Dear Editor:
In response to "The President's Forum" in the May 21, 2001 issue of DC, I say: If Dr. Winterstein would simply read the ICA's policy handbook, he would not need an explanation why the ICA opposes acupuncture as part of chiropractic practice.
Dr. Winterstein's university and other chiropractic colleges that have changed their names to universities of the "Health Sciences" (or some such name change) are endeavoring to include the use of other health care disciplines such as acupuncture; naturopathy; homeopathy; and more, as part of chiropractic practice. The ICA stands against such efforts to mongrelize the chiropractic profession, and yes, "bang, bang" shoots them down!
Fred H. Barge,DC,PhC
past president, ICA
Historical Clarification from the Ivory Tower
Dear Editor:
With regards to David Prescott, DC, JD, in his recent article (Counsel in dissent: chiropractors vs. acupuncturists - Part III. Dynamic Chiropractic 2001 [July 2];19[14]:28,34-5,42), I would like to provide clarification to some of the historical information he offers concerning relations between the chiropractic and naturopathic educational communities.
First, I can find no evidence that the NCA Council on Education (CoE; forerunner of today's CCE) issued any prohibition against "chiropractic colleges teaching natural methods of treating the sick (except spinal manipulation)" in 1952. While there are one or more pages missing from the surviving copies of the CoE's minutes for its two meetings that year (Indianapolis in January, Miami Beach in June 1952), apparently the scope of practice issues dealt with by the CoE on those occasions included the efforts of the Los Angeles College of Chiropractic's (LACC's) "graduate school" and the California Chiropractic Association to provide postgraduate education in "specialty subjects," such as radionics and nutritional supplements. If Dr. Prescott has some contrary information, I would very much like to review it!
The LACC made a decision to cease awarding doctorates in naturopathy from its undergraduate program at the time of its "grand merger" with the Southern California College of Chiropractic in 1948, but the amalgamated school's graduate program continued to award the "ND" for a few years longer (Keating, 2001, p. 102). However, the college succumbed to pressure to discontinue instruction in "borderline subjects" such as "pharmacology and certain phases of operative minor surgery in the graduate school" (Minutes, 1951). When the CoE met in June 1952 (Minutes, 1952b), the former dean of LACC's graduate school, Lee Norcross,DC,ND, had been dismissed, largely owing to his advocacy of this much broader scope of instruction. These events are reviewed in a recently published history of the LACC (Keating, 2001).
For much of its early history, naturopathy defined itself as a "drugless" profession. (Today's "naturopathic medicine," as practiced in Oregon, for example, is a muchbroader-in-scope healing art, and includes some prescription medications.) Much of what naturopaths practiced in their early years is encompassed today within the notion of "chiropractic physiological therapeutics." The CoE not only did not prohibit such "natural methods," but it battled with the straight chiropractic colleges (including a few within the CoE) to insist upon inclusion of the schools in the CoE-mandated curriculum. Moreover, some jurisdictions, such as California and Ontario, mandated instruction in physiotherapeutics as a condition for chiropractic licensure. Even if the CoE had wished to ban such procedures, it could not have done so without preventing the licensure of DCs in several locales.
Ironically, some of Dr. Prescott's suggestions for broadening chiropractic curricula to include traditional naturopathic and "drugless" methods parallel those of the National Chiropractic Association (NCA; forerunner of today's ACA) some six decades ago. The distancing of naturopathy from chiropractic education began in the 1930s, and reached a turning point at a 1939 meeting in Chicago of representatives of the broad-scope-tolerant NCA, the Chiropractic Health Bureau (CHB, forerunner of today's ICA) and the American Naturopathic Association (ANA) (Keating, 2001, p. 77; Watkins, 1939). The Palmer/CHB faction felt that mixer-chiropractors should be licensed as naturopaths, to which idea the ANA lent its support. However, the NCA argued that there were 16,000 broad-scope DCs practicing naturopathic methods (i.e., "drugless" therapies in addition to adjusting), vs. only 2,000 licensed naturopaths. The NCA announced its intention to oppose:
"...any plan that would cause the passage of separate physio-therapy laws or naturopathic laws to cover liberal chiropractors, but rather favor liberalization of chiropractic legislation where it is felt desirable to legalize liberal practice." (Watkins, 1939)For the next 15 years, the NCA's board of directors brought pressure to bear upon the chiropractic schools within its orbit, to force them to discontinue awarding naturopathic doctorates. Meanwhile, the CHB/ICA railed against schools teaching intervention methods other than adjusting (e.g., Naturopathic, 1957). With the death in 1954 of W.A. Budden,DC,ND, president of Western States College School of Chiropractic & School of Naturopathy, and former dean of the National College, a major barrier to NCA's plan was passed. Many of naturopathy's drugless methods continued to be taught, with NCA-CoE approval and encouragement, as part of the chiropractic curriculum.
I hope this is helpful information. For those who may be interested, I can provide hard copies of the retyped minutes of most of the CoE's meetings during 1948 through 1968 at a cost of about $1 per page.
References
- Keating JC (Ed.): A History of the Los Angeles College of Chiropractic. Whittier CA: Southern California University of Health Sciences,2001.
- Minutes of the annual meeting of the NCA Council on Education, Detroit, 22-27 July 1951 (CCE Archives).
- Minutes of the annual meeting of the NCA Council on Education, Miami Beach, 23-26 June 1952b (National College Library, Special Collections).
- Naturopathic scandals threaten chiropractic! ICA International Review of Chiropractic 1957 (May); 11(11):6-12.
- Watkins CO. Guest editorial. National Chiropractic Journal 1939 (Sept);8(9):6,53.
Joseph C. Keating Jr.,PhD
Homewood Professor
Canadian Memorial Chiropractic College
Military Chiropractic May Be Restricted to Privileged DCs
Dear Editor:
Tricare Network, the military's largest subscriber program, is now administered by HealthNet! As a result, DCs may instead face the same access restrictions for military patients that are already imposed in civilian HMOs and PPOs.
A HealthNet Foundation (Foundation Health Federal Services is now owned by HealthNet) official acknowledged to me that "Instead of going through the trouble of finding and credentialing enough DCs for Tricare Network, it's easier to just use HealthNet DCs, since they're already credentialed through American Specialty Health Plan" (ASHP)!
Eighty-seven percent of all DCs are barred from participating in HealthNet, or 94 percent of HMOs, since their access is limited by the ASHP!
Therefore, the ACA's "greatest legislative victory in 26 years in opening up the military to chiropractic" may instead be a goldmine for ASHP owner George DeVries and 13 percent of the profession! Could the ACA leadership foretell the future, or are most of them already ASHP providers?
I recently asked an ASHP chiropractor, "How's it going?"
He replied, "I'm so damn busy busting bones, I don't have time to slow down!"
Obviously, quality care is no priority for HMO "doctors." In a nation that prides itself in "self-determination," legal monopolies that enrich themselves by stealing patients prevail, and "legislative victories" strangle the chiropractic profession.
Paul Kell,DC
San Diego, California
"TCM lobby wants to foster an air of mystery"
Dear Editor:
Thank you for providing both sides of the issue in the May 21, 2001 DC ("DCs Who Perform Acupuncture - Turf War, or Question of Training? Point-Counterpoint"). It was quite revealing to see how uninformed Mr. Molony really is about this issue.
I studied TCM acupuncture, and I agree that it is a very complex study. This is not due to any inherent complexity, but to artificially imposed obfuscation clearly intended to prevent understanding. Dr. Amaro mentions Dr. Worsley's method of acupuncture, which is lucid, truly traditional, and works.
I also had the distinct pleasure of studying under Dr. Amaro's direct instruction a few years ago. The contrast between TCM and Dr. Amaro's instruction cannot be overemphasised. TCM presents a background of theory, and then moves to memorizing long lists of named conditions and "formulae" of points with little real understanding. This is like using a cookbook. You identify a syndrome and then perform the listed treatment.
Dr. Amaro teaches the "how" and "why" of acupuncture, and has students apply principles to determine treatments. There is one optimal solution, but there is usually more than one way to obtain the desired result.
The TCM lobby wants to foster an air of mystery, like a medieval guild. Mr. Molony is clearly afraid of the truth that acupuncture is not that complicated, because once the truth is out, his guild will no longer be able to control acupuncture.
Dr. Amaro's credentials speak for themselves (listed in the article). His vast experience in the field makes him a credible expert. If this doctor is willing to put his name on my certificate after the course of study he prescribed, and after passing the competency exam he designed in collaboration with a Chinese medical/acupuncture institute in China, that certainly seems like a solid testimony to the validity of his assessment.
What are Mr. Molony's credentials? Why should we consider his opinion to somehow be more valid than Dr. Amaro's?
Ultimately the determination will be spoken vox populi. If Mr. Molony's approach is superior, people will figure it out soon enough, and those he opposes will no longer be in demand for their services. However, if Mr. Molony is mistaken (and I respectfully opine that he is), the same forces will clear the chaff.
Mr. Molony must either recognize this and let the people decide or openly admit his contempt for the general populace evidenced by his belief that we are not intelligent enough to figure this out on our own.
Glyn Thomas Gowing,DC,FIACA
Woodruff, South Carolina
Peeved by Part IV
Dear Editor:
The January 29 issue of Dynamic Chiropractic with its wonderful letter to the editor about the audacity of the NBCE regarding student test money that expresses my views to a T. At least the money went to the ACA!
Many state boards are requiring proof of completion of Part IV for licensure. Although it is beginning to limit my choice of states in which to practice, I refuse to pay $800 to take another test that does not guarantee my income will improve. I don't think any of us involved in the pilot Part IV would have encouraged its implementation if we knew students would be gouged in the future. That is the equivalent of a house payment.
I thought this testing agency was nonprofit. If not, does this mean that every DC who paid for a test has the right to vote for what this agency does, and who runs it? I am required by some invisible law to take these tests to be able to access a chiropractic livelihood. Where does this law define what happens to any NBCE profit left over at the end of the year? I can use my share of the profit for the ACA.
My grandfather said for every government regulation there is a gravy train with freeloaders. The only way to stop it is to derail it when it is running at full throttle. Thank you, "Mr. Anonymous," for speaking for those of us who are angry at the graft surfacing at all levels, who are too busy being chiropractors to be heard.
Linda Terrell,DC,C.Ad.
Rio Rancho, New Mexico
"Would you want your MD adjusting your atlas, or a physical therapist performing your heart surgery?"
Dear Editor:
The front page of Dynamic Chiropractic's June 18 issue illustrates the reason why we must define our profession clearly. As a practicing DC, I know the unique service I have to provide. It is quite clear that if we choose to take the profession in a direction that includes all that is not medicine, we will come under attack. What right do we have as chiropractors to practice physical therapy? What right do we have as chiropractors to use acupuncture? What right do we have to offer any number of non-chiropractic services in our offices? "Limited" is the answer. We are limited in our understanding of these issues, and should therefore be limited in their use.
If you were a patient, what would you want? Would you want a weekend seminar attendee to conduct your knee surgery? How about the nutritionist providing your acupuncture? Would you want your MD adjusting your atlas, or a physical therapist performing your heart surgery? Then why are we trying to duplicate services already available from other providers?
Let's focus on chiropractic. I understand why this may be confusing. My first year of chiropractic college was spent in Chicago, and my first class on chiropractic listed all the things that were chiropractic. Let me tell you, the blackboard (yes, they really were black) was covered - not with subluxation, adjustment, and the detrimental effects of a subluxated spine, but with every therapeutic intervention short of drugs and surgery. (If this is the definition of chiropractic, then how are we unique?) I knew at that moment I was in the wrong place. A short 2-1/2-hour drive west allowed me to understand the unique service we have to offer, and to transfer my credits.
If you don't understand how incredible or life-altering correcting subluxations can be, go to the Fountainhead for its Lyceum in August and find out. Patients respect the fact that you are not a "do-it-all." They are put at ease when you say, "If you would like acupuncture, then I know a good practitioner here in town," or, "I will work with your physical therapist to help you get better." Everyone knows that a jack-of-all-trades is a master of none. My patients know that I am a master of chiropractic, and I use my education credits to further my knowledge of chiropractic technique, neurology and philosophy; in this way, they can be assured that they are receiving the best that chiropractic has to offer. My brother examined a patient from Florida, and after the exam and report of findings, he gave that person an adjustment. That was the first time the individual had ever been adjusted, and the patient had been seeing a chiropractor for years.
Let's get focused, and together we can present a profession based on a philosophy of life, supported with science, and delivered with artistic grace to a public desperate for another option in health care. I know it's hard to stand out in the crowd: to go against the grain; to swim upstream. But people respect those who have spines and stand up for what they know is right. So if you don't think that correcting subluxations is the most important thing you do in your office, then start studying - because you will find that the adjustment is a unique service, and everything else is duplication.
Joseph P. Piché,DC
Traverse City, MI
"the 'physios' ... outnumber the chiropractors down here by 50 to one!!"
Dear Editor:
It is good to see you folks in the U.S. have finally seen the writing on the wall. Your comments are right on the ball. The issue the chiropractic profession has to look at is the fact that the public just wants to be fixed; they really don't care who does it. The physios (physical therapists) know this. They outnumber chiropractors.
Right now you have the physios challenging the profession. We went through that here in Australia 10 years ago and lost the battle through apathy, tight pockets and egos, in my opinion.
Do you want to know what the next challenge will be? It is this: We have new restraint-of-trade laws that have required a rewriting of all legislation. The massage therapists are now mobilising to get the legislation changed so they can do spinal manipulation and adjustments. They outnumber the chiropractors down here by 50 to one!! Believe me, these problems have only just begun for your people.
In my opinion, the right place for a chiropractor to be in all this is with a specialist profile of the "doctor of last resort," for the patient on entry to the clinic, and on first consideration of any new problems on exit from the clinic. We need a specialist profile. Nobody gets results like we do! That is why the physios want to use our skills.
The literature shows that all the old stuff they did never worked as well as what we do.
In the end, the practice of a chiropractor will stand or fall on results. We just have to stay 20 years ahead of these parasites. Let's hope you can light a fire under these doctors that bury their heads in the sand, who have had it so easy for so long. Whenever you have your head buried in the sand, you can be sure which end gets kicked first.
Donald McDowall,DC
Belconnen, Australia