Challenge to Chiros

by

A CHALLENGE TO CHIROPRACTORS

“An idea that isn’t dangerous is

hardly worth calling an idea at all.”

Oscar Wilde

 

As chiropractors we know there is no more dangerous idea than the Big Idea.

Dr. Sid built his bell tower in remembrance of the victims in the medical war, a symbol that seems forgotten. If actions speak louder than words, many in the chiropractic profession have become tone deaf to the meaning of his bell tower.

Lest we be reminded from New York to Louisiana to California, chiropractors were routinely harassed, extorted, arrested, often ran out of town, and beaten up by the local police. During the first half of the twentieth century, over 12,000 American chiropractors were prosecuted over 15,000 times, and some 3,300 were sent to jail for practicing medicine without a license.[1]

Even DD Palmer spent a few days in jail. Are you prepared to do the same to keep the Big Idea alive?

According to historian Russell W. Gibbons, chiropractors felt the brunt as one of the first grass roots movements in America:

“…like abolitionists, chiropractors were systematically persecuted and driven from town to town. Like the feminists and suffragettes, chiropractors were made objects of ridicule. And like the civil rights workers of more recent times, chiropractors were intimidated and subverted by agents and provocateurs. In the finest tradition of reform movements, they were imprisoned for their beliefs.” 

Fred Courtney, DC, adjusting cell mates

in LA County jail, Feb. 1921

In California roundups were used to jail chiropractors en masse:

“In just one year [1921] 450 of approximately 600 chiropractors were hauled into court and convicted of practicing without a license. They were given jail sentences or the alternative of a fine. They chose to go to jail.”[2]

 Despite over a century has passed since our inception in 1895, little has changed — chiropractors are still marginalized and ridiculed. A few years ago, famed attorney George McAndrews was asked why the chiropractic profession seems to be no better off than it was in 1987 after he won the milestone Wilk v. AMA antitrust lawsuit.

Needless to say, George was very annoyed and replied, “Because the damn chiropractors haven’t done anything with it!”

He was right. This should remind us all of the 1964 Civil Rights Act that did little until MLK, Jr. and his followers took to the streets to protest urging the implementation of this federal law. Certainly, the March in Selma and his “I have a dream” speech on the steps of the Lincoln Memorial led to changing attitudes in America.

Indeed, the law does nothing to create social change until someone presses the point with action. Perhaps it’s time for chiropractic to stage its version of “I have a dream, too,” to dramatize our struggle for healthcare equality, for patients freedom of choice, and freedom from medical oppression.

In reality, we are still marginalized, we still endure the medical prejudice —  ‘chirophobia’ — embedded into our society by bigoted MDs and a tainted press, our image remains stained, we have no presence in the media, most markets are closed or severely limited, and we remain a fractured profession with factions rather than solidarity.

Some within our ranks have lost hope, they are children of little faith, and they appear to have capitulated to the Dark Side of medicine.

We know who they are when they profess anti-subluxation rhetoric, they are the outspoken chiro-agnostics when they ridicule the healing power within, when they demand pro-prescription rights in an era with too many drugs. We know them when they profess ‘Choosing Wisely’ which is code for ‘Guessing Blindly’ by using nonspecific methods for nonspecific treatments for nonspecific care at a time when ‘best practices’ calls for specific analysis for specific care.

They have lost sight of the Big Idea; those who BJ Palmer wrote about when he said, “Many people suffer with a constipation of thought and a diarrhea of words. Many a man has the eyesight of a hawk and the vision of a clam.”

If it weren’t for our great clinical results, we would be gone with the political wind a long time ago just as the AMA and the Committee on Quackery planned in 1963 to “contain and eliminate” our profession.

Regrettably, the medical war continues but has changed from fighting over scope of practice rights to the scope in the marketplace where we remain contained and nearly eliminated. You can understand why this medical war in the marketplace is so fierce considering spine care is the 3rd largest medical issue only behind heart and diabetes; this is a huge market, nearly $100 billion is at stake as well as a battle for cultural authority on spine care.

Today DCs are scrambling for patients from the margins of the market dominated by inept MDs using “outdated models of care” that has led to the present opioid crisis and the tsunami of failed back surgeries.

In fact, many investigators are openly in contempt of “usual medical spine care.” The Lancet review on LBP spoke of “the widespread use of ineffective and harmful care” and the “disastrous effects of damaging medical intervention” – narcotic painkillers, epidural steroid injections, and spine surgery.

The Lancet review levied the challenge to “tackle entrenched and counterproductive” forces in order to protect the public and mitigate the financial burden on taxpayers:

Protection of the public from unproven or harmful approaches to managing low back pain requires that governments and health-care leaders tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo.”

The gauntlet has been thrown down, but does the chiropractic profession have the backbone to tackle the entrenched and counterproductive forces in the medical trenches?

To the pain management clinicians doling medicinal heroin like candy and spine surgeons profiting with blood on their hands, our Big Idea is very dangerous. Not only would it save millions of patients from opioids and surgery, it would show the world their deception and incompetence.

Editor Mark Schoene acknowledge in his article, “U.S. Spine Care System in a State of Continuing Decline”:

Medical spine care is the poster child of inefficient care…such an important area of medicine has fallen to this level of dysfunction should be a national scandal. In fact, this situation is bringing the United States disrespect internationally.”

If chiropractic is to become the cultural authority and portal of entry on spine-related issues, we cannot sit back as patients still encounter resistance to access our services. We cannot idly sit by in Ivory Towers to change our fate or to protect the public welfare, and yet expect the public and press to recognize the value of our contributions.

Are we willing to fight for our rights and the right of patients to access our care? What are you willing to sacrifice as our Founder and forefathers often had to do? Would you be one of the 12,000 American chiropractors who were prosecuted over 15,000 times, and one of the 3,300 who went to jail for practicing chiropractic without a license? Do you have the backbone of your ancestors or did you lose it somewhere in our leisure society while getting high and playing video games?

Only a few of you may recall MLK, Jr’s stirring speech at the Lincoln Memorial and fewer of you may remember on February 1, 1960, when four black students sat down at a ‘whites-only’ lunch counter at the Woolworth’s in downtown Greensboro, North Carolina. Denied service, the four young men refused to give up their seats. The sit-in movement soon spread to college towns throughout the South. It began a movement that change the nation.

Are chiropractic students willing to ‘sit down’ for chiropractic by ‘standing up’ for our rights to serve a society where back pain is a $100 billion industry totally mismanaged evident by the fact LBP has become the leading disability in the nation, military and in the workplace? This did not happen by accident, but by the sham management by the medical spine care industry – “the poster child of inefficient care.”

Today one thing is for sure, 124 years since the birth of chiropractic, we have more scientific research and evidence-based guidelines to support our brand of spinal care. Indeed, today if there is an “unscientific cult,” it is medical spine care, not chiropractic.

With this battle cry in hand and with the plethora of new armaments on our arsenal, the lack of action by the chiropractic profession is dumbfounding. I say today that will change. 

As a leading chiropractic college touting itself as “The not-so-little university that is changing the world,”  Life U. must embark on the meaningful changes to help the world. It cannot become an Ivory Tower where the faculty, students, and other “people suffer with a constipation of thought and a diarrhea of words.”

It must develop talented speakers and writers to tell the Big Story of chiropractic to a nation starving for our services. Let the bell tower chime as a daily reminder on campus why our predecessors sacrificed so much for us. As BJ warned, Life U. cannot become a caldron where “Many a man has the eyesight of a hawk and the vision of a clam.”

Every chiropractic college must keep this caldron of academia boiling with renewed hope. They must keep the Big Idea of social revolution in health care alive as a “dangerous idea that is worth calling an idea” to help a nation and world sinking into oblivion with drugs and unwarranted surgeries.

Life U. has the most progressive spokesmen in the profession, it has the most advanced curriculum taught by the best instructors, and its students will be the best trained spinal care practitioners fighting not only against the pandemic of pain and disease, but as spokesmen and women against the onslaught of disastrous medical care that has created this opioid crisis and onslaught of unnecessary back surgery.

Some might say the only noticeable change at Life U. occurred in the sports world when Life beat Cal on the rugby field for the national championship. Undoubtedly, this was a feather in Life’s cap for attaining such athletic excellence, but now is the time at Life University to take the same competitive spirit to tackle Emory University’s Orthopaedics & Spine Center not on the rugby field but on the medical field for supremacy in spine care.

Indeed, the staff at Emory probably wonders why this challenge hasn’t already happened because the writing is on the wall written by its own leader. To his credit, even Dr. Scott Boden, director of the Emory Orthopedics & Spine Center, wrote in 2003 in Spine journal: “Many, if not most, primary medical care providers have little training in how to manage musculoskeletal disorders.”[3]

Dr. Boden also did the seminal research in 1990 debunking ‘bad disks’ as the sole causation of LBP when he stated his skepticism about surgery for bad disks:

“It should be emphasized that back pain is not necessarily correlated or associated with morphologic or biomechanical changes in the disc. The vast majority of people with back pain aren’t candidates for disc surgery.”[4]

Dr. Boden also suggested:

“The best thing is to have an organized, integrated approach that uses state-of-the-art and cost-effective care.” [5] 

Who better fits his description than chiropractors? Certainly, he cannot be suggesting usual medical care is state-of-the-art, safe, or clinically and cost-effective. Indeed, the comparative studies show DCs are the best buy, but no one is telling the public – that has been our profession’s greatest problem – the failure to tout our own horn.

Dr. Boden’s admissions must be heard by the public and press. Just as Life ruggers kicked butt on the rugby pitch, now is the time to make our case in the media to a contest of clinical and cost-effectiveness between chiropractic care vs. medical spine care.

All the public has heard is the medical chirophobic narrative about our profession — chiropractors are quacks, dangerous, unscientific, cause strokes, paralysis, yada, yada, yada… Indeed, where is the chiropractic voice now to proclaim our superiority in spine care, let alone the progress in neurophysiology research done by Heidi Haavik, Ted Carrick and Scott Rosa? Certainly, their Big Ideas are truly dangerous to mainstream medicine.

Our profession and Life U. now have the opportunity to ride an all-time high wave of scientific support to renew its reputation, but I say the chiro associations and colleges must do more to promote this major paradigm shift in spine care.

Consider the shock in 1961 when President John F Kennedy called for landing a man on the moon within a decade. Life U. can do what may appear at first to be another unattainable act to make chiropractors Americans’ primary spine care providers as we should be by virtue of our superior training, our great clinical results, and our cost-effectiveness. We can and must do more; the sooner the better!

This not a new call for action considering Life’s declaration at its Life.edu website where it is written:

We are vitalistic visionaries relentlessly committed to disruptive social innovation…

LIFE’s faculty promotes an atmosphere which encourages open-forum communication and a free exchange of ideas, inspiring students to express new and revolutionary solutions in a challenging, yet supportive environment.

I can think of no more “disruptive social innovation” than promoting chiropractic care as the logical solution to the opioid crisis and the pandemic of back pain.

So, keep in mind what Oscar Wilde once said, “An idea that isn’t dangerous is hardly worth calling an idea at all.”

I daresay there is no more dangerous idea than the Big Idea. Let this Founder’s Day celebration and this bell tower built by Dr. Sid to be a reminder of our Lasting Purpose as Dr. Sid so eloquently said:

“Loving, Serving and Giving out of your own abundance is not to be confused with Loving to get, Serving to get, and Giving to get.”

 We can do this. Now let’s renew our faith in our Founder and forefathers and re-engage in the medical war with a new war plan, a renewed spirt, and be the solution the public worldwide so desperately needs.

[1] Russell W Gibbons, “Go to Jail for Chiro,” Journal of Chiropractic Humanities 4 (1994): 61–71.

[2] B Inglis. The Case For Unorthodox Medicine, New York: GP Putnam (1963)

[3] S Boden, et al. “Emerging Techniques For Treatment Of Degenerative Lumbar Disk Disease,” Spine 28(2003):524-525.

[4] Boden, S et al. (2003) Emerging techniques for treatment of degenerative lumbar disc disease, Spine 28:524-525.

[5] S Boden, et al. Emerging Techniques For Treatment Of Degenerative Lumbar Disc Disease, Spine 28 (2003):524-525.