is the largest and best organized
nonscientific health care system in Western society. Its impact upon
public health is too great to ignore.
Become familiar with chiropractic's tenets and practices. Teach about
these to your students.
Be aware that chiropractic recruiters are working through career guidance
counselors to attract students to the profession. Inform students
about the true nature of chiropractic so they can make wise choices.
Urge educators to work with reformist chiropractic organizations to incorporate
chiropractic education into accredited universities.
To Attorneys and Law Enforcement Agencies:
Recognize that litigation offers an effective means to bring reform to
chiropractic. A number of scientifically oriented chiropractors
now stand ready to offer assistance in malpractice lawsuits. This
helps to take away the usual defense of justifying a chiropractor's clinical
inadequacies of diagnosis and treatment as standard practice.
Become familiar with the fallacies and common abuses of chiropractic.
Attorneys with insights in these areas can serve as specialists in the
prosecution of chiropractic malpractice
Vigorously enforce current scope of practice laws. Many of the current
abuses by chiropractors are illegal.
To Medical Doctors, Dentists, and Other Scientific Health Care Providers:
Limit your professional association to chiropractors who reject the cultism
and pseudoscience of chiropractic and meet the criteria for scientific
practitioners as suggested by NCAHF.
Encourage professional associations to undertake studies of chiropractic
within their regions and issue appropriate statements of their findings.
Actively lobby legislators to enact laws to curtail abuses by chiropractors
and other health care deliverers.
Report chiropractors who exceed their legal scope of practice to law enforcement
Provide educational materials to patients about the nature of chiropractic.
Cooperate with efforts to control the quality of health care delivery such
as the establishment of a single regulatory board with broad representation
from basic science and legitimate consumer groups for all providers.
To Reformist Chiropractors:
Organize yourselves into a clearly identifiable group with a code of ethics,
standards of practice, and scientific guidelines.
Publicly proclaim the shortcomings of cultist and pseudoscientific chiropractors.
Lobby for laws to reform chiropractic practice.
Be available to attorneys to enable injured patients to receive just recompense
for abuses by irresponsible and nonscientific chiropractors, and to bring
pressure by the courts to more clearly define malpractice.
Press for reform within established chiropractic organizations.
Encourage chiropractors who have remained silent about the abuses of public
relations oriented chiropractic leadership while they practiced in a reasonable
conservative manner to take a stand for reform.
Establish a liaison between your reformist groups and other professional
health organizations to gain their support and cooperation.
Communications Dept., Chiropractic: State of Art 1984, American
Chiropractic Association, Arlington, VA, 1984
Farrell, J and Twomey,L.,''Acute low back pain'' MedJ Aust
Haldeman, S. "Spinal manipulative therapy" Clin Orth & Rel Res,
Moritz, U. "Evaluation of manipulation and other manual therapy", Scand
J. Rehab Med, ll:173-179, 1979
Parker, G. B. and Tupling, H., "A controlled trial of cervical manipulation
for migraine" Aust New Zealand J Med, 8:589-593, 1978
Neher, A. The Psychology of Transcendence, Englewood Cliffs:Prentice-Hall,
Homola, S. Bonesetting, Chiropractic, and Cultism, Panama City,
FL: Critique Books, 1963
Duke, R. and Spreadbury, T. "Closed manipulation leading to immediate recovery
from cervical spine dislocation with paraplegia," The Lancet, pp.
577-578, September 12,1981
Dan, N. and Saccasan, P. "Serious complications of lumbar spinal manipulation,"
Med J Aust, 2:672-673, 1983
Kewalramani, L., et al, "Myelopathy following cervical spine manipulations"
J Phys Med, 61:165-175, 1982
Daneshmend, R., et al, "Acute brain stem stroke during neck manipulation"
Med J, 288:189, 1984
Gorman, R., "Vertebral artery occlusion following manipulation of the neck"
Zealand Med J, 89:362, 1979
Nyberg-Hansen, R., Loken, A., and Tenstad, 0., "Brainstem lesion with coma
for five years following manipulation of the cervical spine," J Neurol
Simmons, K., et al, "Trauma to the vertebral artery related to neck manipulatlon"
J Aust, 1:187-188, 1982
Easton, J. and Sherman. D, "Cervical manipulation and stroke" STROKE,
Kane, R., et al "Manipulating the patient: A comparison of the effectiveness
of physician and chiropractic care," The Lancet, June,29: 1333-1336,
Martin, R. "A study of time loss back claims," Workmen s Compensation Board,
State of Oregon, March, 1971
Higley, H., Back Injuries, Des Moines, IA: American Chiropractic
Homewood, A. The Neurodynamics of the Vertebral Subluxation Canada:
Chiropractic Publishers, 1973
Jarvis, W. "The New Zealand chiropractic report--an evaluation" New
Zealand J Physio 8:6-10, 1980
Jensen, B. The Science and Practice of Iridology, Bi-World Publ,,
Provo, UT, 1952
Hyman, R. "Cold Reading: How To Convince Strangers That You Know All About
Them" The Zetetic, 1:18-35, 1977; 22a.
Livingston, M. "Spinal manipulation causing injury: A three year study"
Orth Relat Res, 81:82-86, 1971
Modde, P. "Malpractice as an inevitable result of chiropractic philosophy
and training" Legal Aspects of Med Practice, Feb:20-23, 1979
Zauel, D., and Carlow, T., "Internuclear Ophthalmalegia following cervical
manipulation" Annals of Neurol, l:308, 1977
Beatty, R. "Dissecting hematoma of the internal carotid artery following
chiropractic cervical manipulation" J Trauma, 17:248-249, 1977
Davidson, K., et al, "Traumatic vertebral artery pseudoaneurysm following
chiropractic manipulation" NEURORADIOLOGY, 115:651-652, 1975
Rinsky. L, et al, "A cervical spinal cord injury following chiropractic
manipulation" Paraplegia, 13:223-22, 1976
Benassy, J. and Wolinetz, E., "Quadraplegia after chiropractic manipulation,"
RHUM, 24:555- 556, 1957
Schelihas, K., et al, "Vertebrobasilar injuries following cervical manipulation"
Med Assoc, 244:1450-1453, 1980
Miller, R. and Bunon, R. "Stroke following chiropractic manipulation of
the spine" JAMA, 229:189-190, 1974
Zak, S. and Carmody, R . "Cerebellar infarction from chiropractic neck
manipulation" Ariz Med, 41:333-337, 1984
Krueger, B. and Okazakl, H. "Vertebral-basilar distribuation infarction
following chiropractic cervical manipulation", Mayo Clin Pros. 55:322-332,
Harrison, J. ''Strokes'' ICA Malpractice Alert, 2:1-2, 1981
Levine, J., Howe, J., and Rolofson, J., "Radiation exposure to a phantom
patient during simulated chiropractic spinal radiography", Radiol Health
Data Reports, 12:245-251, 1971
Smith, P and Doll, R., "Mortality among patients with ankylosing spondylitis
after a single treatment course with x-rays", Brit Med J, 284:449-460,
Abrams, H., "The overutilization of x-rays", New England J MED,
Barrett, S., The Health Robbers, Philadelphia:George Stickley Co.,
Smith, R., "A golden touch for chiropractors" Todays Health, June,
National Advisory Commission on Health Manpower, Report of National
Advisory Commission on Health Manpower, Vol II, Washington. D.C.: U
S Government Printing Office, 1967
Consumer's Union, "Chiropractors: Healers or Quacks?", October, 1975
National Analysts Inc., "A Study of Health Practices and Opinions" Springfield,
VA: National Technical Information Service, 1972
Whorton, J., Crusaders for Fitness, NJ: Princeton University Press,
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