The Future of Traditional Chiropractic or the Therapeutic Gambit-Checkmate


Gambit def. 1: a chess opening in which a player risks one or more minor pieces to gain an advantage in position.
The checkmate that traditional chiropractic has fallen into today is that its practitioners are adjusting people with a medical condition and expecting that the correction of the vertebral subluxation will make a difference in the outcome of that medical condition. To do that you must perform a diagnosis to determine whether that is a reasonable expectation. The argument against traditional chiropractic is that whether you are addressing a medical condition directly with therapeutic chiropractic or indirectly by correcting the/a cause of that medical condition you still must perform some level of diagnosis to insure that your care, even if you maintain it is not to treat the condition, is safe and not delaying necessary medical care. What the broadscope aspect of the profession is saying is that diagnosis represents the greatest and most important part of medical practice and even if you are going to limit your care to correcting a vertebral subluxation in someone with a medical condition you still need to come up with a diagnostic and prognostic conclusion. The diagnosis gambit “checkmates “ the traditional chiropractor unless he wants to go back to the previously abandoned position that chiropractic can and will correct the cause of all diseases and as a result any type of diagnosis, differentiating one disease from another, is not necessary. That is a position that the chiropractic profession had previously and correctly abandoned years before.
“Checkmate”, in chess as I understand it (my knowledge of the game is extremely limited. My brother-in-law a fair chess player remarked that I extended our game for so long because I was such a bad player that he could not develop a strategy to defeat me) involves putting your pieces in such a position that whatever move or moves your opponent makes will result in the ultimate loss of his king and the game. Checkmate is essentially saying “you can go on if you want but the end result is assured”. A good or even an average chess player will realize this, especially if he is able to think a few moves ahead and will resign or concede the game. There are two ways to avoid the medical diagnosis gambit and hence checkmate. Actually there are three but we have already discussed the futility of the first, maintaining the chiropractic adjustment corrects the cause of all disease. In that case, diagnosis differentiating one disease from another is totally unnecessary. That leaves two ways of avoiding it. BJ took the first way. The patients that came to the BJP research clinic usually had already been diagnosed (and usually treated) by a medical physician. So the diagnosis was already done, not one the medical profession could disagree with and the condition had already been deemed a medical failure. Research of this type is usually not done in a private practice unless we want to take only the people who have been diagnosed and treated without success by the medical profession. I’m sure most chiropractors, even the therapeutic ones do not want to be a secondary, (referred to) profession. Traditional chiropractors would like to see people first. In fact I think they were responsible for the phrase “chiropractic first, medicine second, surgery last”. Part of their model is prevention. If they are going to see people first and for prevention and instead of going to the medical doctor, they are going to have to come up with some sort of a diagnosis and prognosis that assures he public that chiropractic care is safe, effective and will actually prevent the condition from ever needing medical intervention.
The only other way to avoid the medical/diagnosis gambit and the inevitable check-mate that will result is to not address disease in any way. That is the approach that is called Objective(straight) Chiropractic or non therapeutic chiropractic. Of course it necessitates clearly defining what the chiropractor is going to do for the person coming into the office and what he is not going to do. It requires that he/she overextend himself/herself in reminding the practice member in every way possible that chiropractic does not address disease or its cause. There are no other ways to avoid falling into the medical/therapeutic gambit, the checkmate. The gambit that therapeutic chiropractic has performed sacrificed a few pieces in that they were willing to concede that traditional chiropractic can be effective in addressing indirectly or directly the/a cause of disease. By conceding that assertion by the traditional chiropractors, allowing them to take credit for the possible alleviation of certain diseases (without) legitimate research, they are backing them into a place where they must admit that they had to perform the procedure of a medical diagnosis. Even to prove by research the effectiveness of chiropractic in any disease alleviation, requires first diagnosing that condition. Chess gambits are used all the time, all of them are copied from ones previously used by the chess masters. The therapeutic gambit used by chiropractors was first used on them by the medical profession, the AMA and Joseph Sabatier when Dr. Joseph Janse testified in the England Case in Louisiana. The therapeutic chiropractor does not care whether the traditional chiropractor addresses medical conditions with chiropractic, just as long as he has first performed the most important aspect of medical care. Doing the necessary diagnostic tests and concluding that the disease condition will respond to chiropractic in a positive manner or referring out, must be a prerequisite to chiropractic care in the traditional model. Even if the chiropractor is only adjusting he is practice drugless medicine all the same.
The only real and effective defense against the medical/therapeutic gambit, as I see it, is for traditional chiropractors to become objective straight chiropractors, rejecting the need to treat medical conditions and as a result, the need to diagnose. They must disassociate themselves from addressing disease or its cause. They must limit their procedures to a clearly non-medical objective, LACVS so that the forces of the innate intelligence of the body can be more fully expressed. Period!

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Posted in: Thinking Straight

This article has 1 comment

  1. Don 11/16/2014, 10:55 pm:

    Dr. Strauss,
    I can see the diagnosis gambit and checkmate situation you describe.

    IMO there is also a similar situation presented in the realm and interest of “public safety”.
    Some individuals/groups are of the opinion that regardless of the intent of intervention (LACVS or therapeutic) certain conditions must be ruled out in order to safely start or continue with care.
    Notice how this implies the need to diagnose.
    Interesting chess match analogy. Thanks Joe!

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