Where Do We Stand?

Since we are often asked for our stand on issues in the chiropractic profession, Palmer College of Chiropractic has begun a formal process to develop position statements. Once created, these statements will be used for a variety of public purposes and audiences. They will not be based on consensus, but will represent the positions of Palmer College based on our tenets; historical perspective; our principles; our values; our philosophy; and the best information modern-day scientific research can provide. The responsibility for taking a stand on certain issues is ours as the fountainhead of the chiropractic profession, and one that I personally take very seriously.

One recent request for Palmer's stand on an issue came from chiropractors in Nebraska, where an attempt was made to change legislative language that would essentially rename chiropractors chiropractic physicians. On the coattails of this same proposal was a provision to mandate continuing education hours in acupuncture, rehabilitation, nutritional counseling, and laboratory analysis. Palmer was asked for its opinion on this physician statement and stood opposed to the change. I signed our response, not so much to oppose those who choose to call themselves chiropractic physicians on their business cards, as to put a halt to a regulatory change that would rename all chiropractors in Nebraska chiropractic physicians, even those who chose not to use this term. In this way, Palmer Chiropractic is taking a stand against the move to mandate the teaching of medical modalities under state provisions for relicensure of continuing education.

The following is further clarification of our position on this issue, reflective of the Palmer tenets and the spirit of the philosophy of Palmer Chiropractic. Analysis and discussion of what words mean, as well as their appropriate usage, is fluid because the meaning of words changes with context, the reader or listener's point of view, and over time.

All of that being said, I would like to make it clear that Palmer College of Chiropractic, based on our tenets, principles, history, philosophy and values, is opposed to the use of the terms physician and medicine as descriptors for the word chiropractic. Palmer College views the terms physician and medicine as unnecessary and inappropriate qualifiers to the appellative chiropractic. The terms chiropractic physician and chiropractic medicine serve no useful purpose and to blur the lines of distinction between medicine and chiropractic. 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.

This point of view is outlined in the Palmer tenets, which clearly state that the training of a Palmer chiropractor does not include pharmaceuticals, acupuncture or surgery. I believe the noun chiropractic needs no qualifier. We should be proud of the status to which our profession has risen. We have arrived. In my view, any qualifiers to the noun chiropractic are unnecessary, as we have the term chiropractor to designate the practitioner of chiropractic.

The profession of medicine 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. Its usage in conjunction with chiropractic is unnecessary and confusing.

Having said this, I recognize that we must communicate what chiropractors are and what we do to a diverse marketplace of potential patients who, at best, may have little or no knowledge of chiropractic, and at worst, may have misconceptions due to false information.

In some states, regions or countries, the use of chiropractic physician to describe chiropractors has been legislated because of pressures from third- party payers or other marketplace issues. If, for example, chiropractors are not being reimbursed for their services by health insurance companies in a certain state or country, simply because they are not called physicians, then there's a tough personal choice to face.

What are the arguments against this practice, in addition to the simple fact that the words chiropractic and chiropractor were specifically chosen by the profession's founder to describe a unique, new method of health care that is separate and distinct from medicine?

State by state, our forefathers fought for, and succeeded in securing separate and distinct status from medicine. Chiropractic has found a way to provide a unique service with a unique philosophy of health, without duplicating or demonizing medicine. We should be proud of our distinct difference from medicine. Medicine itself sees the need for change and is challenging its own model. It is not time to join or attach ourselves to its coattails by using such terminology.

This is our challenge for today: standing together in our philosophy and conveying to the public what chiropractic is and can do to improve overall health and wellness. Chiropractic today can stand in the clear light of consciousness that it is a well-accepted form of health care. We should accept the responsibility that is ours in the health care disciplines: condition-based care without the use of drugs and surgery, health care to enhance the individual's internal function and external resistive adaptations, and lifetime family wellness/development care to enhance human performance. Chiropractic is the primary way to achieve these ends in my opinion.

We must carefully examine whether the end justifies the means in using terminology such as chiropractic physician or chiropractic medicine. We must decide whether short-term personal gain is appropriate in comparison with long-term professional, patient and societal needs. The public associates "medicine" with the treatment of disease. This is, of course, antithetical to chiropractic philosophy. Does using these terms further confuse a marketplace already bombarded by conflicting messages about alternative health care? When you choose to use a term other than chiropractor to describe your practice and yourself, understand that you risk the possibility that the public will continue to misconstrue the meaning of the word chiropractor, and seek your care only when they experience symptoms and disease.

I assure you when you turn to The Fountainhead for an opinion, one will be rendered. Will it suit us all and our varying perspectives for the profession? Certainly not, but before you condemn any action taken by Palmer please remember Herbert Spencer's warning: "There is a principle which is a bar against all information which is proof against all arguments, and which cannot fail to keep man in everlasting ignorance. That principle is condemnation before investigation."

When you are in doubt about any public stand taken by Palmer, ask us why. And remember that in Palmer College of Chiropractic's history, there have been very few times when The Fountainhead did not have the courage to give an opinion. Rest assured that Palmer Chiropractic will not expediently exchange tomorrow's significance for the profits of today.

Guy Riekeman,DC
President, Palmer College of Chiropractic
Davenport, Iowa