J. Zimmerman, D.C., a member of the World Chiropractic Alliance International Board of Governors (IBG), recently addressed the Chiropractic Association of Ireland (CAI), that nation's foremost national chiropractic organization.

Dr. Zimmerman was invited to speak on the types of chiropractic practices in the United States, the direction chiropractic care has taken in the U.S, and the possible path of chiropractic in Ireland. Throughout much of Europe, chiropractic is unregulated and not covered by health insurance policies.

The Irish government is in the process of legislating chiropractic practice. Yet, unlike many other nations, it is not becoming involved directly with writing policies, guidelines and definitions. Instead, it has asked the CAI to develop legislation and submit it to the government. In effect, chiropractors are writing chiropractic laws. Zimmerman was brought to Ireland to help unite the chiropractors in this important endeavor.

"There are two types of chiropractors in Ireland, musculo-skeletal based and strict wellness-based," he explained to the The Chiropractic Journal (TCJ) upon returning to the U.S. "As you can imagine, these two factions can very easily become at odds when defining chiropractic. The crux of my lecture was that in the United States there are three types of chiropractic practices: the musculo-skeletal-based, the subluxation-based and the strict wellness-based practices."

Zimmerman defined musculo-skeletal-based chiropractors as those practitioners who treat pain-based muscular conditions and symptoms. "They typically take care of back pain, neck pain, headaches, etc. Once the symptoms are gone, the patient is finished with chiropractic care until they are once again symptomatic," he said.

During his address to the Irish chiropractors, Zimmerman defended musculo-skeletal-based D.C.s as highly skilled, scientific and respected professionals. "They perform an admirable service and should be able to continue to practice as they choose," he stated. "After all, chiropractic is the safest and most natural care for the spine and the bottom line is that chiropractic can and does help back and neck related symptoms."

Next, Zimmerman defined the subluxation-based chiropractic model.

"I explained that subluxation-based chiropractors do not treat symptoms or conditions. The only goal of the subluxation-based chiropractor is to correct vertebral subluxations," he said. "While subluxation-based chiropractors do not treat symptoms or conditions, they can and will care for patients with symptoms or conditions."

He gave an example from his own subluxation-based practice.

"If a patient presents with back pain or a child with ear infections, my goal is not the treatment of the symptom, but the correction of the subluxation to allow the body to express improved function. I will perform spinal analysis and testing to determine if subluxations may be the cause of the patients condition. Subluxation-based chiropractors also recommend preventative or wellness check-ups to periodically correct subluxations in non-symptomatic patients."

Zimmerman went on to explain, "The strict wellness-based chiropractic practice does not treat symptoms or conditions, nor does it care for patients with symptoms or conditions. The wellness chiropractor's only goal is restoring bodily function, enhancing performance and improving quality of life. The wellness chiropractor achieves this goal by correcting vertebral subluxations, thus restoring and maintaining spinal integrity."

He added that wellness-based chiropractors recommend weekly to monthly wellness check-ups and generally call their patients clients or practice members, as the word "patients" denotes sick people.

If a client complained of a symptom or a condition, wellness-based chiropractors would explain that the treatment of conditions other than vertebral subluxations is not within their scope of practice and refer them to another chiropractor or a medical doctor, Zimmerman noted.

"My goal was to point out, not only the differences in the three types of practice, but the similarities," he told TCJ. "For instance, the pain-based chiropractors are only a step away from being subluxation-based chiropractors. If musculo-skeletal-based chiropractors take an extra 10 minutes with their patients and explain the role of the nervous system in chiropractic care – and then recommend preventative care – they are just a hair's breadth away from being subluxation based."

In addition, he noted it was his opinion that, "Subluxation-based chiropractors have a lot in common with strict wellness chiropractors. They both agree that regular chiropractic improves bodily function and expresses more life. To be a complete wellness-based chiropractor, subluxation-based chiropractors would have to stop addressing and caring for people with conditions other than vertebral subluxation, stop using treatment plans and start a cash practice."

Reflecting his belief that legislation should safeguard the rights of all three types of chiropractors to practice, Zimmerman said he wanted to stress that all three perform important services and are valuable to the profession. "I pointed out that subluxation-based language, such as the language the World Chiropractic Alliance utilizes in its policies and position papers, is the language that allows the intertwining of all three types of practice."

Dr. Lawrence Woods, CAI president and WCA IBG member praised Zimmerman's address.

"Dr. J. Zimmerman's talk was a pivotal point in the history of the CAI and in the future of chiropractic in Ireland," he noted. "(It) broadened the perspective on both sides of the fence here in Ireland. Even though we choose to not practice pain-based chiropractic, our wellness chiropractors understand that chiropractic is a valuable tool for helping people with physical ailments.

"The musculo-skeletal chiropractors now also understand our wellness point of view and how it fits in the big chiropractic picture," Dr. Woods continued. "After Dr. J's talk, quite a few musculo-skeletal-based doctors made comments that they would even like to observe a wellness practice in action. Thanks to Dr. Zimmerman, the next few crucial months, as we are defining our profession for our nation, should go smoothly."

Said Zimmerman, "The most important point I wanted to make with the chiropractors in Ireland, is that they control the destiny of their profession, they are pioneers. The laws they lay down now will define what and how they do things from here and after. The Irish chiropractors can literally have the practice of their dreams."

During his presentation, Zimmerman also promoted the concept of a cash practice.

"I dream of a chiropractic practice that is not encumbered by some third party profit monger, such as our health insurance companies. I dream of a practice where thousands of people go for health and wellness care that they value and pay out of their own pocket for the service," he remarked. "My dream practice can and does exist in Ireland and it also does for any Irish chiropractor who is strong in principle and fights for the rights of the entire profession."

In concluding his talk, Zimmerman stressed that Irish chiropractors, "by laying down the correct legislative definitions, policies and positions, will be responsible for setting the tone and changing the direction of chiropractic in all of Europe. And, maybe if we're lucky, it could trickle on back to the United States."