The chiropractic technique world believes research can be used to discredit and invalidate the foundation of chiropractic techniques. The chiropractic research world believes that chiropractic techniques are focused on self-preservation and financial growth; that the technique world is fearful of scrutiny and see research as a threat its self-professed claims.
What comes across to me, as a part of both worlds, is the significant chasm between the two groups. Misunderstandings and misconceptions often lead to conclusions that create disharmony at a time for the chiropractic profession when harmony is most needed.
The chiropractic technique world limits research because:
- it believes that research will fail to convey the success of its techniques into the "language of research";
- it doesn't understand the research terrain or "lingo";
- it doesn't know how to "scientifically" prove its assertions and methodologies;
- the art and vitalism of chiropractic cannot be measured in a "linear" way, and that research will distort them;
- peer review requires submissions and scrutiny, which is all very intimidating.
Although research studies attempt to search for the "truth," there are specific difficulties with any form of research. Sometimes this is due to the misconception by the chiropractic technique world that research outcomes are either positive or negative. What the chiropractic technique world must understand is that all research legitimizes chiropractic and, most specifically, a technique's integrity, and allows the profession to flourish.
All research findings are essentially "good," and studies that do not "prove" the legitimacy of a specific chiropractic technique can still be of value by illustrating:
- problems in study design;
- problems with the tester or testee;
- alternate interpretations and definitions of the research;
- that a reason for a specific chiropractic result my be due to an entirely different mode of action;
- that the positive outcome to therapy may be due to another indirect aspect of the care; and
- that a diagnostic or treatment protocol of a chiropractic technique may be be ineffective.
The chiropractic technique world needs to understand that all outcomes to research studies demonstrate ethics, sincerity, and responsibility. Research may sometimes show that a chiropractic technique or method is questionable, at best, or, at worse, invalid. However, because of all the difficulties of performing and interpreting research, a technique's methods or procedures are often called into question, sometimes unjustly so.
This relationship between chiropractic techniques and research is paradoxical. If unbiased research were performed by a chiropractic technique, then the chiropractic research world would look at the chiropractic research world as having ethics, sincerity, and responsibility. If, on the other hand, the findings of the study were used to discredit a technique in the general chiropractic community or in society, then understandably, the technique world will be hesitant to put itself in a difficult and awkward position.
The trend between the research and technique chiropractic worlds has only come to the forefront in the past few decades. With the publication of the Journal of Manipulative and Physiological Therapeutics and advances in chiropractic research in the late 1960s, the chiropractic research world entered a new phase of development.
From 1930 to1950, Major MB DeJarnette,DC, pleaded with the chiropractic profession to research its diagnostic methods and treatments. Unfortunately, he presented his own documented research in his own texts, rather than in peer-reviewed journals.
Typical to the chiropractic technique world until recently, most descriptive chiropractic technique texts were anecdotal. Often, statements in these texts would not be justified or reference any literature. Chiropractors have been quite happy with this method of information- sharing, much to the consternation of the research world. Most chiropractors are only interested in what will directly help them help their patients.
What we must understand is that research can directly help chiropractors by sharing with them advances in health care. Chiropractic techniques will be modified with updated findings. At the same time, it is essential that the research world supports and encourages the efforts of the chiropractic technique world.
I have found that the majority of technique leaders are sincere about their discoveries and feel strongly about their methodologies and procedures. I have also found that researchers are often offended by what they perceive as a lack of rationality, and tend to see the technique leaders' motivations as more financial than intuitive. For our worlds to grow and flourish, we would do well to look at what is best in each, and try not to focus on the faults.
Charles Blum,DC,FICS
Santa Monica, California
Dr. Charles Blum, a graduate of Cleveland Chiropractic College - Los Angeles, is a past president of SOTO-USA and the organization's representative to the AATMD.