"Leadership is one thing; interference is another."
Dear Editor,
The February 12 issue of Dynamic Chiropractic contains a column by Guy Riekeman, DC, titled "Where Do We Stand?" Dr. Reikeman appears to take great pride in the fact that he interfered with the attempts by the chiropractors in Nebraska to amend their rules and regulations to include the term "chiropractor/chiropractic physician." This was being proposed in response to a district court judge ruling that doctors of chiropractic were not covered by "physician's liens."
Dr. Riekeman said he was asked for "its" (Palmer's) opinion on this physician statement and stood "opposed to the change." It should be noted that Drs. Sid Williams, Gerry Clum and Robert Hoffman from the ICA also submitted letters that were intended to interfere with the wishes of the majority of chiropractic physicians represented by the Nebraska Chiropractic Physician's Association, which has been active in representing the interests of the chiropractic profession for the past 35 years.
I do not know how Palmer makes its decisions to interfere in state legislative concerns, but here at National, we have a policy that we do not enter into the situation unless invited to do so by the prevailing state association. It is our position that the profession of chiropractic should evolve as its practitioners promote its evolution. I am not at all convinced that any single college or chiropractic degree program should take it upon itself to try to determine the future of our profession. Leadership is one thing; interference is another.
What is just as important, in my view, is that the actions of Dr. Reikeman and the others have done nothing to promote intra-professional harmony and accommodation. What we see here instead is action born of arrogance, the arrogance that allows individuals who represent an entity to use their position to attempt to define for the majority in a state what their profession really should be. That kind of arrogance was once the primary province of the allopathic profession, and here we see a clear example of its application within our own ranks.
In the article, Dr. Reikeman states that "the terms 'chiropractic physician' and 'chiropractic medicine' serve no useful purpose" and "blur the lines of distinction between medicine and chiropractic." He goes on to state, "whereas medicine has traditionally established the use of physician in association with the MD degree, Palmer College holds its usage with the noun 'chiropractic' to be inappropriate and obfuscatory. The word 'chiropractic' is complete in itself and does not necessitate a qualifier."
"The profession of medicine," he states (no doubt referring here to allopathy), "has no such descriptive noun for its practitioners. Thus the term 'medical physician' came into being, to differentiate the medical doctor from other forms of medical involvement." Actually the "medics" used the term "physician" to differentiate themselves from surgeons who were looked down upon at the time as being less learned. Even then, the term "physician" was applied in its appropriate meaning as "one who heals," and that applies just as correctly to the chiropractor as to the medic.
The chiropractic is identified in the Oxford Dictionary as an adjective, just as one would expect. It is identified in lesser dictionaries as a noun, primarily because we in the profession have used this adjective so frequently as a noun that it has come to be accepted that way - at least by us - and we are the ones who have provided the definitions to the dictionary folks here in the U.S. Chiropractic is a "noun cognate" at best, and the majority of people outside our profession with whom I have contact do the obvious thing. They say "chiropractic medicine." Hardly a newspaper or magazine interview occurs in which the reporter does not use the term "chiropractic medicine."
We, once again, are trying to make our own language, as BJ Palmer tried to do. What most chiropractors probably do not know is that these ideas were not original with Palmer, who derived his "thots" on language directly from Elbert Hubbard. Nevertheless, today, we, as a profession that purports to serve the public, should see the need to also live in the society that we hope to serve. What point is there is any slavish devotion to terms that are outdated or confusing? And chiropractic is a confusing word to most outside of our profession.
It is good to be very clear about the meaning of medicine, which is defined as: "that department of knowledge and practice which is concerned with the cure, alleviation and prevention of disease in human beings, and with the restoration and preservation of health. It is also, in a more restricted sense, applied to that branch of this department which is the province of the physician, in the modern application of the term; the art of restoring and preserving the health of human beings by the administration of remedial substances and the regulation of diet, habits, and the conditions of life."
Some in our profession will argue that from this definition, it is very clear that we do not fit, because in their view we do not "cure or alleviate disease" in humans, we only locate and correct the subluxation. The obvious question then becomes, "What is the subluxation if not a disease?" If it is something wrong with the human anatomy and physiology that is not considered normal, then it is a "disease," defined by the Oxford Dictionary as: to deprive of ease, make uneasy, to put to discomfort, or inconvenience; and further, to bring into a morbid or unhealthy state, to cause illness or sickness."
It should be immediately obvious that even those members of the profession who profess to only correct spinal subluxation are, in fact, practitioners of the art known as "chiropractic medicine."
If allopathy has usurped the term medicine as its own, shame on us for letting it do so. It is a generic term that refers to healing with methods other than surgery, and was originated for that purpose. I certainly believe that by any standard in our profession, even if we say we do not treat disease as some believe, we must be in the business of "restoration and preservation of health.
The issue is that we do these things in a different way from the ways used in allopathy. Thus, it becomes not only proper, but valuable for us as a profession to state loudly and clearly that we practice chiropractic medicine, not allopathic or osteopathic medicine.
Where the term physician is concerned, the application is completely appropriate as a noun modified by the adjective chiropractic. Here is why this is true.
The Oxford Dictionary reveals that the use of the term reaches into antiquity and has several meanings, as follows:
Physician:
- a student of natural science or of physics;
- one who practices the healing art, including medicine and surgery;
- one legally qualified to practice the healing art as above, especially as distinguished from being qualified as a surgeon only; or
- a healer; one who cures moral, spiritual or political maladies or infirmities
According to the Oxford Dictionary, in the 1600s the physicians were considered the more learned individuals, while surgeons or chirurgions were considered the more experienced. In any event, one aspect of this term always pertains. A physician is a healer, or perhaps, more appropriately, one who promotes healing.
Do we fit into this definition? It seems obvious that we do, and again, we are a particular kind of physician, so it is completely appropriate for us to refer to ourselves as chiropractic physicians. Furthermore, in numerous states, we are specifically licensed as "chiropractic physicians," so it is not only appropriate - it is legally correct.
One thing that always happens when some DCs read what I just said is that they will write vitriolic letters accusing me of being a "wanna-be MD." They will say that I am not proud of what I am, etc. Even Dr. Riekeman used this tack when he on several occasions stated, "We should be proud ... etc." In other words, if you don't agree with the direction he is proposing, you are somehow less, you are not proud of your profession, you are not "as good as," etc. None of these things are true, of course, and have no relevance whatsoever to the reasons why I promote logical use of the English language. Furthermore, those that know me well, may tell you that I tend to sometimes be "too pro-chiropractic" in many ways.
Let us turn once again to Nebraska. The term physician in Nebraska, as in Illinois, allows us to be peers with the allopathic and osteopathic physicians and that means we are included in the programs in which they are included. That benefits our patients and it benefits us. It allows us to be appointed to positions that affect public health, and places us in a position to promote chiropractic medicine to the public that we serve. How can this be a bad thing?
Are we so weak-kneed that we will immediately seek the right to use prescription drugs because we are called physicians? If that is true, then why, here in the "bastion of chiropractic medicine and chiropractic physicians" (Illinois) has this not happened? Perhaps those of us considering ourselves chiropractic physicians are just confident enough in our education, knowledge and expertise that we are not haunted by the specter of absorption into allopathy. Sometimes it is those most afraid that make the most noise. It is so reminiscent of the various sects in the churches of America. But then, we are not a church, are we? Do we really need the doctrine from Davenport, or can we manage to all by ourselves? I think the chiropractic physicians of Nebraska can handle the situation just fine. Let's get out of their business unless they, as a profession, not one or two disgruntled individuals, invite us in.
James Winterstein,DC president,
National University of Health Sciences
Lombard, Illinois
Oversimplified ?
Dear Editor:
I recently read with great anticipation the article written by Russell W. Shurtleff,DC, ("Using Whole-Food Supplements in Clinical Nutrition" from your March 12, 2001 issue). While I fully understand the main point Dr. Shurtleff is trying to make in this article, I do believe that there has been an oversimplification of this issue, and there are some points of confusion that need to be clarified and addressed.
There must be a distinction made between the two entirely different goals of providing a general nutritional supplement to support a varied diet of fresh whole foods to maintain optimal health, versus the use of specific nutritional factors used therapeutically to either correct frank deficiencies or influence a particular pathological process. While it sounds really nice and rational to make statements like, "It is better to derive your nutrients from whole foods, rather than from synthetic vitamins in pill form," that does not really take into account many challenges faced by nutritionally-oriented clinicians. The article quotes the famous botanist James Duke,PhD: "Vitamins and phytochemicals are better taken in their evolutionary context - as they occur in plants - not isolated and out-of-context." As a general rule, that is correct. However, Dr. Duke was not referring to the use of specific nutrients to correct a discrete pathology or biochemical difficulty within the body. The examples are too numerous to mention; however, nutritionally correcting many pathological conditions, including hypercholesterolemia, hypertension, diabetes, and many others is just not possible solely with whole-food- based supplements. As well, correcting many metabolic lesions created by genetically induced enzymatic abnormalities, firmly identified by cutting-edge laboratory testing, such as organic acid analysis, would require a much higher dosage of specific nutrients than is feasible to acquire from truly 100- percent food-based supplements.
Many supposed "whole-food-derived" supplement brands simply are not that. If you actually read the labels of these supplements, including one of the largest brands marketed to chiropractors as a food-based supplement, they reveal items such as pyridoxine hydrochloride. This is not a naturally occurring form of pyridoxine found in foods, but rather, the typical USP synthetic form of the vitamin. These companies often start with a whole food in the supplement, but usually spike these products with USP vitamins in order to get even reasonable dosages within the pill. At this point, it is just not economically feasible, nor physically possible to get therapeutic levels of key nutrients into a tablet or capsule that has been wholly derived from food.
An example of supposed whole-food supplements can be found on Dr. Shurtleff's own website, where he gives nutritional recommendations to people based mainly on a subjective questionnaire, and then sells supplements. Some of these supplements have ingredients like clay and bone meal, to name only two. These substances are often known to be contaminated with heavy metals and other chemicals, neither of which I would classify as "whole-food." I do not know many people who eat clay and veal bone meal!
I understand the overall point that Dr. Shurtleff is trying to make, and I too have an appreciation for the power of the entire food substance and/or herb. No amount of supplement pills can ever make up for a bad diet, or fully replace the multitude of health-enhancing phytonutrients derived from quality whole foods. A similar controversial topic exists within the herbal community in the debate over of the traditional use of whole herbs versus the modern Western use of standardized herbal extracts. In reality, they probably both have their place. As a teaching professor at a college of chiropractic and naturopathic medicine respectively, I try to present the benefits and drawbacks of both approaches. This should be true with orthomolecular vitamin therapy as well.
I also do believe that there is a knee-jerk reaction to the word synthetic when it comes to vitamins. These are termed synthetic only because they are derived via a laboratory process. It is true that commonly found over-the-counter brands of synthetically manufactured vitamins do not contain all forms of the vitamin found in whole foods, such as is the case with alpha-tocopherol (vitamin-E) supplements. However, the vitamin that is there is structurally identical, and is utilized in exactly the same way by the body as the one derived from food. Imbalances caused by common multivitamin-mineral supplements, as suggested in the article, are also overstated. Product formulators understand these relationships and design the product so that this situation is not allowed to happen, unless overt and gross abuse of singular mineral supplements is occurring.
I would also encourage Dr. Shurtleff to refrain from citing books written by individual authors who often have corporate relationships, personal preferences, or particular agendas when making such strong statements. He would do better sticking to primary research and clinical trials published in scientifically accepted peer-reviewed journals.
David M. Brady, DC, CCN, DACBN
assistant professor of clinical sciences
University of Bridgeport,
Colleges of Chiropractic and Naturopathic Medicine
www.wholehealthconsult.com