How can that be? How could chiropractors talk for over a century and still be more divided than ever? How could like-trained professionals seem to disagree on almost everything related to the healing art of chiropractic?
The answer is simple. Although chiropractors have been saying essentially the same thing for decades, we have been speaking in different dialects, if not completely different languages.
For a perfect example of the problem, look no further than the United Nations. Imagine leaders from Germany, France, Italy, and China trying to communicate with each other without translators? They could be in agreement about a vital matter, but would not realize it. That is exactly what I believe has happened and is still happening in chiropractic. We have been saying essentially the same thing for decades, yet are still completely unable to understand what our colleagues are saying. It has been our own Tower of Babel, and has resulted in distrust, division - even hatred.
Wouldn't it be wonderful if someone could translate the many dialects and languages in it so we could truly understand each other? Wouldn't it be great if a learned group of chiropractors could agree on what chiropractic is and what chiropractic does? Wouldn't it be great if a document could be created that would once and for all define chiropractic so completely and accurately that all the major chiropractic organizations would adopt it as official policy?
Your natural reaction may be, "It will never happen in this profession!" Well, guess what? It already has happened!
The translation has been made, the document has been created, and every major organization in chiropractic has already endorsed it, including: the American Chiropractic Association (ACA); the International Chiropractors Association (ICA); the World Chiropractic Alliance (WCA); the Association of Chiropractic Colleges (ACC); the Congress of Chiropractic State Associations (COCSA); and, most recently, the World Federation of Chiropractic (WFC).
The document is known as The ACC Paradigm and was authored by 16 chiropractic college presidents in 1996. Those affixing their signatures to the document included Drs. James Winterstein; Reed Phillips; William Dallas; Sid Williams; Carl Cleveland III; and Thomas Geraldi.
You may ask, "If all those organizations and all those presidents can reach a consensus on precisely what chiropractic is, then why is there still so much dissension within our profession?"
The reason is also simple. It is because the document has not become known and is not being used as our foundation. The purpose of this article is to tell, or remind you about this magnificent position paper, so that this profession can once and for all end its Tower of Babel.
If you are not interested in what a document like this says, then you probably are not interested in the future of this profession. Let's look at the major components of the ACC Paradigm.
After the preamble, the ACC Paradigm gives a position on chiropractic that reads as follows:
"Chiropractic is a health care discipline, which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery."The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function, (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. In addition, doctors of chiropractic recognize the value and responsibility of working in cooperation with other health care practitioners when in the best interest of the patient.
"The Association of Chiropractic Colleges continues to foster a unique, distinct chiropractic profession that serves as a health care discipline for all. The ACC advocates a profession that generates, develops, and utilizes the highest level of evidence possible in the provision of effective, prudent, and cost-conscious patient evaluation and care."
Wow! Did you get all of that? In just five concise sentences, all 16 college presidents discussed and agreed on eight major and often divisive issues, including:
- no drugs;
- no surgery;
- the inherent recuperative power of the body to heal itself;
- the importance of the nervous system and its relationship to the preservation and restoration of health;
- the effect of structure upon function;
- that this is a unique and distinct profession;
- the appropriateness of referring patients to other practitioners; and
- that chiropractic generates, develops, and utilizes the highest level of evidence possible.
The sixteen college presidents next tackled the purpose, principle, practice, and foundation of chiropractic under the heading of "The Chiropractic Paradigm." Here's what the document says about these important issues:
"Purpose - The purpose of chiropractic is to optimize health.
"Principle - The body's innate recuperative power is affected by and integrated through the nervous system.
"Practice - The practice of chiropractic includes establishing a diagnosis; facilitating neurological and biomechanical integrity through appropriate chiropractic case management; and promoting health.
"Foundation - The foundation of chiropractic includes philosophy, science, art, knowledge, and clinical experience."
Again - did you get all of that? In just four brief sentences, the sixteen college presidents were able to discuss and agree on several controversial issues, including:
- chiropractic promoting health;
- the body's innate recuperative power affected by and integrated through the nervous system;
- the necessity of establishing a diagnosis;
- chiropractic facilitating neurological and biomechanical integrity;
- the appropriateness of case management, and;
- philosophy, science, art, knowledge, and clinical experience being the foundational components of chiropractic.
Now, you're probably saying to yourself, "Did the presidents deal with the big issue of subluxation?" You bet they did! The document concludes with the following section on subluxation:
"Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.
"A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health. A subluxation is evaluated, diagnosed, and managed through the use of chiropractic procedures based on the best available rational and empirical evidence."
In three short sentences, the presidents were able to discuss and agree:
- that the chiropractic profession focuses particular attention on the subluxation;
- in defining "subluxation;"
- to link subluxation to possible organ system function; and
- describe how it should be diagnosed and managed.
When I first read this brief, 486-word document, I was amazed how clearly and concisely the presidents were able to define and describe this profession. In effect, they created a masterpiece.
And, as an ACA officer, I have had the opportunity to watch the ACC Paradigm work its magic on several occasions. When the COCSA hosted a national leadership conference in St. Louis last April, the document was used as the foundation for the development of its vision statement; when the ACA, ICA and ACC held a joint legislative committee meeting in Washington, D.C. last December, the groups agreed that the document should be used as the starting point; and when Dr. Carl Cleveland III hosted a meeting of the ACA; ICA; FSCO; COCSA; and WCA last February, the document was again used as the foundation for most of the discussions that took place.
Those meetings made three things very obvious: First, this profession is more united than divided; second, the biggest obstacles to unity are not the issues, but rather the rhetoric and egos of chiropractic leaders; and finally, the basic tenets contained in the ACC Paradigm really are supported by almost every element of our profession.
Although some continue to say that a split profession is good for chiropractic, since it is much like having a Democratic Party and Republican Party, they are simply wrong. When the United States goes to war, it does not go to war as Republicans or Democrats. It fights as Americans and under one flag!
That's what we must do now, because in case you haven't heard, this profession is now at war: one being fought on several different fronts.
We are at war in the courts with the Blue Cross/Blue Shield organizations that have severely limited reimbursement for and access to chiropractic care. We are at war in the courts with the federal government to overturn the HCFA policy that allows the chiropractic service to be delivered by non-chiropractors. And we are war legislatively to insure that active military personnel and veterans have access to chiropractic care and that Medicare beneficiaries receive reimbursement for X-rays and physical examinations.
It is time for this profession to end the civil war that has pitted our brothers and sisters against one another; to speak with one voice; to fight under one flag; to salute the ACC Paradigm and unite!
(Note: The complete ACC Paradigm, and its accompanying paper, "ACC Chiropractic Scope and Practice" are listed on ChiroWeb.com. Go to http://www.chiroweb.com/archives/19/05/09.html.
James Edwards,DC
Emporia, Kansas
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