CHICAGO, Illinois -- The Research Agenda Conference IV (RAC IV), July 23-25, brought more than 200 chiropractors and other health care professionals together for high-level academic dialogues on chiropractic research. RAC has nearly doubled its attendance each year since the first conference in 1996, attesting to a growing interest in all aspects of chiropractic research -- a kind of expanding research consciousness.
The conference was titled "Chiropractic Research: Implications for Practice, Policy, and Professional Development." Topics discussed at the conference included the basics of scientific writing, grant proposal development, and a dialogue on the appropriateness of theory-driven research in chiropractic.
Serving as co-directors of the conference were Cheryl Hawk,DC,PhD, associate professor for the Palmer Center for Chiropractic Research, and William Meeker,DC,MPH, who is the director of research at Palmer. They were assisted by a multidisciplinary planning committee. The conference was also sponsored by two federal agencies: the U.S. Health Resources and Services Administration, Bureau of Health Professions, and the National Center for Complementary and Alternative Medicine.
The annual research agenda conference fulfills the specific aims of the Consortial Center for Chiropractic Research (CCCR), which includes developing scientific capabilities in the chiropractic profession. The CCCR is a cooperative effort with the Office of Alternative Medicine and the National Institute of Arthritis, Musculoskeletal and Skin Diseases (both within the National Institutes of Health). The CCCR faculty and staff are from the chiropractic colleges of Palmer, National, Northwestern, LACC, Western States, and the University of Iowa and Kansas State University.
"RAC IV focused primarily on development of infrastructure capabilities in chiropractic research," explained Dr. Hawk,DC. The highlight of RAC IV in her view was "a very productive academic dialogue on the need for basic science research on chiropractic theory, including the definition of subluxation, adjustment and the nature of disease and health."
An Open Dialogue on Research into Chiropractic Theory
On the second day of the conference, four chiropractic researchers presented talks on theory development in chiropractic. The topics presented ranged from "Chiropractic Theory as Professional Identity" to "The Definition and Purpose of Theory." On the final day, RAC IV participants listened to additional presentations on chiropractic theory development (including subluxation research) and joined in a lively discussion on the relevance, appropriateness and difficulty of research into the heart and soul of chiropractic. Audience reaction to this topic was extremely positive, indicating the importance of chiropractic theory to drive the profession's research efforts.
"As a chiropractor with over 30 years of experience in the profession, I was heartened by the free and open discussions that those in chiropractic education and research engaged themselves in at the recent Research Agenda Conference in Chicago," observed Peter Martin,DC, president of Palmer College of Chiropractic West. "To me, this indicated a coming of age for the chiropractic academy. When people who are leading the development of knowledge for our profession can discuss and debate without rancor such topics as theory development, it speaks well for the future of chiropractic."
Dr. Martin contended that chiropractic has survived, despite strong opposition, for the simple reason that it helps people. "Chiropractic will continue to survive and thrive for that very reason. Theories are out there to be tested. It is good that we have gained the maturity to be able to test ours without fear."
Others praised the friendly, open manner in which participants with opposing beliefs participated in the discussions. "It wasn't a consensus-building or decision-making process, nor a debate with people taking one side or another," noted Dr. William Meeker, director of the Palmer Center for Chiropractic Research. "Participants agreed to disagree in a friendly, humorous fashion."
Dr. Meeker was candid in his assessment of the conference. "If there was a consensus, it was that everyone was comfortable admitting what we don't know and that we have research challenges ahead of us. I'm optimistic that this open academic dialogue will help researchers develop innovative research projects that investigate the basic concepts of chiropractic care. This type of dialogue bodes well for the future of chiropractic research and the profession itself."
A Full Spectrum of Chiropractic
The three-day RAC IV conference included discussions on the full spectrum of chiropractic: clinical practice; basic and high-level research processes; the research culture; biomechanics; and neuroscience.
The conference also geared itself toward a variety of participants. There were workshops tailored to those with little research experience and programs on topics such as grant writing that were presented with the sophisticated research scientist in mind. The conference included respected presenters from health science fields outside of chiropractic. "While the Research Agenda Conference is primarily a chiropractic development effort, it was interdisciplinary in terms that we were learning from other professions in scientific development," said Dr. Hawk.
Presenters included eminent scientists from many fields. Israel Goldberg,PhD, presented a program called "Developing a Successful Grant Proposal." Dr. Goldberg is a former senior executive at the National Institutes of Health whose scientific training is in experimental psychology.
Friday's keynote speaker was Wayne Jonas,MD, formerly the director of the NIH Office of Alternative Medicine and currently a faculty member in the Department of Family Medicine at the Uniformed Services University of the Health Sciences. His talk, "Chiropractic Research: When Paradigms Clash," explored the challenges that face chiropractic research today as it seeks a place among accepted concepts in biomedicine and science and strives to effectively implement chiropractic procedures and philosophy into health care networks.
Opening remarks on Saturday were by Marc Micozzi,MD,PhD, executive director of the College of Physicians of Philadelphia, an anthropologist and noted authority on CAM (complementary and alternative medicine).
Other presenters included Jacqueline Stolley,RN,PhD, who spoke about the research culture in the nursing profession, and Christopher Bork,PhD,PT, who presented a program on the research culture in physical therapy. Both of these presenters have decades of experience in their professions, are active in research and are prolific authors in their respective fields of expertise.
Closing remarks at the conference were delivered by James Dillard, MD,DC, a founding medical director of the Oxford Health Plans alternative medicine program, one of the first health plans in the country to incorporate alternative medicine in a major way. He teaches at the Columbia University College of Physicians and Surgeons and is the author of Alternative Medicine for Dummies.
In short, RAC IV provided an opportunity for those in the chiropractic profession with diverse backgrounds and points of view to come together to discuss a common interest -- chiropractic research. "The RAC IV conference in Chicago provided a forum for college presidents, researchers and field DCs to voice their views on the direction chiropractic research should take," observed Palmer College of Chiropractic President Guy Riekeman,DC. "Should it be subluxation-oriented? Should it be guided by principles or demands from third-party payers? Palmer's Board has supported subluxation research as the basis of our efforts for the future. You can say these researchers don't represent my chiropractic view, or they have an opposing agenda, but the bottom line is that the bulk of money coming to chiropractic research is through government agencies. To be heard, you must be part of the dialogue. For this alone, it's an important, even critical event."
The Next Installment
RAC IV organizers are already talking about RAC V, anxious to build upon the success of RAC IV and incorporate participant feedback in the next conference. Dr. Meeker expects RAC V to convene at about the same time next year. Stay tuned for details.
