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| Digital ExclusiveTruth and the Politics of Knowledge
Peter Parker, the novice photographer in the famous "Spiderman" comic strip, was shocked to hear the editor of the Daily Bugle tell his staff to distort his image and feature the superhero as a criminal: "It will sell more papers."
Likewise, in the '60s and '70s, the AMA Committee on Quackery was instrumental in flooding the public media and the scientific literature with information designed to defame chiropractic. For those not familiar with recent history, H. Doyle Taylor, chairman of the committee said, in part, "[The committee]... has considered its prime mission to be, first, the containment of chiropractic, and ultimately, the elimination of chiropractic."1
This infusion of evil extended all the way to the House of Delegates of the AMA:
It is the position of the medical profession that chiropractic is an unscientific cult whose practitioners lack the necessary training and background to diagnose and treat human disease. Chiropractic constitutes a hazard to rational health care in the U.S. because of the substandard and unscientific education of its practitioners and their rigid adherence to an irrational, unscientific approach to disease causation.2 (emphasis added)
This Committee on Quackery established short-term goals in 1967 that every doctor of chiropractic should find repugnant even today:
- that chiropractic coverage in Medicare is not obtained;
- that recognition or listing by the U.S. Office of Education of a chiropractic accrediting agency is not achieved;
- to encourage continued separation of the two national associations; and
- to encourage state medical societies to take the initiative in their state legislatures in regard to legislation that might affect the practice of chiropractic.
In the short term, the committee failed. In the early '70s, chiropractic gained acceptance in Medicare on a limited basis. It took another 20 years to gain the right to take X-rays on Medicare patients. The Council on Chiropractic Education (CCE) also gained recognition by the U.S. Office of Education in the early '70s.
Unification of the two national chiropractic professional associations was on the verge of universal acceptance in 1980, until a segment of one national association rallied enough of its troops to vote down the merger proposal. It is hard to determine at times whether harassment from the Committee on Quackery was any worse than the turmoil of our own internal dissension, which often seems in concert with many of the goals of the AMA committee.
Chiropractic in California is now feeling the force of the committee's fourth goal. While the scope of practice in California over the years has been consistently reduced, other bodies are now grabbing a piece of the action. Legislation has been introduced by the physical therapists to grant them the right to direct access to patient care, limited diagnostic privileges, limited prescription knowledge and the right to read X-rays; the naturopaths have introduced legislation to grant them licensure as "physicians" and use manipulation; and the athletic trainers have introduced legislation to limit who can do athletic physicals (and chiropractors are not included).
The influence of the committee, as revealed in the proceedings of the landmark Wilk et al. anti trust trial, spread far and wide. The Surgeons General joined in:
Chiropractic theory and practice are not based upon the body of basic knowledge related to health, disease and health care that has been widely accepted by the scientific community. Moreover, irrespective of its theory, the scope and quality of chiropractic education do not prepare the practitioner to make an adequate diagnosis and provide appropriate treatment. (emphasis added)
Popular magazines such as Reader's Digest and Consumer Reports, and the leading medical journals of our day, all have carried articles designed to defame chiropractic and frighten the public away from "unscrupulous practitioners." Such bullying tactics irritated and frustrated those of us in the chiropractic profession who could immediately identify the falsehoods, half-truths and innuendo carried in these many publications. What amazed many of us even more was the willingness of an inadequately informed public to accept all it was told by its "doctors," or what it read in the newspapers or the popular magazines.
Except for the occasional grateful patient, there seemed to be few critical thinkers in all the land. "If it was published, it must be true," was the current thought of the day. If a doctor, lawyer or perceived "expert" said chiropractic was dangerous, it must be so.
To those of us who lived through those dark days when the profession we loved was being maligned, memories of frustration resurface. How could a public, a government and an association (the AMA) that held the public trust be so wrong, oppressive and bigoted? It happened.
Has Anything Changed?
Yes and no! The Committee on Quackery no longer exists, but perhaps there is no need, given the propensity of chiropractic to fulfill the goals of that committee on its own accord.
Yes and no! Legislative activities have brought many rewards to chiropractic (the Department of Defense and VA projects, for example) but this has come through hard-fought battles against strong resistance-and the battles are far from over, as in California.
Yes and no! Public rhetoric toward chiropractic is more common, but still comes in a mixed format: some positive; some derisive.
Yes and no! The unsuspecting and sometimes gullible public still questions the veracity of chiropractic because someone who "buys ink by the barrel" chooses to print something negative!
A Look in the Mirror
For a profession that has been the subject of outright prejudice and the victim of an uncritical, widespread public acceptance of prejudice manifested in the misuse of information; presentation of only one side of the argument; half-truths; and biased perspectives, self-reflection is long overdue.
We all have experienced the recent flood of rhetoric through the many media available today - Web pages, e-mail and conventional print media and lecture platforms - regarding the CCE.
Have we, as members of the chiropractic profession, acted any differently than the gullible public of the '60s, when presented with a single perspective on a subject? I speak of the rhetoric swirling around recent actions taken by the Commission on Accreditation (COA) regarding Life University College of Chiropractic and organizational changes within the CCE itself.
Lawsuits have been filed; public statements have been released; newspapers have been printed; and the stories continue to flow. The court of public opinion cries for a verdict before facts are understood.
How are those who have embraced the pronouncements of the media any different from the public who unsuspectingly accepted the anti-chiropractic rhetoric espoused by the AMA in the '60s? Where are the critical thinkers who are not, "... tossed to and fro, and carried about with every wind of doctrine, by the sleight of men, and cunning craftiness, whereby they lie in wait to deceive" (Ephesians 4:14)?
Since the separation of a father and son (D.D. and B.J.), this profession has hobbled its own progress and failed to achieve the greatness of its own destiny. Perhaps the reasoned actions taken by the CCE and the reactions of others will set the stage for this profession to rally toward unity, or draw clearly defined distinctions between camps. The future literally is in our hands. The vultures, whether they be committees on quackery or editors of the Daily ("Chiropractic") Bugle await the outcome of self-destruction or self-distinction.
References
- Wilk, Chester. Medicine, Monopolies and Malice. Avery Publishing Group, Garden City Park, NY, 1996, pg. 45.
- Ibid. pg. 46.
Reed Phillips, DC, PhD
President, Southern California University of Health Sciences
Whittier, California