Book Review

The name David Chapman-Smith should be familiar to all chiropractors. He was counsel for the 1979 New Zealand Commission of Inquiry into Chiropractic. Most would know DAC-S as editor and principal author of The Chiropractic Report, the newsletter which he founded in 1986. For those involved in the politics of chiropractic, DAC-S is known for his role as Secretary-General for the World Federation of Chiropractic and General Counsel for the Ontario Chiropractic Association. He has also authored numerous articles in the medico-legal and chiropractic literature and is a co-editor of national chiropractic practice guidelines in both the United States and Canada. Given this background, even though he is not a chiropractor, DAC-S is well positioned to write The Chiropractic Profession. Its Education, Practice, Research and Future Directions.

Furthermore, because his wife holds both chiropractic and medical qualifications it may not be unreasonable to assume that DAC-S has an insight into the chiropractic profession which is only available to the spouse of a chiropractor. Such credentials could result in a substantially biased work. To his credit, DAC-S recognised this potential source of criticism and deals with it on page 7 of Chapter 1: Introduction by challenging readers to continually check to see if important facts and conclusions are supported by reference to published research and other documents. Good advice not only when reading The Chiropractic Profession.

As the title suggests, DAC-S’s book considers the chiropractic profession from a number of angles. It provides readers with a succinct summary of the status of the profession’s education, licensure, research, and growth around the world. In his own words, the goal of The Chiropractic Profession is to provide a comprehensive overview of the chiropractic profession in language suitable not only for health professionals but also for the general reader (p.3).

To make the book very user friendly, there is a comprehensive Table of Contents which facilitates using The Chiropractic Profession as a quick reference. The utility of the volume is further enhanced by the inclusion of a Summary of Facts on Chiropractic, which is somewhat akin to an Executive Summary, which one finds so valuable when reading reports and submissions. The Summary of Facts provides readers with rapid access to information on: 1) Definition of Chiropractic, 2) Origin and Professional Organisation, 3) Education and Licensure, 4) Licensing Laws, 5) Title and 6) Practice.

The Chiropractic Profession is a work of ten chapters, each of which is a stand-alone document.

Chapter 2: Chiropractic History takes readers back to 1895 when chiropractic was discovered and then, in thirteen pages, encapsulates a century of chiropractic history through to the late 1990s without missing any of the important events that have served to shape the profession.

Chapter 3: Current Status of the Profession provides readers with information on demographics of the profession as well as its professional organisation, law, education, literature, research funding and post-graduate specialties.

Chapter 4: Education and Licensure is an essential and necessary resource for dispelling misinformation about the perceived shortcomings of undergraduate or pre-professional chiropractic education. One should not be lulled into believing that such misinformation is history. As DAC-S points out in Chapter 4s introduction, focus groups in Canada and the USA found that a significant portion of the public thought that chiropractic education was about 2 years in duration, was greatly inferior to medical education and was basically chiropractors teaching chiropractors in unregulated private schools.

Chapter 5: Principles and Goals of Chiropractic Care and Chapter 6: Scope of Practice offer a rational discussion on these topics. Some chiropractic quarters may find them narrow. However they are written from the basis of intellectual honesty and will serve the profession well.

Chapter 7: Manipulation offers a concise overview of the science and art of manipulation/adjustment

Chapter 8: Back Pain provides readers with a comprehensive, evidence-based discussion about chiropractic’s successful management of patients with low back pain.

Chapter 9: Public and Medical Attitudes Towards Chiropractic looks at surveys of the public’s views of the chiropractic profession, utilisation rates, satisfaction rates, the role of the media, the role of employers and the new significance of complementary and alternative medicine. This chapter will no doubt give all chiropractors a warm fuzzy feeling.

Chapter 10: Future Directions for the Chiropractic Profession may well give some chiropractors a sinking feeling because it asks the question - What is the future of chiropractic in a rapidly changing health care system. It answers by reporting the findings of the Institute for Alternative Futures (IAF), a think tank located in the United States. The IAF’s mission is to assist individuals and organisations more wisely to choose and create the futures they prefer. The IAF was commissioned by the National Chiropractic Mutual Insurance Company (NCMIC) to consider the nature of demand and supply, the state of the research evaluating chiropractic and to provide recommendations for the future of chiropractic in the United States to the year 2010. The ensuing reports offer four possible scenarios for the chiropractic profession in 2010. In DAC-S words, the IAF’s reports are optimistic if the chiropractic profession can adapt to the challenges of the era but sobering if it cannot.

There is little doubt that The Chiropractic Profession should be on every chiropractor’s shelf, in public and school libraries and utilised by anyone writing a political submission pertaining to chiropractic. Chapter 10 should be compulsory reading for all Australian chiropractors, educators and chiropractic students.

If there is a shortcoming to the book it would be that it is written with a largely North American focus, which is not entirely surprising considering the makeup of the profession. There are some minor factual errors within the book, which have been noted elsewhere (see Ebrall 2000) and I have noted some referencing errors. I agree with Dr Ebrall when he suggests that any future edition of The Chiropractic Profession would benefit by a stronger Australian content and a switch to the Harvard system of referencing. This writer believes that The Chiropractic Profession could serve as a wakeup call to the Australian profession in order that its future is ensured.

Ebrall P (2000) Book Report, Chiropractic Journal of Australia. 30(1):25-28

J Keith Simpson BA(Hons), DC, PhD (Candidate)