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Backs to the Wall: Chiropractic's Legal History

Chiropractic.  The word itself is so polarizing.  Some people hear the word and roll their eyes while others just can't wait to tell you how great THEIR chiropractor is.  Why is it viewed so differently among people?  Why is it largely misunderstood by the medical profession?  Is it new wave or a modern version of the healing practices of antiquity?  There are many questions and (depending on whom you talk to) even more answers.

There is one thing about chiropractic that I truly love above all else.  Although the profession has seen many advances and changes, the principle behind chiropractic has never changed.  How many professions can say THAT?  Misalignments of the spinal joints cause damage to the joints as well as dysfunction in the nervous system, which (in addition to pain) can cause dis-ease throughout the entire body resulting in a myriad of symptoms and illnesses (neck pain, back pain, migraine headaches, sciatica, fibromyalgia, extremity numbness, etc.).  Chiropractors utilize non-surgical, non-pharmaceutical means to realign the spinal column to promote healing in the joints and remove pressure from the nervous system.  The principle seems pretty straightforward for most, but this idea was vehemently challenged by the medical establishment in the early part of the 20th century.

Adjusting Spines?!?! That's a Felony!

At the very least, the medical profession thought chiropractic was useless chicanery, at worst they warned that chiropractic adjustments were harmful to one's health (reminds me of a story about a pot and a kettle...hmm).  In fact, the medical profession fought so hard against chiropractic that doctors of chiropractic were put in jail for "practicing medicine without a license" in the 1930s.  Of course, by not prescribing medications, stitching up wounds, or relieving fractures, it boggles the mind how anyone would try and accuse chiropractors of trying to "practice medicine."  It didn't matter what the treatment was, medical doctors could not stand the thought of people needing anything but drugs and surgery for their health.  It just wasn't scientific enough.  This was in the days when lobotomies were done routinely, physician endorsement of cigarettes was common, and only a decade after bloodletting fell out of fashion, but that's besides the point.  Doctors of chiropractic sat in jail so I could do what I do today and all they were trying to do was offer an alternative in order help to their fellow (wo)man.  Meanwhile, politicians have been allowed to run free for decades (just kidding...sort of).

Once it was proven that chiropractors were not, in fact, "practicing medicine," they were allowed to return to their homes and their practices.  The chiropractic profession was established as its own entity, with its own set of
guidelines on education and scope of practice.  It was spelled out very clearly what a chiropractor could and could not do and they were clearly second class citizens in the healthcare field.

Although the law of the land clearly placed medical doctors as the gatekeepers to health care and chiropractors as obvious adjuncts to medical care , the medical establishment didn't stop there.  It just wasn't good enough.  They wanted their competition out of the picture altogether.  Hence, the American Medical Assocation conducted a decades long smear campaign against chiropractic.  In medical schools, clinics, and hospitals, chiropractic was considered unscientific and unsafe (again, by the same people who thought cigarettes were OK) and this mantra was to be repeated by every doctor, student, professor, nurse, etc.  It was not to be questioned and no proof of these claims was needed.  It was accepted as dogma.  Their bylaws also clearly stated that any medical doctor who "associated" with a chiropractor would be ostracized for doing so.  What this meant is that no medical doctor at any time could ever refer a patient to a chiropractor.  This effort was supposed to drive every DC out of business and kill chiropractic care forever.  But they underestimated one small thing: the actual patients.  People with health care problems don't care about politics or egos.  They want help and they were willing to see chiropractors in order to get it.  This alone kept chiropractic alive.

Apparently, medical doctors still couldn't stomach the notion that anyone would even dare to help people with their health while lacking the initials "M.D." after their name.  They felt that anyone outside the "cool kids club" shouldn't be allowed to offer any services related to health care!  Well, they have a name for that type of business model.  It's called a monopoly.  And those are illegal in the United States of America.  So in 1976, Dr. Chester Wilks and four other chiropractors sued the American Medical Association, as well as several physicians, for violations of sections 1 and 2 of the Sherman Antitrust Act.  It was a true David vs. Goliath battle.  More like David vs. an army of Goliaths.

The legal process is long and when you have an army of lawyers like the AMA does, you can drag it out even longer.  However, in 1987, Judge Susan Getzendanner ruled that the AMA had engaged in an unlawful conspiracy in restraint of trade "to contain and eliminate the chiropractic profession."  She went further, stating that the "AMA had entered into a long history of illegal behavior." She issued a permanent injunction against the AMA to prevent such future behavior. To this day, the AMA can not publicly or privately denounce the profession of chiropractic with baseless allegations.  It did not force them to play nice with chiropractors, they just couldn't officially bully the profession anymore.  Of course, the AMA used every bit of their financial and political might to appeal (they petitioned the supreme court three times), but the injunction was upheld.  Apparently, you just can't point at a competitor and call them a quack without evidence, especially when you're going to profit financially because of it.

There is no "Rx" in Team

Dr. Wilks imagined a world where medical physicians and chiropractors could provide the people of this country with the best health care possible, pooling our resources and working together for the greater good.  So where are we now?  Well, that depends who you ask.  Just the mere fact that chiropractic is still around is significant.  With all the profession has been up against, we still stick around.  Why?  Results.  If we weren't getting the results, there is no way we could have weathered the storm and survived as a profession.  Chiropractic has been the ultimate "grass roots" story in health care.  No huge multinational companies to fall back on.  No limitless advertising campaigns to promote it.  No major political clout to receive funding and entitlements from the government.  Every time the profession has had its back against the wall, it was the patients themselves who helped chiropractors fight for their right to practice.

As the result of the Wilks lawsuit and others like it, things have changed "legally" but discrimination against chiropractors is still abound in the medical establishment.  Patients often tell their MD when they have had results in our office after the doctor's treatments have failed.  Instead of expressing relief that their patient's migraines are gone, most get dismissive (even snippy) about the patient coming in to see me in the first place.  On the other hand, some patients tell me that their doctor is happy for them and they encourage them to keep seeing me because they see the results.  We even have a couple medical doctors and osteopaths in the Muskegon area that refer patients to us. So I have to admit that things are improving.

At the end of the day, it really is up to the patient to decide what is best for THEIR OWN health.  Not every patients needs a pill.  Not every patient needs an adjustment.  Just don't let politics or egos (or insurance companies) get in the way of you receiving the health care that is best for your particular problem.  If you feel like you've been treated like a number.  If you are tired of your doctor just giving you pill after pill after pill.  If you're tired of getting the "because I said so" type answers to your questions, maybe it's time to give chiropractic a try (or a different chiropractor).  If you're seeing a DC, share it with your doctor.  They won't listen to me.  But they just might listen to you.  We are facing a health care crisis of epic proportions right now in this country.  We are sicker now than we have ever been.  Bickering is useless.  Name calling is useless.  Arguing semantics is useless.  It all comes down to one thing: the patient.  That goes for me, as well.  I understand that there are times when my treatment is unable to treat a condition.  I have no problem sending my patients to a medical professional in those cases because the only thing that matters is the patient.  We all need to work together in order to give the people of this country the best care possible.

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