After an 11-year court battle, five chiropractors have won what is being called the "Victory of the Century" for chiropractic.

On August 27, U.S. District Court Judge Susan Getzendanner found the American Medical Association (AMA) and its co-defendants guilty of having conspired to destroy the profession of chiropractic in the United States. She labeled their actions "lawless" and will issue Orders of Injunction to prevent further harassment of the profession.

The chiropractors who initiated the suit (known as the "Chicago Five") were Drs. Chester Wilk, Michael Pedigo, Patricia Arthur, Steven Lumsden, and James Bryden. The case has been widely referred to as "the Wilk case."

The 101-page opinion ruled that the AMA, along with the American College of Surgeons and the American College of Radiology, had violated the Sherman Antitrust laws by using an ethics ban on interprofessional cooperation to organize a national boycott of doctors of chiropractic by medical physicians and hospitals.

The American Academy of Orthopedic Surgeons (AAOS) was also found guilty by virtue of having "knowingly joined the conspiracy but to have ceased its participation in 1986 with no likelihood that AAOS would renew any boycott or conspiracy against chiropractors."

There was insufficient evidence, the ruling stated, to tie the other defendants in the case -- the Joint Commission on Accreditation of Hospitals and the American College of Physicians -- to the antitrust conspiracy.

The American Hospital Association, the Illinois State Medical Society, the American Academy of Physical Medicine and Rehabilitation, and the American Osteopathic Association settled with the chiropractors prior to the judge's decision.

Trial evidence showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive misinformation campaign to discredit and de-stabilize the chiropractic profession, and engaged in numerous other activities to maintain a medical physician monopoly over health care in this country.

According to Judge Getzendanner's ruling, "There are lingering effects of the conspiracy; the AMA has never acknowledged the lawlessness of its past conduct and in fact to this day maintains it has always been in compliance with the antitrust laws; there has never been an affirmative statement by the AMA that it is ethical to associate with chiropractors; there has never been a public statement to AMA members of the admissions made in this court about the improved nature of chiropractic despite the fact that the AMA today claims that it made changes in its policy in recognition of the change and improvement in chiropractic; there has never been public retraction of articles such as 'The Right and Duty of Hospitals to Deny Chiropractic Access to Hospitals; a medical physician has to very carefully read the current AMA Judicial Council Opinions to realize that there has been a change in the treatment of chiropractors and the court cannot assume that members of the AMA pour over these opinions; and finally, the systematic, long-term wrongdoing and the long-term intent to destroy a licensed profession suggests that an injunction is appropriate in this case. When all of these factors are considered in the context of this 'private attorney general' antitrust suit, a proper exercise of the court's discretion permits, and in my judgment requires, an injunction."

Getzendanner ruled that the actions of the AMA and its co-conspirators over the last 25 years had caused serious damage to the competitive process in health care, to the profession of chiropractic as a whole, and to individual doctors of chiropractic and the patients they serve.

The judge indicated that she is working on the Orders of Injunction, and will issue them in an effort to prevent further illegal actions by the AMA and the other named groups, and to correct some of the adverse effects of the antitrust violations.

The testimony presented during the lengthy court case went beyond proving the guilt of the AMA. It addressed the key question of the validity of chiropractic.

Among the most persuasive arguments was testimony given by Per Freitag, M.D., Ph.D., professor of orthopedics. In court, he offered convincing evidence of chiropractic's effectiveness as shown by a research study he had conducted.

The study monitored the length of average orthopedic in-patient stays at John F. Kennedy Hospital in Chicago, which incorporates chiropractors into their patient care program, and Lutheran General Hospital, which does not utilize chiropractic. According to the research study, the average length of hospitalization for patients at JFK Hospital was five-to-seven days compared to 14 days at Lutheran General. Dr. Freitag testified that the only difference in care was the inclusion of chiropractic.

Also offered into testimony during the case was evidence that the maternity ward of JFK Hospital was demonstrating significant success with the use of chiropractic care in place of intradermal steroids.

According to the study, the use of epidural steroids to relieve pain was markedly reduced where the expectant mother received chiropractic care in the pre-natal period and in the labor and delivery rooms.

In addressing the question of the relative merit of chiropractic training as opposed to medical training, Freitag told the judge that, in his opinion, the anatomy and dissection labs at National College of Chiropractic were superior to those at the University of Illinois Medical School, and that chiropractors have a better understanding of musculoskeletal ailments than do medical doctors.

On that same topic, Dr. John McMillan Mennel, professor at five medical schools and noted author, testified that Palmer Chiropractic College and Life Chiropractic College were equal in academic excellence to the best medical schools in the nation he had examined. He also noted that a new medical resident in a hospital normally has no more than four hours training on the musculoskeletal system and may actually have no training at all in some cases.

In view of the overwhelming evidence validating the efficacy of chiropractic, Judge Getzendanner found absolutely no grounds for the AMA's long-standing claims that the field was "quackery."

Kenneth L. Luedtke, D.C., president of the American Chiropractic Association (ACA), extended his organization's congratulations to "the Wilk plaintiffs and their very capable counsel."

He said, "The verdict of the District Court is a ringing affirmation of the courage and tenacity of the chiropractic profession in overcoming the obstacles that have been placed in its pathway by the American Medical Association and other medical trade organizations. Chiropractic looks forward to a future of service to its patients based on the mutual professional cooperation and respect of all segments of the health care delivery system."

Michael Pedigo, D.C., president of the International Chiropractors Association (ICA) echoed those sentiments.

"The profession of chiropractic had its beginning only 92 years ago in the United States. It developed rapidly following World War II and the Korean War, spurred by its expertise and successes in efficiently relieving pain, referred pain, headaches, joint dysfunctions, and other neuro-spinal problems at low cost and without drugs -- problems that were not being adequately addressed nor studied by the medical profession.

"The all-out assault on chiropractic waged by the AMA and its co-conspirators," he continued, "was actually an undeclared war on the sick people who dared to challenge the arrogance and ignorance of the medical community by seeking help from doctors of chiropractic. The AMA's actions have tarnished the image of medical physicians everywhere.

"As we have in the past," Dr. Pedigo concluded, "we renew our request that medical physicians and chiropractic physicians join their respective areas of expertise for the good of their primary constituency: the people of the United States who experience poor health, those who find themselves confined to hospitals, or those who generally wise to maintain themselves in an optimum state of health."

Dr. Wilk, whose name has become synonymous with the struggle against the AMA, expressed his own excitement at the decision, noting, however, that several statements issued by the AMA after the decision continued to contain misleading statements.

"They don't have to love us," he said in an interview with The Chiropractic Journal, "but they'll have to respect us and respect the law. There are laws in this land that say they can't do certain things, and they're not above the law. You can't just take the spots off the leopard and expect it to be tame. They'll still be dangerous, but at least they're not going to be so open because their lawyers are going to tell them 'shut up or you'll go to jail.'"

The Chicago-based D.C. foresees that the decision will help to eliminate some of the ignorance about chiropractic prevalent within the medical profession.

"You can't blame the average M.D. in the street (for the AMA actions)," he commented, adding that the AMA is a "reactionary group" that "doesn't speak for the whole medical profession."

Wilk also urged chiropractors and chiropractic organizations not to lose the momentum created by the judgment.

"It's a hot topic right now," he stated. "The newspapers and magazines are interested at the moment. But in three months, it'll be old news, no one will give a hang about it."

He suggested a united public relations effort by the chiropractic community nationwide to saturate the media with information on the trial, and the evidence made public during it. "Now is the time to form speakers' bureaus and get on the talk shows, go to the papers, get out in front of the public," he stressed.