I Have a Dream, Too

by

JC Smith, MA, DC

www.medicalwar.info

 Each year when I hear Dr. Martin Luther King, Jr.’s stirring speech, “I Have a Dream,” originally given in 1963 at the Lincoln Memorial, I just listen in awe, spellbound by his eloquence which has never been matched since by contemporary statesmen, nor has his passion for equality been seen in anyone of late. Most people will admit that MLK’s dream for his people and our nation was truly inspirational and motivational. I can only imagine what our country might be like today if he were still alive.

As a doctor of chiropractic, I feel a similar “withering injustice” that he and his fellow African-Americans felt. As MLK spoke, my mind kept translating the word “Negro” for “chiropractor,” and I felt a similar passion for equality. For example, the second paragraph of his speech hit a nerve with me as a chiropractor:

“But one hundred years later, we must face the tragic fact that the [chiropractor] is still not free [to access by all Americans]. One hundred years later, the life of the [chiropractor] is still sadly crippled by manacles of segregation [in most hospitals] and the chains of discrimination [by insurance companies and Medicare]. One hundred years later, the [chiropractor] lives on a lonely island of poverty in the midst of a vast ocean of material [medical] prosperity. One hundred years later, the [chiropractor] is still languishing in the corners of American society [seeing 10% of Americans] and finds himself an exile in his own land [boycotted by public hospitals and ostracized by the medical media]. So we have come here today to dramatize an appalling condition.”

I often wonder when we chiropractors will take the same platform “to dramatize [our] appalling condition”. Although legislation and litigation have delivered us from the throes of medical imprisonment, we still find ourselves mired in a second-rate image, patient acquisition, and economic status.

Without a doubt, the most memorable phrase in MLK’s speech came when he said, “I have a dream that my four children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.”

Like MLK, I have a dream too that someday healthcare providers will not be judged by their diplomas or by the historical dogma of their predecessors but rather by the help they give to patients. I have a dream that someday all patients will have access to our services. I have a dream that soon the media will give us credit where it is due for helping thousands of patients avoid unnecessary drugs and back surgeries. Moreover, someday the neurophysiologic principle of our healthcare will be as well known as the bad blood theory of the allopaths.

I have a dream today that all Americans will benefit by our care without harassment from their medical doctors or dissuaded by a biased news reporter or insurance claims adjusters who limit our care to an impractical few visits. This may sound more like a pipe-dream than reality, but MLK also had his dream that sounded far-fetched to many of his own people at that time.

I have a dream that all people will learn a new paradigm that healing does not always come from a bottle of pills or from the scalpel, but good health habits. I hope that someday people will cherish their bodies as a temple rather than as a vehicle to quick death fueled by junk phoods, drugs, tobacco, and alcohol.

I have a dream that chiropractors will overcome their petty differences, unite into one organization, and rebuke any and all obstructionists or demagogues, no matter how charismatic or “philosophical” they may appear. I dream that chiropractic education will reflect quality rather than quantity, and that freedom of speech and thought will prevail where it may only speaks in half-truths. I dream that this profession will raise its clinical standards to do what is best for patients’ needs rather than what’s best for doctors’ needs.

The power of MLK’s speech came from two sources: the Bible and the Constitution. Throughout his speech are continual references to Biblical metaphors and to democratic ideals, simply asking when these principles will apply to all Americans, including blacks and other minorities.

In turn, I think we chiropractors should also use such metaphors. Rather than Biblical ones, however, I believe a constant reference to the principles of 1) Patients’ Bill of Rights and to 2)free enterprise in an open marketplace where “distributive justice” for all should ring loudly. We should be asking when these economic ideals will apply to all practitioners and to all patients regardless of the type of treatment involved.

Just as MLK dreamed of the day when “little black boys and black girls will be able to join hands with little white boys and white girls and walk together as sisters and brothers,” I wonder when MDs and DCs can practice together in every hospital and every HMO for the betterment of all patients. After all, our mutual enemies should not be each other, but pain and disease. Unfortunately, the AMA does not share my belief. Somewhere in the fray this point has been missed.

One only has to understand the history of the medical war against chiropractors to realize how the medical bigotry began. 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.” ^[1]

Whereas racism and sexism, for instance, have diffuse origins, medical bigotry essentially can be traced back to one man. Few Americans understand the role of Morris Fishbein, MD, former AMA Executive Director (1924-1949), also known as the Medical Mussolini by his colleagues due to his tyrannical leadership, who headed the AMA for a quarter of a century to wage war on all competitors. Russell Gibbons recognized the singular impact of Fishbein and concluded he was “the most important non-chiropractor to influence the chiropractic profession.”^[2]

Fishbein announced this anti-competitive war policy openly when he wrote in his book, Medical Follies in 1925 that “Scientific medicine absorbs from them that which is good, if there is any good, and then they die.” ^[3] His policy was continued in 1962 by the AMA’s Committee on Quackery “to contain and eliminate chiropractic” that still rings true today despite the Wilk et al. v. AMA et al. antitrust trial victory. Sadly, Fishbein’s policy remains in place today albeit more covert.

His goal was to eliminate as many non-MDs as possible, even those progressive MDs who used alternative methods. Not only did he attack chiropractors, his AMA predecessors and his successors have attacked every other healthcare profession, beginning with homeopaths, naturopaths, true osteopaths, dentists, optometrists, and today the AMA fights encroachment by nurse practitioners. Indeed, the AMA has never espoused the virtues of a free market place in healthcare with open competition to drive down costs and improve services. Consequently, we have a medical monopoly profiting in a healthcare crisis of unsustainable costs.

Nearly forty years after MLK’s riveting speech underneath the glaring brow of ol’ Abe Lincoln himself, his dream has still not been entirely fulfilled although great steps have been taken to further his cause. For chiropractors, however, we have struggled for over 100 years fighting the slings and arrows of outrageous medical conduct and public/media prejudice and, as HCFA has demonstrated, often our profession seems to have taken a step backwards.

Unlike the civil rights movement, we chiropractors have never had a charismatic leader with such a magnanimous calling. Even BJ Palmer and Sid Williams, two hugely successful charismatics in chiropracTIC, were tainted by their own greed and megalomania, alienating the chiropractic mainstream and the call for unity while serving to fracture our profession’s image with hyperbole and eccentric behavior. Until we find that special person who garners the media’s attention and advocates equality in health care for patients and providers, we will continue to be a loose band of downtrodden, second-class practitioners. Until we make medical bigotry unacceptable, we will continue to ride in the back of the medical bus. We will continue to struggle until we find a strong faith in our leadership.

As MLK stated,

“With this faith we will be able to hew out of the mountain of despair a stone of hope. With this faith we will be able to transform the jangling discords of our nation [profession] into a beautiful symphony of brotherhood. With this faith we will be able to work together, to pray together, to struggle together, to go to jail together, to stand up for freedom together, know that we will be free one day.”

I’m just a small town country chiropractor wondering when the civil rights movement will include our profession. Today it is certainly not politically correct to be racist, sexist, anti-Semitic, homophobic, or Islam phobic, but it is still okay to bash the chiropractors. We remain the last bastion of medical bigotry that the press refuses to reveal. Even progressive and liberal news media ignore this obvious medical bigotry, undoubtedly reflecting the AMA’s historic propaganda. William Trever outlined the ill-begotten propaganda strategy used by the AMA’s Committee on Quackery to destroy the reputation of the chiropractic profession.

“Time and time again the AMA’s Merchants of Misinformation have subverted the truth for their own fascist ends. Using these tactics to ‘build up a case’ against chiropractic they have taken objective reports, studies, and individual opinions in favor of chiropractic and reversed them into what appears to be anti-chiropractic views coming from many “non-medical” sources. Done enough, this tactic would give the appearance that ‘everybody knows that chiropractic is an unscientific cult.’”^[4]

Ironically, the call for healthcare equality initially began with Benjamin Rush, MD, a Founding Father and signer of the Declaration of Independence, who warned of the rise of a medical monarchy. Dr. Rush, the father of American medicine, believed in the separation of powers as it applied to the exercise of the professions. He wrote:

“The Constitution of this Republic should make specific provision for medical freedom as well as for religious freedom. To restrict the practice of the art of healing to one class of physicians and deny to others equal privileges constitutes the Bastilles of our science. All such laws are un-American and despotic. They are vestiges of monarchy and have no place in a republic.” ^[5]

Few people have ever appreciated the heroism and perseverance required to be a chiropractor. Just as black Americans were forced to sit in the back of the bus, chiropractors were thrown under the medical bus. Historian Russell Gibbons told us that “chiropractors felt the brunt as one of the first grass roots movements in America.”^[6] And for this effort to attain social justice in healthcare, they paid a heavy price.

History books have rarely, if ever, mentioned that 12,000 chiropractors were jailed, collectively, over 15,000 times in the first thirty years of the twentieth century for allegedly practicing medicine without a license, resulting in 3,300 convictions, even though chiropractors never used drugs or surgery.^[7]   Ironically, their real crime was getting people well without drugs or surgery. No matter what healing method used, the AMA was against any and all competition and used its political might to maintain their monarchy, including mass arrests.

Until 1922, when a referendum was passed in California to protect chiropractors, roundups were used to jail chiropractors en masse as this account testifies:

“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.”[8]

 Convictions became more difficult as patients refused to testify against them. In 1922, after four chiropractors were jailed in Taft, California, the judge asked the sheriff why there were so few witnesses in view of the many subpoenas issued. The Sheriff said:

“Your Honor, the sheriff’s office has been unable to catch the witnesses. They hide under beds and run out the back doors. They won’t testify against these chiropractors. The Sheriff’s office has a lot of important business, so if you want these witnesses, you’ll have to catch them yourself.”[9]

Although a cascade of victories in state legislatures won the chiropractic profession legal recognition and protection from medical harassment, the acrimonious, dominating medical monarchy—aided by a medical-friendly media—would continue to battle chiropractors in the war for public opinion and in federal/state legislative conflicts. Although chiropractic had dodged one bullet with licensure, it was certainly not out of the line of fire in the medical war. Today the medical tactic is to have “chiropractic wither on the vine” by boycotting its presence in the news media and limiting our care in insurance coverage and hospitals.

In this era of evidence-based care, the medical warlords turn a blind eye to the research debunking the disc theory as the cause of back pain and the tsunami of unnecessary spine fusions. They also choose to ignore the positive studies and guidelines extolling the benefits of our brand of spinal care with Type M disorders. Nor do they want to acknowledge the research touting our effectiveness with some Type O and Type B disorders. Certainly the medical profession would prefer we and our ideas stay incarcerated from public view. Freedom of speech has never been the stalwart principle of the AMA.

Indeed, despite being the third-largest physician-level profession in the nation, if not the world, when was the last time you read an article or viewed on television an interesting article about our profession? Okay, stop thinking because most of you can’t recall any such journalistic investigation into the changing paradigm in spine care or anything about the injustice chiropractors have endured. We are, in essence, the Mystery Science Profession unless we are being bashed, such as we’ve seen over the last two years on Medscape where a study from England, “Deaths After Chiropractic: A Review Of Published Cases,” by Edzard Ernst of the Medical School at the University of Exeter, once again raised the level of fear over chiropractic care when he noted that “Twenty-six fatalities were published since 1934 in 23 articles.”^[10]

Considering this covers 76 years and equates to 0.34 deaths per year, instead of sounding an alarm as Ernst attempted, he should have praised chiropractic care for its obvious safety since this is an extremely low rate in comparison with equivalent medical methods of drugs, shots, and surgery for the same diagnostic conditions. But this sensational headline made for interesting reading among the medical bigots who fed upon this medical fuel of outrageous journalism in their knee-jerk condemnation of all things chiropractic.

Nonetheless, many DCs remain steadfast in determination, although I don’t know how many DCs would go to jail (and I don’t mean for insurance fraud) like Drs. Fred Courtney or Herbert Reaver did in 1921. Instead of fighting for full equality as MLK, Jr. and his followers, we seem to fight over crumbs, ignoring the big picture of our image in the court of public opinion.

Can chiropractors aspire to the same hope that MLK inspired in generations of his people? Do we have any potential leaders who can draw an entire profession of diverse intellects together united by our commonalities rather than by our differences? Or will this dream of enrichment eventually become our on-going nightmare? As one notable chiropractic educator once told me, “it may take a few more funerals before unity is likely.”

If we are to win in the court of public opinion, we must re-brand ourselves in the media, and I don’t mean via celebrity testimonials, either. Apparently our present media strategies don’t work since we are virtually ignored in the mainstream and even our F4CP ads are rejected by medical journals. 

Since the media refuses our civil requests as a learned profession, we must go guerilla. We need to take to the streets. We need to Act Up on Capitol Hill. We need to protest our lack of media exposure. We need to mobilize our students as we did at Berkeley to instigate the Free Speech Movement.

Perhaps we need a Selma demonstration to draw attention to our plight or are we too “uppity” to make a scene that might embarrass those Uncle Toms who prefer modesty and temperance instead? Many are too comfortable in our narrow rut to make waves as MLK, Jr. once did to free his people.

 One prominent chiropractic researcher once suggested that we need to make love, not war, with the medical profession. I wonder if MLK, Jr., ever held the same sentiment about making love with Jim Crow? He certainly avowed non-violence, but he never favored being bent over the barrel, ya folla? Okay, stop laughing, since I doubt the medical associations desire to make love to us. Certainly, we are still at war with the medical profession, like it or not.

Indeed, do we have the backbone to make our case public and to fight for our American rights? As usual, I’d love to hear your thots.

 

If you desire to learn more about the medical war against chiropractors and the call for reform in spine care, you can purchase my new book at www.medicalwar.info

Enjoy,

JCS