When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
Introduction
Having grown up in a chiropractic family, I have been privileged to observe the profession's development over nearly half its existence, and for more than half that time as a full participant. It has been exciting to watch chiropractic grow out of persecuted marginality to become a vigorous mainstream profession, and extremely rewarding to be part of that process. The advancement and legitimation of chiropractic has been matched by developments in its literature, the emergence of peer-reviewed, primary-source journals coinciding with the latter stages of legitimation and an increasing emphasis on research.
By 1990 there were several of these journals and in May of that year, with the support of the Foundation for Chiropractic Education and Research, their editors formed the Chiropractic Research Journal Editors' Council. Since then, CRJEC has met annually to discuss current issues in chiropractic and biomedical publishing and to set standards and policies. The primary purpose of these standards is to ensure that material published in member journals is well-researched, coherently presented, and adequately supported by data and references. Other concerns council has addressed in forming its policies include access to the chiropractic literature through databases, conflicts of interest, research ethics, advertising ethics, and fraudulent publication. CRJEC publishes a report of each meeting in the Journal of Manipulative and Physiological Therapeutics.1-3
The members of CRJEC, listed at the end of this article, are bound by Council policies, however editors of other publications which also represent the chiropractic profession are not. It has become a matter of considerable concern that there is material still being published in some chiropractic journals, trade magazines, and tabloids which, in effect, compromises the profession's credibility. While it is outside the scope of CRJEC to be a watchdog in this regard, it is Council's aim to offer assistance and leadership. With this in mind, the authors of the following report, which was tabled for discussion at the 1993 meeting of CRJEC, have given permission for it to be published in Dynamic Chiropractic.
Discussion Paper by Committee on Ethics and Advertising Standards
By Editors Russell W. Gibbons, Thomas Bergman, John GrosticThe 1992 third annual meeting of the Chiropractic Research Journal Editors' Council (CRJEC) in Chicago authorized the formation of a Committee on Ethics and Advertising Standards and asked that a preliminary report be made for CRJEC's 1993 meeting.
CRJEC expressed concerns about "the use and type of advertising that appears in the chiropractic literature" and said that chiropractors "must realize that the integrity of the profession is at risk when inappropriate advertising and/or classifieds appear in its professional journals."
In presenting these preliminary points as a discussion paper, members of the committee are aware that this is a sensitive issue among those who are involved in editing, production, publication, and marketing to and for the chiropractic profession.
Chiropractic does not enjoy the resources of the drug and pharmaceutical industry in the form of seemingly endless advertising revenues supportive of the hundreds of medical journals in North America. Chiropractic is restricted to x-ray and nutritional supplement advertising, with a smaller percentage from the physical therapy modalities.
An examination of the so-called "trade" publications or tabloid newspapers marketed to the chiropractors reveals a large-consumption advertising by "practice building" consultants and companies. Without any subjective commentary from this committee, it is apparent that this has been a continued source of negative external public relations by those medical "chiropractic watchers" who seek to discredit trends within the profession.
The discovery process of the Wilk case by George McAndrews and other counsel for the profession amassed a huge body of literature which brought little credit to many of the journals and publications within chiropractic in the period which encompassed the litigation.
Other groups, including the ACA, have sought to address the ethical issues involved in "practice building," further compounded in recent years by court decisions which have removed most restrictions on health providers who seek to advertise in the telephone directory business or yellow pages. It is not the intention of this committee to offer further observations in this area, other than to again quote Counsel McAndrews, who warned last year "of the enormous damage to the reputation of the profession and its members that many such unsubstantiated ads do."
It only seems logical that if CRJEC is committed to the upgrading and professional advancement of journals and serials directed toward the chiropractic profession, that it also offer suggestions or guidelines for ethics and advertising. Accordingly, the following areas of concern are submitted for further discussion and comments by editors and publishers of journals and trade publications directed toward chiropractic:
- Unsubstantiated Claims. Publishers (with consultation of editors qualified to make evaluations) should review copy which suggests that any particular technique or modality makes other therapeutic approaches "unnecessary" or not "cost effective." The use of materials which suggest "exclusive" access for those practitioners utilizing the service, and offering therapy in areas not within the chiropractic guidelines (i.e., cancer, AIDS, etc.) should be areas of concern for publishers.
- The "Money" and Patient Volume Syndromes. Advertising copy which portrays money should be especially offensive to any professional publications (the frequency of such ads is excessive in the trade publications) as are ads which equate "successful" practices with the number of patients seen daily/weekly. This involves another internal practice procedural discussion, but again becoming copy utilized by those seeking to discredit the profession.
- Classified. Many otherwise presentable journals may accept borderline advertising, such as those for questionable degrees (see below). Classified and display classified advertising which seeks to bring the practitioner into marginal practice areas (dare we suggest colonics?) as well as various "investment opportunities," whose copy might not be acceptable in other professional journals, might well be screened.
- Easy and Quick Degrees. If public perception about chiropractic education is still uninformed, it may be that some of its journals and publications accept, without question, advertising from institutions designated as "unaccredited," which in previous times would be dubbed "diploma mills." Today any number of journals and trade newspapers in the profession run such ads, offering advanced degrees for nonresident study and "life experience," as well as for degrees in homeopathy, naturopathy, and nutrition. Such advertising recalls the difficult evolution of chiropractic through its own diploma mill era, and has no place in its literature today. It is still a practice for some "technique" and modality organizations to offer "fellowships" or "diplomates" of equally questionable value. Additionally, it diminishes the value of every legitimate advanced degree achieved by chiropractors.
- Sex Exploitation. It is sad that a profession with such a pioneer history of equity in schooling and practice should, as it approaches its centennial, have even minor instances of sex exploitation. Those who read the literature are aware of advertisers (usually sophisticated copy produced by agencies) who use the female body in ways which have little or no relationship to the product or modality. This is an editorial problem on occasion as well, and is a regular feature of one magazine which claims a large chiropractic audience. A profession which now has one in five students who are women, with appropriate association, college, and research achievements, and a growing number of women practitioners, should not tolerate such vestiges of sexism.
There are many other areas which this committee could present for discussion, and it will hopefully generate such commentary and additions. That is the purpose of this initial draft, and we welcome the contributions of all CRJEC editors and associates within the profession.
References (to Introduction)
- Chiropractic Research Journal Editors' Council. Report from the Chiropractic Research Journal Editors' Council. J Manipulative Physiol Ther, 14:1-3, 1991.
- Chiropractic Research Journal Editors' Council. Report from the Second Annual Meeting of the Chiropractic Research Journal Editors' Council. J Manipulative Physiol Ther, 15:1-3, 1992.
- Chiropractic Research Journal Editors' Council. Report from the Third Annual Meeting of the Chiropractic Research Journal Editors' Council. J Manipulative Physiol Ther, 16:1-2, 1993.
Members of the Chiropractic Research Journal Editors Council:
Thomas Bergmann, DC
Editor-in-Chief
Chiropractic Technique
735 Keokuk Ln.
Mendota Heights MN 55120
Tele: (612) 452-2310
Fax: (612) 687-9249
Mary Ann Chance, DC
Rolf Peters, DC
Editors
Chiropractic Journal of Australia
P.O. Box 748
Wagga Wagga NSW 2650
Australia
Tele: 61-69-21-3238
Fax: 61-69-21-8869
Russell Gibbons
Editor
Chiropractic History
207 Grandview Rd.
Pittsburgh PA 15215
Tele: (412) 237-4554
Fax: (412) 237-4512
John Grostic, DC
Editor
Chiropractic Research Journal
1269 Barclay Circle
Marietta GA 30060
Tele: (404) 424-0554
Fax: (404) 429-8359
Robert Hazel Jr., DC
Editor
Chiropractic Sports Medicine
220 Vroom Ave.
Spring Lake NJ 07762
Fax: (908) 449-2369
Grace Jacobs, DA
Editor
The Journal of Chiropractic Education
590 N. Vermont Ave.
Los Angeles, CA 90004-2196
Tele: (213) 661-8170
Fax: (213) 660-5387
Dana Lawrence, DC
Editor
Journal of Manipulative and Physiological Therapeutics 200 East Roosevelt Rd. Lombard IL 60148 Tele: (708) 268-6524 Fax: (708) 268-6554
Simon Leyson, DCEditor
European Journal of Chiropractic
Gwendwr, 16 Uplands Crescent
Uplands, Swansea, W. Glamorgan SA2 OPB
Wales
Fax: 44-639-63-9649
Brian McMaster, PhD
Editor
Chiropractic: The Journal of Chiropractic Research and Clinical Investigation 741 Brady St. Davenport IA 52803 Tele: (319) 326-9190 Fax: (319) 326-5826
Silvano Mior, DC, FCCS(C)
Assoc. Editor
Journal of the Canadian Chiropractic Association
1396 Eglinton Ave., West
Toronto, Ontario M6C 2E4
Canada
Tele: (416) 781-5656
Fax: (416) 781-7344
Robert Mootz, DC
Topics in Clinical Chiropractic
433 Estradillo Ave., Suite 104
San Leandro, CA 94577
Tele: (510) 351-7136
Fax: (408) 983-4017
Anthony Rosner, PhD
Dir. of Research
Foundation for Chiropractic Education and Research
1701 Clarendon Blvd.
Arlington VA 22209
Tele: (703) 276-7445
Fax: (703) 276-8178