Houston We’ve Got a Problem

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have no idea what the strategic plan was on the part of those who would medicalize chiropractic to motivate them to take on the largest chiropractic college in the world. It would seem a smaller school with less political and financial clout would have been a better choice. If we are to assume that this was a political move, and we must, then they must have had good reason. (By political we mean that the desire on the part of the accrediting agency is not to evaluate the quality of a program but to conform that program to their preconceived and philosophical idea of what that program should be.)

So we must ask ourselves, why wait to this point to lower the boom on a chiropractic college and why pick out the biggest one? What is their strategy? Perhaps I give them more credit than they deserve but I find it is always safer to think your enemy is smarter than they are than to think them dumber than they are.

While we do not know the details of their decision to not accredit Life University, from the reaction of the people involved, I believe we can conclude that in one way or another, it centers around the issue of diagnosis. That is the fundamental issue. The medicalization of chiropractic necessitates incorporating diagnosis into the practice. The survival of chiropractic as a non-therapeutic practice necessitates keeping diagnosis in every form out of the practice of chiropractic. Therein is the problem. For the last twenty years, a segment of our profession has maintained that we treat certain medical conditions and hence we need to be as competent in determining the presence of those medical conditions in order to know who we can treat and who we cannot. They are the people who run the Council on Chiropractic Education. There is another segment of the profession, those who I refer to as traditional straights in Refined by Fire. They are the chiropractors who have been “getting sick people well” or “correcting the cause of all disease.” When their schools became accredited by the CCE, they acquiesced to their standards which included increasing courses in diagnosis and doing diagnostic workups in the clinical setting. They knew very well that these procedures were not done in practice but they thought that the schools could play the CCE game and then the chiropractor could practice as he desired after graduation. They realized that NO chiropractor is adequate in medical diagnosis. So they played the game and got sucked into the CCE model.

Now suddenly they are saying they don’t want to be medical physicians. Yet the moment they gave in on the idea of diagnosing medical conditions, either for referral or contraindications, they were hooked. The Association of Chiropractic College’s standards include diagnosis. They were so happy that the therapeutic schools acquiesced to the inclusion of concepts like “innate intelligence” and “vertebral subluxation” they gladly signed on the dotted line ignoring the issue of diagnosis. To the CCE and the therapeutic model schools, the inclusion of the terms innate intelligence and vertebral subluxation means nothing. Allowing it in there was a meaningless gesture. The issue of diagnosis sets the tone for the direction of the chiropractic profession and all the schools signed onto that ship. Now they want to get off.

You know, we often need to look at things from the other side’s perspective. All they can see is if we are addressing medical conditions in any manner to treat, refer, correct their cause or rule them out, put them in an insurance form, or provide a medical alternative, then we need to be competent in medical diagnosis. Whether we correct vertebral subluxations or love innate intelligence makes no difference. Whether we want to call it chiropractic diagnosis, referential diagnosis or anything else is not the issue. We need to be as competent as the medics and yet the profession is not that competent and some of the profession (the traditional straights) do not want to be. The CCE cannot understand that, and frankly, neither can I.

Here’s the problem. This may very well get to the courts. If the traditional schools, chiropractors, and the national organizations take the same position that they have for years, i.e., providing an alternative to medicine to treat the cause of disease, I believe the courts will side with the CCE position. Of course, there is a defensible position. It is the one that the objective straight, non-therapeutic chiropractors have taken for the last 20 years. But the schools have rejected that position or abandoned it, if they ever held to it at all, and unless the leaders of the college are willing to totally embrace it, I see some real problems in the future. To do that will not be easy. Frankly, their leadership, their spokespersons, their “chiropractic specialties,” their publications, their legislative efforts, their literature, their seminars and just about everything else they say and do bespeaks the indefensible position that has precipitated the CCE’s attack and given those who would medicalize chiropractic the confidence that they can win this battle. They can say they are non-therapeutic, that they do not address disease in a way that necessitates medical diagnostic skills, but everything about them says otherwise.  V18n4

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