Imagine

While it may be difficult or even unrealistic to do so, one has to wonder what would have happened if ...

Many years ago, an interesting book was published speculating on what the United States would be like if the Confederacy had been successful in its attempt to pull away from the Union in what we now call the Civil War. One of the ultimate points is that the two countries would eventually band together for mutual benefits, much like the European countries have done in recent years.

Imagine what would have happened if the leaders of the American Medical Association (AMA) had NOT chosen to form the AMA's Committee on Quackery in November of 1963?

Where would chiropractic be now if the medical profession had decided to let the chiropractic profession live (or die) on its own merit?

In considering this issue and discussing it with others, there were some who felt that, in retrospect, the AMA attack was the best thing they could have done for the chiropractic profession. It sounded the call for the research, guidelines, public relations and political activism we have today. The lawsuit against the AMA also served to unite the profession against a common enemy (not to mention provide multi-million dollar funding for chiropractic research).

Would we have all this without their attack? We can only speculate.

But what could our relationship have been with medical doctors, nurses, osteopaths, etc.? The AMA spent over 20 years telling their members that professional association with chiropractors was unethical. Without this severe impairment to professional cooperation, would DCs, MDs, and DOs be working together as if to do so was a normal part of caring for a patient?

It is probably safe to say that the efforts of the AMA to "contain and eliminate" the chiropractic profession cost the people of the world, particularly the people of the United States, millions of dollars in unnecessary costs and less effective (and at times inappropriate) health care. It will still be years before this damage is fully reversed.

But what about the chiropractic profession, what has it cost us?

The loss in terms of reputation, patients and ultimately dollars is incalculable. It is more than just a loss of 30 years of normal existence. These losses will also take many more years to reverse. The reality is that the wounds are deep and will take a substantial amount of time to heal.

But that doesn't mean we shouldn't strive for a normal, reciprocative relationship with other health care providers that may not share our same philosophy! We should never forget the lessons of the past, but we should not allow them to restrict the progress of the future.

This does not mean that the various health care professions and specialties will not continue to compete for shrinking dollars. On the contrary, the Clinton administration is placing a great deal of value on credible research that demonstrates the efficacy of a particular treatment.

Recently, there are indications suggesting that the current leadership of the AMA may be moving toward normalizing professional relations with the chiropractic profession:

An article entitled "Solving Our Primary Care Crisis by Retaining Specialists to Gain Specific Primary Care Competencies" appeared in the July 21, 1993 issue of the Journal of the AMA (JAMA). One of the four options for "fixing the system" and solving the primary care physician "crisis" included increasing the number of generalists in medical school, increasing the number of primary care physicians and "Let the remainder of (primary) care be given by nurse practitioners, physician's assistants, homeopaths, naprapaths, chiropractors and other non-allopathic physician providers."

What?!?! Is this the same AMA that tried to "contain and eliminate" the chiropractic profession? Maybe not. Maybe this isn't the same AMA. Maybe the new generation of MDs has a different understanding of chiropractic as it relates to general health care.

Something else has happened that shows a new spirit of respect: the AMA is beginning to offer its clinical publications to the chiropractic profession. In particular, the "Guides to the Evaluation of Permanent Impairment" is being advertised to the profession in this issue.

As usual, there are those who will suggest that these changes are the result of the chiropractic profession becoming more medically oriented. They may even suggest that the profession had "sold out." They will try to tell us that "war" is the only way to deal with the medical profession and that unless we fight, we will be overthrown or converted. I personally believe that chiropractic and the chiropractic profession is far stronger than that.

The profession should never forget the lessons learned by the Wilk et al suit. But that shouldn't stop us from accepting our place in the health care system. We can still enjoy the intra-professional cooperation that we should have had.

Imagine what could happen if ...

DMP Jr., BS, HCD(hc)