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Two Perspectives on the Proposed CCE Revisions

Acting in Our Collective Best Interest

Dear Editor:

I just finished reading your article in the latest edition of Dynamic Chiropractic ["What Is the CCE Trying to Pull?" by Dr. James Edwards, Nov. 4 issue]and I couldn't disagree with you more. First, I think your referring to the far left and far right with the mainstream in the middle works well in politics, but not in science. The ACA and the ICA are both political organizations who have a goal of bettering the profession for the practitioners. The AMA is also a political organization dedicated to maintaining its control of health care dollars for its members.

However, all three have a serious membership dilemma. None of them has a majority of licentiates as members. The ACA and ICA combined do not equal close to 50 percent of chiropractors in the country and the AMA has about 25 percent of licensed medical doctors as members. So, your claim of mainstream chiropractic is unfounded unless you want to call the mainstream apathetic!

The CCE, on the other hand, is an accrediting organization whose purpose is to determine the minimum educational requirements necessary to qualify for licensure in all 50 states. It is approved by the U.S. Department of Education and has been since 1974.

Fortunately, the CCE recognizes that professions, especially scientifically based health care professions, are not static. There have been hundreds, if not thousands, of changes to the body of medical knowledge since the founding of chiropractic medicine in 1895. However, much of that knowledge has not become a part of mainstream medicine because of stagnant thinkers who confuse a philosophy with a dogmatic religion.

You are correct that D.D. Palmer defined the profession as drugless in 1895. But in 1895, there were very few drugs and many snake oil salesmen. You refer to yourself as a student of chiropractic history. Have you read anything about the history of osteopathy? Andrew Taylor Still, the founder of osteopathy, was a medical doctor who became disillusioned by the lack of scientific teaching in the medical profession and the total lack of any cures or treatments for musculoskeletal diseases. Early osteopaths considered themselves drugless practitioners. Later, they began to split into two camps. The practitioners who used manipulation were known as Lesion practitioners and the practitioners that treated other conditions called themselves Broad practitioners.

As the body of science grew, (around 1936), the Broad practitioners broke away from the Lesion practitioners and started forming hospitals and increased their educational commitment. This increase in education and scope was for the benefit of the patient and allowed the doctor to have a wealth of tools by which to treat patients.

When I was in school (1974-1978), I heard comments by the rank and file lamenting the poor osteopaths. "We don't want to wind up like the osteopaths, do we?" No, I guess we didn't, because while today we are limited to 12 visits a year by Medicare, the osteopaths enjoy total medical acceptance in all specialties. They have doubled their schools and their credentials as physicians, are accepted almost everywhere in the world.

If you really believe that the chiropractic students of today would not want the ability to expand their scope to allow them to actually get jobs and pay off their huge student loans, why don't you and the ACA and the ICA put it to a vote? There are less than 100,000 licensed chiropractors in the country; it would not be that expensive to organize such an endeavor. Then you would know exactly what the mainstream practitioners are thinking. In the meantime, we all should be supporting the CCE, as it is the only link to licensure in the country.

With the advent of a national health care on the horizon, I don't see chiropractic being included in any government-sponsored health policy. The merits of chiropractic medicine are not on trial here; it's solely a money grab for medicine. Organized medicine has and will always have the power to control where the money goes and who gets any share of the pie.

I trust you can see the other side of this situation. It is my opinion that the CCE is acting in our collective best interest and, as such, is deserving of our support. No one is trying to make you change the way you practice. The options of how and whom you can treat is all that is being discussed.

Alan Dinehart, DC
North Hills, Calif.

You Should Be Embarrassed You Put This in Writing

Dear Editor

This isn't exactly what we have in mind when we talk about subluxation removal: The CCE put forth some egregious new proposals which threaten the identity of the chiropractic profession and as usual, gave only a few days to respond. Among other things, the CCE wants to remove the word subluxation from any association with the chiropractic profession. Furthermore, it wants to delete any phrase that sets chiropractic apart as a profession that doesn't use drugs and surgery! Not kidding. The full text of these preposterous new proposals may be viewed on the CCE site, www.cce-usa.org. Anyway, here's my response, which squeaked in under the deadline:

What's wrong with you people today? How on earth did you get into my profession? What do you think you're doing to it? Twisting it to your transient little political expediencies? When was the last time you were adjusted? I think you're due.

You want to take subluxation out of chiropractic? Now why would you want to do that? Let me guess. You think this is some kind of freaky cult phrase that relegates chiropractors to the Stone Age and stigmatizes them as faith healers, or something like that. And you don't want to get any on you, right? That's usually how this line of retrograde thinking goes.

I've noticed in the past decades that the weak-minded individuals who subscribe to this particular dilution of primary principles generally have two things in common: 1) They've never had a successful practice; and 2) They're in some bureaucratic or administrative position, which is their only contact with the real world

Don't be afraid, little mouses. Subluxation isn't a cult word. It's been a well-defined medical term for decades. It doesn't characterize you as unscientific or anti-medical. Many medical sources define subluxation, including Dorland's Medical Dictionary, Merck Manual, Online Medical Doctor, Free MD and the World Health Organization, to name a very few.

When you start looking at these mainstream science sources and their discussions of subluxation, it quickly becomes apparent that the only ones who've ever had a problem with the term subluxation were chiropractors, actually a specific subgroup of non-practicing, non-adjusting chiropractors. Taking subluxation out of chiropractic - wouldn't that be like taking the drugs out of medicine or the cream out of ice cream, or the oil out of the Gulf?

Got a question for you guys ... maybe you can clear this up for the rest of us here: You went to college all those years, then took all those boards, and got a license, right? And so now exactly what service do you think your chosen profession has to offer to the general public - what unique skill do you now possess that no other profession has that would motivate someone to walk through your door? I'm dead serious here. Tell us. Oh, you've never practiced? Oh, I see. And that makes you qualified to regulate the profession exactly how?

Chiropractic was founded a century ago by D.D. and B.J. based on physical and scientific principles that had been undefined up until that time. They defined them. They created a profession based on those principles, a profession which has endured, despite more persecution than any other profession in history.

And why did it survive? Because they were right; their principles proved true. It was a forgotten area (subluxation); displaced vertebrae causing pathological afferent and efferent neurology. And all the millions of patients who have been adjusted all these years - what about them? Was all that just some placebo effect caused by the laying on of hands? Unlikely. Chiropractic voodoo techniques didn't hit big until the '90s. Before that, all those patients were having subluxations cleared by skilled doctors; real doctors by law and by license, and in essence as teachers.

So, now you come along and want some kind of revisionist approach to tell all those patients down through history that they really weren't cured, that their lives really weren't dramatically improved. Based on what? How are you now going to suddenly allege this? Have you just completed years of controlled clinical trials proving the subluxation doesn't exist? No? What then? Oh, yes, of course. What usually serves when reason, science and experience are going to be dismissed out of hand: political rhetoric. Lawyer talk.

Subluxation is disappearing from chiropractic schools and from the profession itself for the same precise reason that philosophy is disappearing. Try and name one other successful philosophobic profession besides us. Why would we be the only profession on earth that not only thinks it doesn't need a philosophy, but is actually embarrassed to have one? Where does that come from?

How about the notion of removing "without the use of drugs and surgery" from descriptions of chiropractic? Why on earth would you want to do that? Only two reasons I can see:

1) You're planning on us getting our Big Chance, like the osteopaths did when they committed career suicide in the 1960s when they agreed to become junior MDs and sell drugs. Don't really see that happening, fellows. Don't see an offer like that in the wings for us anytime soon.

2) The other possibility is that a few of your sensitive bureaucratic minds have the idea that this phrase may annoy some of the more rigid members of the medical establishment. Is that it? Flawed thinking, again. Legitimate, experienced MDs are happy to co-exist with drugless, nonsurgical healing professions. Not only are they not threatened, but many of them patronize such healers themselves, and thousands of them refer patients.

As far as the confusion about the phrase "DCP or its equivalent," that's really a rough draft of an idea, isn't it? Really, it doesn't have much meaning until you define what you're talking about - what would be equivalent to the current DC curriculum? We're almost afraid to ask. But for now, how about just dropping the pretense and desist from using the phrase until you actually have an equivalent. Thanks so much.

The answers to all these problems have already been clearly elaborated in our historical literature. The wheel has already been invented and has been rolling along quite well, in spite of all these periodic efforts to turn it into a square.

With all the problems our beleaguered profession faces year by year, why are we talking about these absurd non-issues; about how we should further limit ourselves and get even smaller? Let's talk instead about how we can expand our political position, our professional presence and dynamic. We have the answer everyone is looking for. Patients are dying to hear the chiropractic message. Why on earth would those posing as regulators want to keep it all a secret?

So, here's my recommendation for your astute new proposals, esteemed magistrates and noblemen: delete them. You should be embarrassed you have ever put them in writing. They are negative and reflect death and retrogression. Try something in the opposite direction; something about how chiropractic enhances life potential, human achievement. mobility, profound immune reserves, cell communication, and neuroplasticity. You know, something verifiable. And useful. Try and be useful.

Tim O'Shea, DC
San Jose, Calif.