January 1991

Wilk wins Supreme Court victory

Chiropractors across the country are rejoicing in the final victory in the Wilk vs. American Medical Association case.

On Nov. 26, 1990, the Supreme Court rejected the AMA's appeal in the Wilk vs. AMA case without comment. This marked the end of the long‑running antitrust case filed against the American Medical Association (AMA) by four chiropractors in 1976.

The Supreme Court's opinion upholds a U.S. Appeals Court decision that found the AMA guilty of trying to destroy the chiropractic profession.

For years, the AMA's ethics code prohibited medical doctors from referring patients to chiropractors or from cooperating with chiropractors in any way. The AMA also ran an unsuccessful legislative campaign to have chiropractic outlawed or denied Medicaid reimbursement.

In February, 1990, the Seventh Circuit Court upheld an earlier ruling by the U.S. District Court in Chicago, Ill., and ordered the AMA to revise its ethical rules to permit cooperation with chiropractors and to publicize the new rules.

However, the AMA appealed the decision to the country's highest court. The association said it had not violated antitrust laws.

"It's a great step in the right direction." Said Dr. Wilk from his Chicago office. "I didn't know what emotion I really felt because it was filed 14 years ago. Maybe disbelief, it really hasn't sunk in yet."

Wilk praised the efforts of attorney George McAndrews who represented the four chiropractors. "He (McAndrews) had such uncommon commitment. We all look great because of him."

But Wilk warned that the impact of the victory on the general public "is going to be very small unless chiropractors get together and get on radio, television and newspapers with their message."

Terry A. Rondberg, D.C., co‑executive director of the World Chiropractic Alliance, said, "Dr. Wilk and (George) McAndrews should both be congratulated for their tremendous win for chiropractic. The chiropractic profession owes a great deal to both men for their courage and commitment. We have all won."

Other national leaders also expressed their exuberance after the Supreme Court's decision.

"Wilk, et al, must be congratulated for their overwhelming victory and commended for their persistence and commitment to this vital cause," said ICA president Fred H. Barge. "The Supreme Court's decision is a significant victory for the profession."

The lawsuit, filed in 1977 by chiropractors Chester A. Wilk, James W. Bryden, Patricia B. Arthur and Michael D. Pedigo, all from different states, did not seek monetary damages, but challenged the refusal of medical doctors to acknowledge chiropractors as health care professionals.

The ICA's general counsel James D. Harrison called the Supreme Court decision "a great relief. After all these years, justice has triumphed. The dirty tactics of the AMA are now a matter of public record."

"The medical doctors who relied upon the AMA to represent them in an ethical and honorable manner should take notice and do whatever is necessary to insure that such conduct never be repeated."

But leaders of the American Chiropractic Association (ACA) warned chiropractors that the fight for acceptance in the health care community continues.

"The ACA is extremely pleased that this 14‑year legal battle has ended in chiropractic's favor," said ACA Executive Vice President J. Ray Morgan.

"However, the chiropractic community must be aware that it has won simply that, a legal battle. The real fight lies ahead in that the chiropractic profession must work together with the medical community for the betterment of the nation's health care."

McAndrews, who represented the four chiropractors in the lawsuit, said this was the third time the AMA has lost in the Supreme Court.

"Time is running out on the AMA's ability to bully other health care providers in the increasingly competitive health care market. The studies, from reputable medical and governmental sources, have been increasingly pointing to the fact that members of the AMA have been deprived of access to more effective health care procedures by a boycott that denied them and their patients access to the documented skills of doctors of chiropractic."

"The AMA has been tripped up by the very scientific studies that it demanded and which now have been used in court to confirm the finding of guilty in the antitrust case. It is certainly hoped that medical and chiropractic physicians, recognizing the scientific proof of the efficacy of chiropractic care, will now cooperate for the benefit of patients everywhere," said McAndrews.

Leaders of state associations have been meeting with their members to discuss ways to remove the illegal obstacles to better cooperation between the chiropractic and medical community.

For instance, Kirk Steketee of Holland, Mich., president of the Michigan Chiropractic Society, said his plans included cross‑referral of patients between chiropractors and medical doctors, prompt addition of chiropractors to hospital staffs and public funding for chiropractic education in Michigan.

Dr. Steketee also asked Michigan Attorney General Frank Kelley to monitor the compliance of the health insurers and the medical community to make freedom of choice in health care a reality for Michigan citizens.

In a brief statement issued Nov. 26, AMA general counsel Kirk B. Johnson said the AMA is, "disappointed, but not surprised by the court's decision" and claimed the "high court only agrees to hear about one percent of the cases requesting a writ.

"We still believe that the lower courts erred in their decision. However, their decision did not call for the AMA to change any policies. The lower court found that AMA's policy for the past 10 years regarding professional interaction between physicians and chiropractors was lawful. The court's decision did not endorse chiropractic. No damages were awarded. Therefore, the decision will have little or no impact on patients and their physicians," said Johnson.

The case now must go back for implementation of the trial court's injunction order and for a determination of the claim of the chiropractors for more than $14 million in legal fees and costs associated with the suit.

In 1987, U.S. District Judge Susan Getzendanner found the AMA guilty of violating the antitrust laws and ordered the AMA to make public her injunction order to all 289,000 AMA members; to print and permanently index her order in the Journal of the American Medical Association; to amend all rules of the association to allow its members to fully cooperate with chiropractic physicians; and to pay reasonable attorneys' fees and costs to the plaintiff chiropractors.

Further proceedings in the case will take place before U.S. District Judge John A. Nordberg in Chicago, Ill.