The Bumble Bee Quandary
In the December 1993 issue of Campus Life, the president of Life College and chairman of the board of the ICA is quoted:
To hell with the scientists. They haven't proven a bumble bee could fly. The subluxation is the entity that is ours, the entity that is new. Make the correction. Don't leave it out. Don't call it treatment.
A less scathing statement by this same person is found in the July/Aug. 1993 issue of Health (p. 53):
Don't say I'm against research,... But a damned fish peddler figured this out! That's the problem: This thing is so simple, but everybody tries to make it so complicated.
And on page 46 of the same article:
Rigor mortis is the only thing that we can't help.
What are the messages contained in these statements? There are many, some more obvious than others, depending upon your point of view. Perhaps he was misquoted in this article as I was.
So often we are confronted with dichotomies of description in chiropractic such as "straights and mixers" or "subluxation based vs. disease based" chiropractors. In actuality, the dichotomy is not so well defined and our variations as a profession extend over a continuum with poorly demarcated intermediate boundaries. At LACC, we have latched onto a phrase that describes where our philosophical perspective fits into this continuum differentiation.
Our approach at LACC as articulated by Dr. Al Adams:
Evidence based, health oriented, patient centered care.
As opposed to the other end of the continuum:
Belief based, subluxation oriented, doctor centered care.
An evidence based approach incorporates the use of science. This does not mean that a belief system is disdained, nor does it mean that science has all the right answers. The aim of science is not to open the door to everlasting wisdom, but to close the door to everlasting error. An inadequate explanation of a physical phenomenon such as the flight of the bumble bee is hardly justification for the castigation of the perpetrators of the scientific method. Such a verbal display of impunity insinuates ignorance.
Historically, ignorance has been an Achilles' heel to the progress of science and the advancement of new knowledge. Is this same attitude of ignorance an Achilles' heel to the advancement of new knowledge in chiropractic? Ignorance spawns prejudice and prejudice germinates discrimination. Is that what we espouse as a chiropractic profession? I think not.
Knowledge on the other hand, produces intelligence or light and truth. As our understanding grows in stature, tolerance increases and perspectives broaden. If knowledge threatens one's belief system, difficult decisions must be confronted. Either the new knowledge is rejected or beliefs are altered. Beliefs founded on faith are difficult to alter simply because new knowledge is presented. Beliefs founded on evidence adapt easily to new knowledge.
In a religious context, beliefs form one's moral values, and evidence based knowledge offers minimal support because the methods of science are limited in their ability to test metaphysical phenomena. The presence of a God can neither be proved or disproved by science. If chiropractic is a religion, a faith based approach that disdains science as inadequate or too complex, is acceptable. If chiropractic desires a seat at the table of health care in this reductionistic, mechanistic, scientifically driven society of managed health care, a faith based religious context is unacceptable. Acceptability is predicated on accountability and accountability is evidence based.
If the world recognized leader of a portion of this profession, the "defender of chiropractic" as dubbed by some, is "belief based" as opposed to "evidence based," where doth he leadeth his people? Is he passing through the parting of the Red Sea into 40 years of wondering in the deserts of Sinai? Or have we progressed to the point where we are ready to cross the river Jordan into the land of mild and honey?
To deny the existence of a reality until proven, however, would mean the denial of chiropractic care to millions of patients. After all, the bumble bee does fly. Where is the balance? Where is the middle of the continuum? Why must our profession continue the internal struggle between pre-scientific mysticism and rational, logical, critical thinking?
Is there another dichotomy: the religious zealots or fundamentalist vs. the pointed eggheads (critical rationalists)? Fractionation vs. homogenization. "A house divided against itself cannot stand," Lincoln said. Is chiropractic to stand or fall or divide into tow houses? Where are the answers to be found and by whom: the national professional organizations, the colleges, their respective presidents, government, researchers? Or is it a decision each of us must make on an individual basis? Where do we stand?
As a chiropractic educational institution, professing to provide a doctoral level educational experience, LACC stands firmly on the foundation of evidence recognizing that faith is, "... the substance of things hoped for, the evidence of things not seen" (Heb. 11:1). Yes there is much in chiropractic for which hope is more prevalent than proof. Faith fills the void created by the absence of evidence. This kind of faith and hope inspires not only enthusiasm but imagination and creativity and the development of new knowledge. The stimulus for theory development, posturing a paradigm, and hypothesis testing, is faith. Without this kind of faith there would be no desire to seek evidence.
When faith forces a blind obedience to a set of beliefs that close the mind to inspiration and the generation of new thought... dogma reigns and darkness replaces light. New concepts and creative ideas are moored in the rocky shoals of distrust and ignorance. The focus of thought becomes centripetal, not centrifugal. Professional responsibility and standards of performance are limited to the minimums set by the central core of the belief system. Don't confuse us with the facts, we've already made up our minds.
An evidence based mind set directs one to seek the light, to pursue further understanding, to move to higher standards, and to challenge the status quo. With all due respect for our historical heritage and recognizing the significance of a living faith, LACC is "full steam ahead," moving into the 21st century on the foundation of an evidence based, health oriented, patient centered approach to chiropractic care.
Reed Phillips, DC, PhD
President
Los Angeles College of Chiropractic
