Thank You, Governor Jeb Bush!

That's right! I mean it when I say, "Thank you, Governor Bush, for vetoing the funding of a chiropractic program at Florida State University (FSU)." By doing so, you have confirmed ever so strongly two perpetuating, but often denied beliefs.

1. Lobbyists make decisions for politicians.

    

2. The leadership of Palmer University prefers to isolate chiropractic education, rather than see it become integrated into the mainstream of public-funded, higher education.

Rather than insert my presumptions why Palmer University opposed a chiropractic program at FSU, let me quote Palmer University Chancellor, Michael Crawford, as reported in Dynamic Chiropractic:

"We simply do not want to place the curriculum under any medical hierarchy, jeopardizing the course of study that is offered by chiropractic faculty to chiropractic students...We are proud of trying to keep chiropractic in a chiropractic school. It is our uniqueness that is currently attracting record levels of public and private dollars for chiropractic research. We are not willing to let nonchiropractors begin to define what chiropractic is, what future chiropractors will learn and what care chiropractic patients will receive."

The debate of "isolation" vs. "integration" of chiropractic into mainstream health care or mainstream higher education continues. A lesson from history on how medicine became the authority in society regarding health care² is in order:

"The rise of medicine, and of the professions more generally, represents one of the more striking instances of collective mobility in recent history. The historical success of a profession rests fundamentally on the growth of its particular sources of wealth and status - its authority. Acknowledged skills and cultural authority are to the professional classes what land and capital are to the propertied. They are the means of securing income and power. For any group, the accumulation of authority requires the resolution of at least two distinct problems: One is the internal problem of consensus; the other is the external problem of legitimacy... Consensus facilitates the articulation of common interests and the mobilization of group effort, while respect and deference, especially from the more powerful classes, opens the way to resources and legally sanctioned privileges."3 (emphasis added) "Nothing weakened the medical profession more than the bitter feuds and divisions that plagued doctors through the late nineteenth century...Medical colleges were a particularly rich source of fraternal hatred...Often the faculty at one school could not abide the faculty of another...The history of medical schools in the 19th century is a tale of schisms, conspiracies, and coups, often destroying the institutions in the process."4

There were battles occurring between the "regular doctors" (allopathic physicians) and the sectarian practitioners (homeopaths and "eclectic" practitioners). The public became involved in the feuding, as chroniclers noted:

"An early sign of compromise came in Michigan, where the state legislature required the incorporation of homeopathy into the University of Michigan Medical School...professors of the two camps taught there together. Homeopathic students took the same basic courses as their classmates, except for materia medica (pharmacology) and the practice of medicine..."5 "The movement toward convergence and compromise now came from both sides...It soon became apparent that wherever sectarians practiced, even in relatively small numbers, the regular physicians were unable to obtain licensing legislation over their opposition. Moreover, specialists, especially in the larger cities, were increasingly unhappy with the professional restriction on consultations. Referrals from homeopathic and 'eclectic' general practitioners represented a potentially significant source of income for them. At the same time, many homeopathic practitioners began moving toward an accommodation with orthodox medicine. While the purists among them held to Hahnemann's faith in extreme dilutions of drugs and believed in treating symptoms individually, the moderates, who were the dominant group, accepted concentrated medicines and thought in terms of treating diseases, as did allopathic physicians. The moderates also rejected as unscientific Hahnemann's belief in a 'vital force.' In 1880, as the internal disputes among homeopaths intensified, their national organization, the American Institute of Homeopathy, split as the purists left to form their own International Hahnemannian Association."6

Perhaps what happened to the homeopaths (movement toward convergence and compromise) is the fear that drove the Palmer decision-making process regarding FSU. The following may also support the Palmer position:

"The incentive to differentiate oneself was now counterbalanced by an incentive to conform and accommodate. At the same time, the development of medical science provided an increasingly firm basis for convergence. The sectarians shared most of the fundamentals of medical science in common with the regular profession; as scientific knowledge advanced into the area of therapeutics, their differences tended to diminish. The growth of science thus reinforced the effect of new institutional relations, laying the ground for a new professional consensus."7

It is interesting that Palmer University supports an isolation policy from higher education while serving as the home base for the Consortium Center for Chiropractic Research (CCCR - mistakenly referred to as the Palmer Research Center on occasion), the largest federally funded research program in the profession. If the research conducted through the CCCR provides a more "firm basis for convergence" with medicine, will the Palmer decision-making machinery opt for isolationism? If yes, will that a effect either the future of the CCCR or the work to be conducted under its auspices? We hope not!

The historians continue:

"The myth persists today that homeopaths and herbal doctors were suppressed by the dominant allopathic profession. Yet the sequence of events suggests otherwise. Both the homeopaths and 'eclectics' won a share in the legal privileges of the profession. Only afterward did they lose their popularity. When homeopathic and 'eclectic' doctors were shunned and denounced by the regular profession, they thrived. But the more they gained in access to the privileges of regular physicians, the more their numbers declined...Enrollment at 'eclectic' schools peaked at one thousand in 1904; by 1913 it was down to 256. In 1900 there were twenty-two homeopathic schools, but ten years later there were only twelve, fewer than in any year since 1880; by 1918 only six remained, and these all ceased to be homeopathic institutions within the next several years."8

On first observation, this would suggest that chiropractic might remain stronger if we continued to fight for our uniqueness and distinctness and opposed the cultural authority of medicine. Rather than accommodate, we should remain isolated and oppose any legal privileges that might expand our scope of services to insure our strength. But further reading into the same paragraph sheds a more perfect light on Starr's perception of the demise of the irregular professions:

"...by 1918, only six remained, and these all ceased to be homeopathic institutions within the next several years. Homeopathy had one foot in modern science, the other in pre-scientific mysticism; this became an increasingly untenable position. While regular medicine was producing important and demonstrable scientific advances, homeopathy generated no new discoveries."9 (emphasis added)

The confusion of our professional identity and existence, and the failure to gain internal consensus and external legitimacy by chiropractic, has not been because of medical opposition, something we have all blamed. We are what we are because of ourselves, our failure to step out of "pre-scientific mysticism" and produce "important and demonstrable scientific advances."

Without question, the great travesty in the FSU veto is a confirmation that the profession does not have enough faith in our own philosophy we so dearly avow as to expect it might survive in the midst of the "gentiles," i.e., the nonbelievers. This is our only justification for isolationism-perpetuation of a model of intellectual immaturity.

References

1. FCA fulminates over funding veto. Dynamic Chiropractic, Vol. 19, Issue 6, July 2001.
2. Starr, David. The Transformation of American Medicine. Chapter three: The Consolidation of Professional Authority, 1850-1920.
3. Starr. pp 79-80.
4. Ibid. p 93.
5. Ibid. p 100.
6. Ibid. p 101.
7. Starr. p 102.
8. Ibid. p 107.
9. Starr. pp 107-108.

Reed Phillips, DC,PhD
President, Southern California University of Health Sciences
Whittier, California