Philosophy for Chiropractors?

I was privileged recently to attend the annual convention of the American Chiropractic Association. The leadership of the ACA is on the right path. The opening speaker, Dr. Scott Haldeman, titled his speech "Chiropractic Philosophy: The Relevance in the 90s."

This speech was right on target. Dr. Haldeman defined philosophy as "the search for wisdom." He defined science as "the search for knowledge."

Philosophy and science can exist separately and often do. As Dr. Haldeman pointed out, before science appeared on the scene, philosophy existed and, in fact, gave birth to science.

In the Chiropractic Journal, I was recently accused of being "anti-philosophy." I took strong exception to this allegation because it is simply not true. It seems to me that a health care profession with no philosophy would be a profession with little reason to exist and, surely, one without a strong sense of direction.

I am opposed to using the word "philosophy" to describe a set of beliefs about how the human organism is constructed or how it functions, and then expanding those beliefs to explain and support a simplistic concept of human health care. To use philosophy in this way is to completely ignore known facts about human anatomy and physiology. This misleads the unsuspecting patient and causes the knowledgeable person to dismiss us and our profession as a "bunch of kooks" or worse.

So, exactly how should we use the word "philosophy" in relation to the chiropractic profession? I believe it should be used in the way that Dr. Haldeman suggested -- as a "search for wisdom," especially the wisdom of the relationship of the chiropractic healing art to human health disease. Such a philosophy should help us answer questions about why we recommend chiropractic treatment instead of some other form of health care for a particular condition or human circumstance. Why are we opposed to the indiscriminate use of drugs? Why would we recommend chiropractic health care for the young person who has a family history of cardiac disease? When should we recommend joint medical and chiropractic care for a specific patient? Is there a reason for a more "natural," less invasive form of health care for human health needs?

When one asks these questions or others like them, one soon comes to the realization that underlying the philosophical answers, one finds the need for scientific justification. Why don't we want our patients exposed to the indiscriminate application of drug therapy? Because it is harmful. How do we know it is harmful? We just know? No, indeed! We know because someone has taken the time to accomplish some degree of scientific validation study that shows that the drug in question produces side effects in a particular percentage of people and that those side effects are harmful. Therefore, if a substitute therapy can produce the same positive health benefits, without the harmful effect of the drug, our philosophy would support the decision to use the less harmful form of therapy -- in this case, chiropractic care.

Our philosophy should, above all, give us a sense of logic, a sense of good and valid reasons for doing that which we do. In this light, I say that a philosophy for chiropractors is essential to our survival! We cannot be without it. It may, in fact, be the only reason why we have continued to be successful in the face of long-term discrimination by many organizations during the past 95 years.

At the National College of Chiropractic, we have always had a philosophy in the sense that I have just described. Recently, we distilled it into our "Profile of the Practice of Chiropractic" which follows:

The National College of Chiropractic Statement of the Profile of the Practice of Chiropractic:

The National College of Chiropractic holds that the practice of the chiropractic physician embraces the whole person with emphasis upon conservative health care which facilitates the inherent potential of the human organism to develop and maintain a state of self-regulation and to invoke self-healing processes with minimal therapeutic risk at reasonable cost.

Chiropractic practice embodies:

Recognition of a diversity of factors which impact upon human physiology among which are biomechanical dysfunction, genetics, trauma, hygiene, microorganisms, nutritional status, exercise, motion, posture, environment, stress, emotion, and human relationships;

Primary care of patients based upon diagnostic evaluation including patient history, physical examination, clinical laboratory data, diagnostic imaging, and other special diagnostic measures, as well as those procedures which are unique to the chiropractic evaluation of human spinal and structural balance and integrity;

The application of a diversity of spinal and other adjustments and manipulations for the treatment, correction, and prevention of neurologic, skeletal or soft tissue dysfunction, and the production of beneficial neurologic effects;

The use of other conservative means including, but not limited to, nutritional counseling, physiologic therapeutics, meridian therapy/acupuncture, trigger point therapy, life style counseling, emotional support, and stress management.

The chiropractic doctor is a primary care, first contact physician who practices within the legal scope of licensure, emphasizes the importance of the doctor-patient relationship, recognizes the need for other forms of treatment when indicated, and who, therefore, interacts fully with other members of the health care delivery team, always in the best interest of the patient.

This profile statement does actually represent, in a very summarized form, the logic and the reason why we do what we do and why we teach chiropractic as we teach it. At the same time, this profile, in conjunction with our full mission statement, provides for the intentional continued search for new knowledge (research) and new wisdom (philosophy).