Dear Editor,

Chiropractic extinction “A students reflection”

“We recognise and respect a universal intelligence (or order) in all matter and an innate intelligence within a living organism that strives to preserve life and, if uninhibited, will express optimal well being” this was deliberated by Australia’s peak governing body the Australian Chiropractic Association. Chiropractic is the largest complementary and alternate medicine in the world that presents itself as an outcomes and empirical based scientific field. However, one may enquire as to what percentage of the population really know exactly what the profession is based on and what percentage of the population would want to seek a practitioner after he or she had learnt that the practitioners educational philosophy was based on a mystic ‘life force’ and not testable scientific evidence.

An appropriate way to start would be to pose a series questions such as these, would you be able to define what chiropractic is? what a chiropractors does? what the greatest threat to chiropractic is? what the future for chiropractic is? and what you as a student can do to ensure that there will a prosperous future for chiropractic? The simple fact is that we are the future of chiropractic and by this right we are in the best position to shape and reform it.

Although Australia is becoming increasingly open for alternative therapy for health issues, the country is also becoming increasingly health educated and more sceptical of unscientific practices. Therefore it is up to chiropractors to be wise about what information is being broadcast to the public and to integrate the profession into a united scientific front. We should be careful about ‘subluxation theory’ and have a more fluid concept of what chiropractic is, such as the biomechanical definition/model of chiropractic care. Chiropractic must stop promoting the metaphysical concept encapsulating the subluxation complex and innate flow.

The only conclusive scientific evidence found in favour of chiropractic, is for its treatment in alleviating Neuromuscularoskeletal conditions. This does not include innate flow, or subluxation and especially not visceral or systemic diseases. So why are we not promoting and educating what we do know (Neuromuscularoskeletal) and abandoning what we don’t know (innate healing)? Why after all this time why does the vast majority of the population still believe chiropractors only deal with the back or that chiropractors are quacks? If the Australian population wants evidence-based chiropractic medicine then why are we still engaging in metaphysical practices that cannot be scientifically measured or proven? Keating stated, “we must replace dogma with data, and we must let our most credible and systematic clinical observations guide theory and practice in chiropractic,” ask yourself is chiropractic doing this? And if so why do so few know that we are? To gain recognition and the respect of medicine and the public alike should we not be promoting this evidence? If it is indeed there as chiropractors state.

Believing that chiropractic works is not enough, nor is our own knowledge that chiropractic is effective, we must communicate this knowledge to the public. This can only be achieved effectively in a health science through empirical evidence and well-designed studies. With studies chiropractic can promote the effective and efficiency of treatment that most chiropractors know through there own clinical experience exists. Do not be confused however chiropractic should not conform to the medical model but it must reform, we must build stronger ties with medicine and the population achieved only through continual research and evidence. Chiropractic cannot afford to fall behind in research while medical research advances. Consider this question, how many patients do you expect will see a chiropractor when the population learns the very tenet of our profession is based on pseudoscientific philosophy and not measurable empirical evidence, and that the chiropractic body has not opted to abandon these antiscientific notions? Keating stated that the subluxation theory is an interesting notion without scientific or empirical validation. I plead with you to think about the implications of this statement, and what evidence or antiscience your professional career will be based on.

There are two major threats to chiropractic that are emerging, but how many of us know or even care about them? If chiropractors and chiropractic students do nothing about it, then who will? The first is the new doctor of physical therapy course being offered to physical therapy students. These practitioners basically follow the exact procedure of a chiropractic examination. The main difference being that they do not endorse the metaphysical, immeasurable subluxation and innate flow concept. While you may argue that they do not adjust, rather manipulate, the public and medicine have no idea about the difference. Perhaps it is because of our arrogance not to scientifically differentiate the two that this is the case. We must show medicine and the population through evidence and abandon what practices and theories are not supported by evidence. The second is the fact that chiropractic is not united. If the profession cannot collaborate and have a united view of what chiropractic is, do and treat, how can we expect medicine or the public to take chiropractic seriously.

One may note that not all aspects of chiropractic can be tested effectively through studies and trails, nor does chiropractic have large financial funds to conduct widespread research. But how long will chiropractic hide behind these so-called limitations? Chiropractic must strive to legitimise its practices. By not doing this and hence going against what the population seeks, chiropractic will have no future, and will indeed be overtaken by many of its competitors. Chiropractic needs to look behind its dogmatic narrow-minded theories and begin to gain recognition for its most basic of practices. Chiropractic must broaden its scope of practice and become ‘wellness doctors’ not ‘subluxation’ or ‘innate’ doctors. It will be only a matter of time before the population makes this simple and readily deducible conclusion. If the subluxation and mystical innate flow is indeed scientifically unfounded then its effect, diagnosis and treatment are also scientifically worthless. That is our professional careers are worthless.

Being a chiropractor will not, in the short term, be an easy road. However I do believe that we can educate ourselves enough to help further the profession and bring reform and promotion. If we students stand as a united front and lobby for what changes are needed, then the profession will have no option but to listen. We can start by opening a forum to voice your concerns about the profession, we can push for more research to be conducted to legitimise the profession, change terminology such as subluxation to other more scientifically measurable terms such as hypomobility or fixation and we can educated yourselves on the real issues facing chiropractic in the early 21st century so we can be ready to combat them as they arise. Education is our best weapon so I have supplied a link by the Institute for Alternative Futures that exemplifies the struggle that we are facing. This offers a further opportunity to explore important issues related to the Chiropractic profession.

* The future of chiropractic: a fight to survive www.altfutures.com/pubs/Future of Chiropractic Revisted v1.pdf

Jade High Chiropractic Student