TOKYO, Japan -- Japan was one of the last major countries accepted as a member of the World Federation of Chiropractic (WFC). After many years of work by Japanese DCs and efficient mediation provided by the WFC Council, a new organization which comprises 41 out of 45 practicing DCs in Japan was formed at the time of the recent assembly in Toronto. (The WFC met for a two-day assembly during the World Chiropractic Congress in Toronto, Canada the week of April 29, 1991. The assembly was attended by 63 delegates and 11 observers representing 32 countries. Japan was represented by 9 delegates. See June 7, 1991 issue of "DC.")
Other important efforts are now under way in Japan to form a coalition of major chiropractic associations which will include thousands of practitioners with various educational backgrounds. While the Chiropractic Council of Japan (CCJ) represents areas outside of Japan, the new coalition of associations will represent chiropractic in Japan. The CCJ is expected to play a major role for this new professional unity.
The absence of laws regulating chiropractic in Japan has allowed not only intraprofessional disharmony but also prosperity of commercial "technique" seminars promoted by domestic as well as overseas entrepreneurs. The recent trend is a mushrooming of "chiropractic" colleges and schools that vie to recruit students through big newspaper advertisements, most of which are ethically questionable.
With the increase of inadequately educated practitioners has come the concomitant complications of health consumer complaints. The news media, that has been generally favorable to chiropractic, recently reported that malpractice litigations for chiropractic are increasing and warned the public of its possible dangers. For those with anti-chiropractic sentiments, this was a great opportunity.
From all perspectives, unity of the profession has became a high priority. The leaders of the profession are becoming aware of the fact that it is a matter of urgency to establish acceptable guidelines for clinical practice and standards of education, a uniformity from which the profession can attain a greater recognition.
Last year, the Japanese Ministry of Health and Welfare (MHW) appointed eight MDs to a committee (mostly orthopedists) to investigate and evaluate chiropractic effectiveness, contraindications, and complications from a medical point of view. The committee invited representatives of chiropractic to two hearings. During the first hearing the DCs gave the committee an explanation of chiropractic theory; the second hearing was a demonstration of chiropractic techniques. It was apparent that the MDs knew very little about chiropractic but expressed concern about complications from chiropractic treatments.
The MD's perspective of chiropractic is often jaundiced by the malpractice publicity that has arisen from the previously mentioned chiropractic practitioners who lack a proper chiropractic education. Conversely, the many patients who benefit from chiropractic are not likely to admit as much to their MDs.
After a year of study, the medical committee presented the final report to the MHW in April. Briefly stated, the committee asserted:
- The subluxation complex, upon which chiropractic is based, has not been scientifically proven, nor has chiropractic's effectiveness.
- Chiropractic treatment should be contraindicated for such clearly diagnosed diseases as disc herniation, spinal canal stenosis, spondylosis deformans, osteoporosis, spondylolisthesis, and ossification of posterior longitudinal ligament; chiropractic treatment would likely worsen these conditions.
For many years the MHW has been reluctant to deal with chiropractic, but their position is changing now. It is probably due to the fact that they can no longer ignore the role of chiropractic in health care and partly due to being confronted with an anti-chiropractic movement from medicine, bonesetting, massage therapists, and acupuncture groups.
Recently, the leaders of seven major chiropractic associations met at the MHW and decided to form a coalition of their associations. This was an historic meeting with the possibility of greater intra-professional cooperation. Significantly, the medical report, as badly as it might sound, was not against the practice of chiropractic as some were afraid at the beginning. The chiropractic profession in Japan is at a crucial period in its evolution and the unity of the associations could not be more timely. We have a positive outlook for our future.
There is no question as to many problems facing chiropractic in Japan. Similar situations are found in the countries where chiropractic has no legal status. We've come to understand the undeniable fact that chiropractic can no longer be left in the hands of the good will of practitioners only. It must be protected through an organized effort, and absence of legislation can no longer be an excuse for our situation. The times have definitely changed. The consumer public is more safety and image-conscious than ever before and demands more from health care providers. What makes our future a little brighter is the fact that the leaders of the chiropractic profession in Japan have finally come to realize that unity is necessary to further chiropractic in this country.
Kazuyoshi Takeyachi, D.C.
Mitsamusa Endo, D.C.
Co-chairmen of the Chiropractic Council of Japan
Tokyo, Japan
