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August 2006

Is medicine switching places with chiropractic?
by Dr. David A. Jackson

For more than a century, chiropractic served as an alternative to medical care. Doctors of chiropractic were health care rebels, eschewing the "drug 'em or cut 'em" mentality, and guided by an entirely different paradigm, replacing medicine's mechanistic approach with a vitalistic perspective.

In recent years, we've seen an alarming trend toward reversing these two positions.

Many chiropractors have, in a clear case of caduceus envy, edged closer to the medical model, choosing to identify themselves as musculoskeletal therapists, calling their profession chiropractic medicine, disowning the concept of subluxation, and even at times espousing the use of drugs in chiropractic.

At the same time, the medical profession has edged toward a more holistic wellness approach.

In an article adopted from the book "Managing Stress, Principles and Strategies for Health and Wellbeing" (Jones & Bartlett Publishers, Sudbury, MA, 1999), author Brian Luke Seaward notes that "medical science is slowly experiencing a paradigm shift."

After centuries of adherence to the mechanistic model championed by Descartes and Newton, medical researchers and practitioners are having to face newer concepts of the universe that jarringly oppose the older notions.

"As a result, standard concepts regarding health and disease are slowly beginning to give way to a more inclusive reality or paradigm," Seaward says. "As an example, very recently medical researchers have learned that emotions can suppress the immune system, giving rise to the field of psychoneuroimmunology, a concept thought inconceivable and ludicrous only a decade ago. The 'body as a clock' mentality no longer seems to answer all the questions posed in the framework of the mechanistic model. In fact, some issues like the placebo effect are being completely revisited."

Since the old mechanistic paradigm doesn't work anymore, the MDs were forced (kicking and screaming) to find another view of the world, and of health. But, as Seaward rightly points out, "Old paradigms are not abandoned until new conceptual models are created and established."

They were lucky. They didn't have to look far for another paradigm that was more in keeping with modern scientific thought and that meshed nicely with the popular trend toward health. The vitalistic paradigm that served as the touchstone of the chiropractic profession was most appealing. By looking at wellness and well‑being instead of disease, the medical profession hoped to re‑invent itself and continue to play the dominant role in health care.

As in any monumental shift in world view, the change is a slow one, but one that has been noted by health care advocates, economists, sociologists, business leaders and researchers.

How long will it be before medical doctors are known as the holistic, wellness experts ... and chiropractors are dismissed as "old fashioned" disease‑oriented body mechanics?

Is there anything we can do to reverse this trend and regain our advantage as the foremost wellness providers?

I personally think there are many things we can ‑‑ and should ‑‑ do.

First of all, we have to stop being afraid of associating ourselves with traditional chiropractic, with the subluxation‑centered profession handed down to us from DD and BJ Palmer and most of the other noted pioneers. We have to stop substituting medical terms for chiropractic concepts like "subluxation" and "adjustment." We must teach our patients, and the public, that chiropractic is not just about treating low back pain but it IS about making a fundamental change in the way the body works, by correcting subluxations.

We also need to conduct the kind of research that can validate chiropractic as a wellness discipline. To do this, we need to encompass all aspects of wellness. As Seaman noted in his book, "total wellness is the balance, integration, and harmony of the physical, intellectual, emotional and spiritual aspects of the human condition. These four components of total well‑being are so closely connected and interwoven that at times, it is virtually impossible to separate and divide them."

These are precisely the four components that were researched in a breakthrough study by Robert Blanks, PhD in 1997. Dr. Blanks, together with Tonya Schuster, DC and Graham J. Dobson, DC, conducted a retrospective assessment of subluxation‑based chiropractic care on self‑related health, wellness and quality of life. Specifically, it examined the impact of chiropractic on four distinct but interrelated health domains: physical state, mental/emotional state, stress evaluation, and life enjoyment. It was the largest study of its kind ever undertaken regarding a chiropractic population.

After surveying 2,818 respondents in 156 practices, a strong connection was found between persons receiving Network care and self‑reported improvement in health, wellness and quality‑of‑life. 95% of respondents reported that their expectations had been met, and 99% wished to continue care.

Dr. Blanks applied the same approach to the Research & Clinical Science (RCS) project, looking once more at those four health domains but expanding the scope of the research to encompass all subluxation‑centered chiropractic care and collecting data on a global scale.

Armed with data on chiropractic's impact on the various aspects of human health, it will be easy for chiropractic to maintain its strong association with the vitalistic paradigm, while the medical profession continues to search for a new model to co‑opt.

The challenge for chiropractic will be to make sure we don't play musical chairs with the wellness concept. If we get up and walk away, it'll be all too easy for the medical profession to slip into our place and leave us wandering around like rebels without a cause.

(Dr. David Jackson is chief executive officer of Research and Clinical Science ‑‑ RCS ‑‑ a private sector research program exploring issues of subluxation correction and chiropractic care as they relate to health and wellness. Previously, he served as president of the Chiropractic Leadership Alliance and Creating Wellness Alliance and was owner/operator of several private practice offices in California and Idaho that specialized in high‑volume, family wellness‑based care. For more information on RCS, call 800‑909‑1354 or 480‑303‑1694, or visit the RCS website at www.rcsprogram.com. Doctors of chiropractic may log on to a special limited‑access area of the site by using the username DC1 and password RESEARCH.)