By now, you are undoubtedly aware of the new standards proposed by the Council on Chiropractic Education (CCE). In his excellent article addressing the proposal, James Edwards, DC, notes that the "left-wing fringe of the profession, through revision to CCE standards, is now attempting to abolish all references to the subluxation, willing to designate our degree as DCM (Doctor of Chiropractic Medicine), and willing to delete all language that states chiropractic is a drugless and non-surgical profession." How could this happen? Well, let's take a look at CCE's history.
Major changes in chiropractic education were initiated in the early to mid-1970s. At this time, chiropractic colleges were accredited by either the American Chiropractic Association (ACA) or the International Chiropractors Association (ICA). In an effort to "upgrade the image" of the profession, both the ACA and the ICA decided to pursue federal recognition for their respective accrediting bodies. The ACA had the Council on Chiropractic Education (CCE) and the ICA schools were represented by the Association of Chiropractic Colleges (ACC). (Note: That ACC is not related to the current ACC.)
Heated debate characterized the efforts of the two bodies to approach the federal government with one agency. An agreement was reached to defer the submission of formal applications for Department of Health, Education and Welfare (DHEW) recognition by both groups. It was hoped that the two associations would be able to resolve their differences and approach the federal government with one agency. Despite this agreement, the CCE submitted an application and obtained approval, while the ACC waited as promised.
No time was wasted persuading state boards to mandate that only graduates of CCE-accredited colleges could apply for licensure. Student support was obtained by dangling the carrot of student loans. The CCE's approach in the days immediately following DHEW approval was autocratic. CCE was not content to coerce dissenting colleges into membership and compliance. Free speech was cast to the wind, with the CCE demanding "loyalty, advocacy, and support of the Council" from all sponsors.
CCE faculty/student ratio requirements necessitated the rapid hiring of large numbers of faculty. In the basic sciences, enthusiastic DCs were often replaced with PhDs unfamiliar with chiropractic. At least one told first-year students that as far as he was concerned, "chiropractic is a lot of bunk." In the past, most chiropractic college applicants had a positive personal experience with chiropractic care, and wanted to share it with others. Many were "second career" students who left successful jobs and businesses to study chiropractic. This was soon to change.
Pre-professional study was mandated, with specific course requirements that discouraged all but the most tenacious. Soon, instead of chiropractic zealots, it was not uncommon for the majority of students in a matriculating class to have never experienced a chiropractic adjustment. When these students were told by their professors that the profession they were entering was "unproven," "bunk" or worse, is it any wonder that many of them closed their minds to traditional chiropractic philosophy? This phenomenon is a major cause of the low perceived value of chiropractic education and chiropractic care common today.
Aiming to Please?
Today's chiropractic curriculum appears to be the result of attempting to please external constituencies. Early chiropractic education focused on teaching the analysis and adjustment of vertebral subluxations. Basic science courses were added in response to state basic science laws, aimed to limit the number of "irregular" practitioners admitted to practice. MDs, DOs and DCs were required to pass these exams prior to taking their respective board exams.
These laws have since been repealed, but the basic science curriculum remains largely unchanged, despite profound advances in our understanding of human biology. Worse, today's pre-professional requirements seem to mimic those of other health professions, rather than address the information needed to pursue a chiropractic curriculum.
Toward a 21st Century Curriculum
What can be done? Let's make room for contemporary, relevant subjects in the chiropractic curriculum, and remove those subjects that merely perpetuate acquired ignorance. Here are some subjects, lacking in most chiropractic college curricula, that I feel are essential to critical thinking and an understanding of the role of vertebral subluxation in health and disease. If you are unfamiliar with some of these terms, do a Google search and enjoy the "mind candy." There is really exciting stuff out there.
Philosophy
Metaphysics
Epistemology
Ethics
Politics
Esthetics
Logic and logical fallacies
Vitalism vs. mechanism
Basic Science: The New Biology
The living matrix
Tone and tensegrity
Semiconductor theory
Non-synaptic communications: Chemical and electronic coupling through gap junctions, ephaptic transmissions, field effect interactions, glial cell messaging, neural rhythmic pulsations
Connectomes
Neuroplasticity
Holographic neural theory
Biological oscillators
Coherence
Entrainment
Learning / memory in the spinal cord
Physiological Models of Vertebral Subluxation
Dysafferentation
Nerve compression and stretch
Axoplasmic flow
Segmental facilitation
Dysponesis
Dyskinesia
Autonomic dystonia
Clinical Models of Vertebral Subluxation
Segmental
Postural
Tonal
Biomechanical Assessment
X-ray spinography
CT
MRI, including weight-bearing
and kinetic
Postural measurements
Dynamic ROM
Neurophysiological Assessment
Thermography
Surface electromyography
Algometry
Heart rate variability
Functional MRI
Evoked potentials
Biochemical Assessment
Oxidative stress
DNA repair capability
Inflammation
Metabolic syndrome
Immune indices
Clinical Paradigms
Salutogenesis
Eu-stress vs. Dis-stress
Ease vs. Dis-ease
Has the CCE of today moderated its autocratic approach? Time will tell, although I have my doubts. It is now up to the profession to ensure that the student of today graduates with a strong philosophical base and a keen awareness of the profound potential of chiropractic's contribution to human health. The fundamental issues are simple. Are we a profession with a clearly defined mission, or are we a profession simply seeking some niche which offers access to a slice of the health care pie? Are we driven by principles or politics? Is our political position defined by our mission statement, or do we grovel to get whatever crumbs the insurance industry tosses our way? Do we have an identity defined by our purpose, or are we chameleons who change our colors to blend into the existing environment?
Resources
- Edwards J. "What Is the CCE Trying to Pull?" Dynamic Chiropractic, Oct. 21, 2010.
- Armstrong KS (ed). A Report on Chiropractic Politics & Education. Chiropractic Foundation of America, 1979.
- Keating JC Jr, Callendar AK, Cleveland CS III. A History of Chiropractic Education in North America. The Association for the History of Chiropractic, 1998.
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