Monday Morning Myopia

Anyone who has spent any time among chiropractors has heard the suggestion that DCs are interested only in the immediately practical, that is, that the measure of the significance of any information is its potential application in the doctor's office. This sort of attitude, a symptom perhaps of the anti-intellectualism in the profession,¹ is one of the most insidious barriers to planning for a brighter future. If we will not plan beyond the next report of findings, the next mortgage payment, or the next practice management seminar, we can hardly hope to deal effectively as individuals and as an organized discipline with the dramatic changes in health care that seems to lurk just beyond the horizon. Our all too common disdain for things academic is our Achilles' heel. As Coulter has suggested:¹

"Our anti-intellectual bias ... has meant that chiropractors have never come to any agreement about those intellectual puzzles whose solutions are important to chiropractic, or even better, humankind. The problem is, therefore, more general than simply anti-medical bias, and the solution is perhaps more complicated than simply clinical research."

Part of the solution to the problems confronting this profession, I believe, is a more thorough and critical familiarity with chiropractic history. Our history defines us. Although a mere description of the course of our lives may reveal little more than who we have been, a critical analysis of events viewed within the context of the times in which we have lived can do much more. A critical evaluation of the social forces which have shaped our lives, for example, may elucidate why we chose the paths we took, may suggest how our lives and our personalities might have been differently shaped had we taken a different path, may clarify who we are today, and may aid us in making choices today that will shape who we will become. History, therefore, is a vital component of any self-analysis and provides at least a piece of the process involved in identity-formation, self-definition, and strategic planning.

The above may seem so trite and self-evident as to not merit reiteration. Who would disagree with Santayana's admonition that those who ignore their past are doomed to repeat it? Unfortunately, in a very real and pragmatic sense, we in chiropractic are guilty of just this, of neglecting to review who we are in terms of where we have come from and what we've been through. Most chiropractors have an extremely fuzzy sense of our past, and are, therefore, disadvantaged in efforts to construe current forces and in planning the future of the profession. For examples, consider the following:

• What political forces have shaped chiropractic's so-called philosophy? Why is philosophy so important, or seemingly so, in chiropractic?

   

• Why did early chiropractors object to chiropractic licensing laws? How did the chiropractic profession subsequently manage to convince the American states and Canadian provinces to grant distinctly chiropractic licensing laws and regulatory boards?

   

• Why did the chiropractic profession improve its educational system over a 40-year period, leading to recognition of the CCE by the U.S. Department of Education? What did we gain and lose in the process? What special contributions have been made by the chiropractic profession to the education of health professionals?

   

• How has epistemology, that branch of philosophy which deals with the nature of knowledge (or how we "know" whatever we think we know), fared within the chiropractic profession? How has our level of concern for epistemology influenced the profession?

   

• How has our "separate and distinct" rhetoric shaped the chiropractic profession? How has it shaped our opposition?

   

• Are chiropractors primary care, holistic physicians, or exclusively subluxation eliminators, or musculoskeletal specialists, or something other? How have DCs actually practiced during the past century? Are there precedents we should draw upon?

   

• Why do the adjacent states of Oregon and Washington have, respectively, the broadest and narrowest scopes of practice.

   

• Will chiropractors' traditional mode of solo practice strengthen or weaken us as we move into the era of manage health care? How has chiropractic fared in previous efforts at national health care reform?

There is so much to be proud of, much to reject, and an infinity to be learned from studying our own professional saga. Fortunately, University of Connecticut sociologist Walter Wardell, PhD, has just recently published the first serious, scholarly treatise on the history of the chiropractic profession. This book, is the novice's entree to the chiropractic century, and ought to be must reading for all DCs:

Chiropractic: History and Evolution of a New Profession, St. Louis: Mosby, 1992, hardcover.

Similarly, the Association for the History of Chiropractic (AHC) has been publishing a quality journal, Chiropractic History, for the past 13 years. Here is a ready resource for those who appreciate the contribution of historical understanding to the continuing problems of the profession. Unfortunately fewer than one percent of chiropractors subscribe to this resource. Here are a few of the papers in the most recent issue, June 1993, of Chiropractic History.

• Russell W. Gibbons² considers the role played by D.D. Palmer, his rival Solon M. Langworthy, DC (president of the American School of Chiropractic and Nature Cure) and the governor of Minnesota in defeating passage of the first bill to regulate chiropractic; this took place in 1905, some eight years before the first law (in Kansas) was actually enacted.

   

• Medical historian Steven Martin, MD,³ considers "The Limits of Medicine" in the early 20th century and how the rise of chiropractic served to focus the alienation of many people in society with the "ungodly" and dehumanizing aspects of science.

   

• "The ignorant instructing the uneducated"⁴ refutes the impression left by medical writers in the first several decades of the century that chiropractic faculty were poorly or uneducated fools; this is accomplished by reviewing the prechiropractic college degrees held by many Palmer faculty of the period, and by noting the multiple scholarly works these supposedly ignorant faculty produced.

The AHC is a nonprofit membership association (chiropractors and others) committed to discovering and preserving the chiropractic heritage. Membership in the AHC is a mere $50/year ($20/year for students) and includes a subscription to the AHC journal, Chiropractic History; (contact Alana Ferguson, MS, executive director, 1000 Brady Street, Davenport IA 52803). This autumn (October 8-9, 1993) the AHC's 13th annual Conference on Chiropractic History will be held at Life College (404-424-0554) in Marietta, Georgia. Definitely not for those with no past and no vision beyond Monday morning.

Reference:

1. Coulter ID: Letter to the Editor: The influence of political medicine on chiropractic dogma: implications for scientific development. Journal of Manipulative & Physiological Therapeutics, 13(4):234, May 1990.

    

2. Gibbons RW: Who killed the first chiropractic legislation? Minnesota, 1905. Chiropractic History, 13(1):26-32, June 1993.

    

3. Martin SC: The limits of medicine: a social history of chiropractic, 1895-1930. Chiropractic History, 13(1):41-44, June 1993.

    

4. Gibbons RW: Association notes: The "Steam from the Fountainhead": a 1920 report by AMA's Council on Medical Education. Chiropractic History, 13(1):8-11, June 1993.

Joseph C. Keating Jr., PhD
Portland, Oregon