No need to write letters to ABC ... as Barbara Walters and Hugh Downes noted, they were inundated by mail before the show aired. Who wrote all those letters? Perhaps it was Innate, guiding the pens of grateful DCs who wrote in to express their appreciation for this free national media exposure? Wasn't it a marvelous opportunity to put "the chiropractic principle" before the public? Or perhaps it was doctors who felt their special improvements on chiropractic technique were not given equal time? Perhaps they were letters from chiropractic leaders insisting that "20/20" was unfair in that Neural Organization Technique or silent-killer-subluxations are not representative of the whole profession?
Well, if you don't share the above sentiments, and felt angry and embarrassed by the most recent expose of chiropractic gobbledygook, what's to be done about it? If your ire is directed toward the "20/20" program for airing our "dirty laundry," I think it's misdirected. What about the dirty laundry itself, and the makers thereof? And, what about ourselves, the chiropractic profession-at-large, who have traditionally dismissed these shenanigans as the unfortunate foolishness of an unrepresentative and minuscule minority? Are we not ultimately responsible, by our silence and tolerance (grudging though it may be), for the outrageous claims and practices in our midst? At one time or another I have seen on chiropractic college campuses all of the methods and heard all the gooney rhetoric aired on ABC's recent program. And this sort of stuff usually goes unchallenged at our schools! Indeed, unsubstantiated claims for chiropractic care and uncritical attitudes toward practice standards are actively encouraged at some of our institutions of "higher learning." It wasn't so long ago that a college president suggested, "Rigor mortis is the only thing we can't help!"1 But I can recall no great outcry nor objection from the ranks nor the leadership in the profession. As a general rule (there are exceptions) we don't appoint college trustees nor hire administrators nor faculty because of their track records in science and scholarship. College leaders too often continue to see their institutions as doctor factories, rather than as centers for scholarly excellence. Our schools continue as poverty-stricken, tuition-driven operations, and we made few concerted efforts to bring our schools within the orbits of the universities of this country, a step which would aid in fostering the critical values of scholarship in health care. Why then should we expect our schools to inculcate scholarly values in successive generations of DCs?
The leadership of the world's largest chiropractic organization is not yet prepared to bite the bullet and work to eliminate the gobbledygook in chiropractic. Despite a commendable and courageous stance on immunizations2 and strong support for the development of practice standards (i.e., the Mercy Conference), the ACA is still not ready to clean up its own periodicals (e.g.,3-5), let alone challenge the forces within the profession which see the promotion of untested theories and theologies as chiropractic's birthright, if not its salvation. The attitude of the ACA has progressed to the point where research is acknowledged as necessary to prove "what we say is true."2 The idea that we should desist from making claims, unless and until the clinical value of a chiropractic method is established, is not yet widely apparent in the profession nor among elected leaders. Indeed, I have been informed that the ACA cannot take responsibility for screening the advertisements which appear in its publications, not even its own advertisements!
Just about a year ago, George McAndrews, chief counsel for plaintiffs in the Wilk case, warned the profession about the hazards of continuing in our propensity to speak without data and to tolerate such in other chiropractors.6 Silent killer subluxations and the like, he suggested, can undermine the hard won advances the profession has made in the scientific arena. However, since Mr. McAndrews admonition there has been little effort to make unsubstantiated claims by chiropractors socially unacceptable among chiropractors themselves. Instead, we seem content to let the journalists and the medical community do our house cleaning for us. The emperor continues to prance around in the buff, and most chiropractors seem unconcerned, if not delighted, with the spectacle.
Ultimately, it matters not whether the venders of chirogibberish are motivated by money or by sincere belief in their particular theories and methods. The issue confronting the profession is to inculcate scholarly values and to make unsubstantiated claims socially unacceptable. Strategies for developing an improved intellectual environment in the colleges and the field have been discussed extensively for more than a decade. What has not been figured out is how to motivate chiropractors to take the necessary steps.
References
- Williams SE. Interview in Health Magazine, July/Aug. 1993, pp. 44-53.
- Winkler KP. Let's make us our minds. ACA Journal of Chiropractic, Aug. 1993, 30(8):5,8,9.
- American Chiropractic Association, patient brochure #ST-3, 1990.
- American Chiropractic Association, patient brochure #ST-4, 1990.
- Chiropractic Works! Foundation for Chiropractic Education & Research, 1991, pamphlet #9116.
- McAndrews G. Open letter to the profession. Dynamic Chiropractic, March 27, 1992, pp. 1, 17.
Joseph Keating Jr., PhD
Portland, Oregon
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