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In Defense of Subluxation Semantics

Dear Editor:

I read with interest the article by Dr. Arlan Fuhr in your November 4 issue ("Subluxation-Based vs. Subluxation-Syndrome-Oriented"). I was especially pleased to see him describe the subluxation as a "syndrome." This is of interest to me because I described the very same concept in a paper published in DC nearly nine years ago (www.chiroweb.com/archives/12/13/18.html).

I just thought I'd point out that, while not a new concept, it is still a valid concept.

Joe Siragusa, DC
Charlotte, North Carolina

Dear Editor:

I am a foreign student presently enrolled at Life University. When I heard the result of Life's recent appeal, I believed it totally deplorable and morally reprehensible. I am coherently aware of the problems and inadequacies Life has shown, but the decision was not in the best interest of the chiropractic profession. No good can come from revoking Life's accreditation.

Obviously, hundreds of students and faculty have been thrown into turmoil, but what about the more far-reaching ramifications? What about the effect this will have on the profession as a whole? The initial revocation brought the world's largest chiropractic college to its knees. Many students have left; foreign student athletes, unable to survive without financial assistance, are forced to leave; the Williams family dictatorship has been elbowed out; and huge cuts were made. The university, on its knees, has been callously kicked in the face one last time.

There are documented guidelines regarding accreditation and appeals, but the events involving Life are unprecedented. Life is obviously not "fixed" yet, but the effort is apparent. If the CCE cared about the future of a great profession it would have made an exception and found a way to help Life through this. What just three people have done is disgusting, but I wonder what motivates a decision such as this. It seems vindictive, political, and totally against the interests of the profession as a whole.

I will stay at Life because I believe it provides an excellent straight chiropractic education. Unfortunately, many who haven't already left now will.

James Le Grice
Marietta, Georgia

All chiropractors know we as a profession lack respect and trust. Only about 10% of the public uses our services. Why?

On November 20, 2002, USA Today ran a lengthy article about chiropractors in California allowing prostitutes to work in their clinics. The same day, the national TV news reported that a chiropractor in Florida was arrested for teaching patients how to fake whiplash injuries and sue insurance companies. In my city, a chiropractor is making cure claims based on philosophy, rather than on scientific or clinical research. And in a recent ChiroPoll, you ask how many chiropractors we would send our family members to.

The American Chiropractic Association and Mr. McAndrews are asking for donations to fight legal battles and to join professional associations. In Georgia, a chiropractic school lost CCE accreditation because while developing the best sports teams in the chiropractic profession, it failed in academic quality. My brother-in-law attended that school, but transferred to New York Chiropractic College because he claimed it to be a "diploma mill."

Chiropractic schools have the lowest GPAs for students entering (and the lowest required); no standard entrance exam; and the fewest percent of them entering with a four-year degree, compared to schools of medicine, dentistry, podiatry, optometry or osteopathy. Public respect and trust in chiropractic is low.

Considering the above facts, it should be obvious to our college presidents, the CCE, ACA and Mr. McAndrews why we are having problems in this profession. We must increase our admission standards now, and seek out students of higher quality, both intellectually and ethically. Selection of students from first-generation college, no four-year degree and "nonprofessional" family backgrounds can only produce what I have mentioned above.

If we expect professional behavior, and responsibility to our profession by joining and giving to our organizations, we must first select professional and intelligent students for our schools. Our colleges have not done this, and fall at the base of most of our professional scandals. I urge all of you and the CCE to increase requirements for admissions into our schools. It's your responsibility. Stop embarrassing the rest of us.

John W. O'Neal, MS, DC
Terre Haute, Indiana

Dear Editor:

I read, with great interest, the letter from Dr. Ken Rich from La Habra, California, "Random Audits for C.E. Credit" (www.chiroweb.com/archives/20/22/07.html). I, too, have found the California Board of Chiropractic Examiners to be, at times, less than courteous, and even unreasonable in its demands. This is a prime example of how government in general (and our board in particular) has gotten "too big for their britches." The members of this board seem to have forgotten that this board - as chiropractic doctors - is ours; and we are not beholden to them. Though I would never recommend anyone violate a law, I can say that were I to encounter the kind of crazy treatment Dr. Rich has mentioned, I would simply supply whatever documentation I had in my files, and go on with my practice. When it really comes down to it, our "license" is actually a "certificate of competency," similar to the certificate a surgeon receives in this state, and need not - strictly speaking - even be renewed.

I am not speaking through my hat; this was first brought to my attention by a dentist acquaintance of mine. (Please consult the "Business and Professions Code (BPC)" about the surgeon's certificate, for example.) Surely, our professional standing should be equal to that of another primary heath care provider. Incidentally, I once inquired of the board, on behalf of my sister (an RN who had given some thought to becoming a DC), as to whether our "license" was a license or certificate of competency, and was advised that it is both. Finally, further examination of the BPC will reveal that, at least in California, a "license" is either a license or a certificate. In my office, it is a certificate (I have no idea what yours is).

What's more, I occasionally hear a colleague complain about some limitation of our scope of practice. As it happens, our scope of practice is defined by the Chiropractic Act, and also by case law. An examination of the latter will reveal that, as chiropractic doctors, we are members of the chiropractic discipline and fraternity, and we are also, incidentally, the current holders of the prerogatives of the earlier "drugless practitioner," which disappeared upon enactment of the Chiropractic Act.

In a word, we have (based on case law and the scope of practice of the drugless practitioner) at our disposal virtually any methods and protocols for the care of the mind and body of our patients, provided there is no penetration of the skin (as in surgery) or any prescribing of pharmaceutical drugs. Personally, I am not happy with some of my fellow DCs who are so into the medical model that they spend hours on tests and documentation, with the patient frequently being forced to wait a day or two before receiving spinal adjustments, but I am happy to practice as a holistic (and primary care) practitioner, who may address more than only vertebral subluxations.

Please do not stand for any bullying by your local city hall, nor by your state chiropractic board. This is totally unacceptable behavior, and inconsistent with our American ideal of freedom. We have surely paid our dues as doctors, and deserve better than this!

Thomas Halle, DC
Los Angeles, California

Dear Editor:

I read Dr. Miller's article regarding practical exam procedures with an open mind. I compliment him on the writing of his book and the dedication to additional training with his "orthopedic diplomate" status.

I feel, though, that his presumption of using techniques as a basis to eliminate orthopedic, neurological tests denies the patient thorough chiropractic care.

Allow me to take another approach to patient care: The biggest roadblock to the health care of the patient is not the lack of orthopedic and neurological testing; it is the lack of application of chiropractic to the patient's chiropractic needs. What about the biomechanical oversights that occur because of the hour-long orthopedic exam?

A simple posture exam is certainly more objective than a Lasegue's test, or even a cervical compression test, due in part to subjective patient input.

Are 99% of the patients that come into a DC's office subluxated? Maybe they like to retain joint mobility before arthritis sets in. Is it possible that people feel they don't get colds as frequently if they get adjusted more regularly?

Chiropractic has been looking for medical acceptance for over 100 years now. Orthopedics and neurological tests are used by chiropractors probably more than medical doctors who, given a low back condition, simply prod a tender erector spinae muscle before "scripting" a two-week regimen of muscle relaxers and anti-inflammatory meds.

Chiropractic shines with its understanding of spinal integrity, proper posture and the elimination of nerve interference. The key is to stay on purpose; do a good job; be professional. Knowing your chiropractic technique, keeping up-to-date with your training and delivering proper chiropractic care to the patient's needs will eliminate the worry, "Did I do the right orthopedic test?" or "If I would have done a leg-length exam, maybe the surgeon wouldn't have gotten him or her!"

Tim Jorgensen, DC
Enderlin, North Dakota

(Editor's note: The following is a letter in response to the latest barrage of invectives from radio talk-show host Jim Rome.)

The Jim Rome Show
c/o Premiere Radio Networks, Inc.
15260 Ventura Boulevard, fifth floor
Sherman Oaks, CA 91403

Dear Mr. Rome:

I feel it is only fair for me to preface my comments with a statement of fact. I am not a fan of yours or your program. To my knowledge, I have never heard or seen any of your broadcasts. In addition, I am not particularly disturbed by your venomous comments regarding the chiropractic profession - with one exception. You do have access to the public airways and have seen fit to express your personal opinions via that mediom. Comments that are obviously biased with no basis in fact cannot go unchallenged.

Since yours is a program dealing with sports, I can only assume you have a great deal of contact, admiration and respect for athletes from every facet of the world of sports. I doubt seriously if you would purposely go on your show and insult the intelligence of the very people who provide material to make the program possible. The comments you have made regarding the chiropractic profession, I feel, have done exactly that. You have insulted those athletes who have and do incorporate chiropractic treatment as a portion of their health regime.

Are you aware of the fact Lance Armstrong and Bill Romanowski have regular chiropractic treatment? Tiger Woods, as well as numerous other PGA touring professionals, rely on chiropractic treatment to assist with one of golf's most common injuries - spinal strains and sprains. How do you think it makes Fred Cox of the Minnesota Vikings and Jack Dolbin of the Denver Broncos feel when you make such malicious statements about their profession? Yes, both are graduate chiropractors!

Dwight Stone credits chiropractic with assisting him during his competitive years, as do many of today's Olympic athletes. Just recently, Emmitt Smith was seen on HBO receiving chiropractic care from the team chiropractor for the Dallas Cowboys. Joe Montana, throughout his career, received chiropractic treatment. A recent survey revealed 45% of NFL trainers have been to a chiropractor and 77% have referred players to one. Do you really believe those athletes and protectors of athletes would seek out care from "witch doctors" or those who "ruin" people's spines for a living?

I really have no problem with you, as an individual, believing or expressing your opinion about anything - including chiropractic. That is a right guaranteed to you under the constitution of our great nation. I do have a problem with you using your position in the broadcast media to express those opinions as if they were factual when you and I know they are not!

There have been those with considerably more education in the health care delivery system than you who have defamed the chiropractic profession with half-truths and absolute lies. There have even been those who have made a career of trying to destroy the chiropractic profession, saying it is a danger to public welfare; all have failed miserably. Even the "untouchable" AMA, with its massive resources, failed.

The bottom line is this, Mr. Rome: I have a difficult time believing you are really a stupid man. This, however, is the impression I am forming. You see, the comments you have made regarding my profession are clearly made as a result of ignorance regarding the subject material. Ignorance breeds stupidity!

Dan Golden, DC
Goodland, Kansas

Dear Editor:

For the life of me, I just cannot understand why we have to take the worthless garbage thrown at us from the Department of Veterans Affairs. Pushing people like Charles Duvall, DC, down our throats is a well-planned insult. That person has been selected by these people to create chaos within our ranks. They will stop at nothing to destroy our chiropractic profession. I just hope that soon we begin a campaign to get him out of the panel and send him to where he came from - the valley of "wanna-be" medical doctors.

M. Moreno, DC, DABCO, DACAN
El Paso, Texas